Who is a Second Opinion for?

An independent review of your company doctor’s recommendation: for a clear perspective on your return to work.

An employee on sick leave is entitled to a second opinion from another occupational physician. (The employer is entitled to additional medical expertise, a “second opinion” from an occupational physician)

For the employee

If an employee reports to the employer that they are unable to work, the employer may have the employee summoned to see the occupational physician. These days, a consultation with the occupational physician and an assessment of the incapacity for work often take place over the phone. The occupational physician then assesses the degree of incapacity for work and, consequently, the employer’s obligation to continue paying wages. The occupational physician also provides reintegration advice.
It sometimes happens that the employee disagrees with this advice given to the employer. For example, a return-to-work plan that the employee believes will not allow for a successful gradual return to work. In the employee’s opinion, the company doctor did not conduct sufficient research to arrive at the advice. No information was requested from the treating physicians. The employee feels that the doctor did not listen carefully.

The employee disagrees with the company doctor’s recommendation. What now?

Since the introduction of the “new Occupational Health and Safety Act” on July 1, 2017, every employee has the right to a second opinion from an independent company doctor—that is, a company doctor who is not affiliated with the organization or its own occupational health and safety service.

Furthermore, no one other than a company or insurance physician may assess medical capabilities, work capacity, and fitness for work.
This cannot be done by a case manager, a case manager with delegated authority, or a person calling themselves a reintegration specialist. Nor may the manager themselves, lawyers, or even general practitioners, on legal grounds, assess anything related to the personal aspect of the degree of work disability. In the telephone assessments that have become common due to COVID-19, the advice is to ensure that you are assessed by a registered occupational or insurance physician.
And employers, if you pay for an expensive occupational physician, ensure that your employees are supervised by a registered occupational physician. (An occupational health physician is a recently graduated general practitioner, not a medical specialist, and not an occupational or insurance physician. A delegated case manager is someone with knowledge of the procedures, who would then be supervised in writing by an occupational physician. This can never constitute substantive medical specialist guidance. After all, that requires a full-time education of about 12 years following high school.)

Can an employee choose their own occupational physician for the second opinion?

In principle, the contract between the employer and the occupational health and safety service or company physician specifies which other company physicians or occupational health and safety services may provide the second opinion. The two industry associations and the scientific association of company physicians, NVAB, have established a special registry from which the employee can choose: National Pool of Company Physicians for Second Opinions (LPBSO), https://www.bedrijfsartsensecondopinion.nl. Mr. Berkhout, a registered occupational physician and forensic expert, is registered with the National Pool.