Entry · PC-78Preventive CareAnnual Health Check-ups for Employees Over 40: What India’s OSH Code Actually Requires (2026 Guide)
Is a free annual health check-up mandatory for employees over 40 in India? What the OSH Code and 2026 Rules say, who is covered, and how to comply.
Quick answer: Since 21 November 2025, Section 6(1)(c) of the Occupational Safety, Health and Working Conditions Code, 2020 (OSH Code) has required employers to provide a free annual health examination to the employees, age groups or classes of establishments that the appropriate Government prescribes (Section 6, OSH Code). The OSH (Central) Rules, 2026, notified on 8 May 2026, make this concrete for dock work and building or other construction work, for every employee who has completed 40 years of age (SCC Online; TaxClue on Rule 5). For other establishments, it depends on the rules your state has notified. Wherever it applies, the employer pays, and the employee cannot be charged.
Key takeaways
- The duty is in the Code: Section 6(1)(c) requires a free annual health examination for prescribed employees. Section 6(1)(g) bars charging employees for safety and health measures, including medical examinations.
- The Central Rules are narrower than many blogs claim: Rule 5 names dock work and construction work, for employees aged 40+, recorded in Form-VIII.
- State rules decide much of the rest: Most factories, shops and offices fall under their state government, so check your state’s notified OSH rules.
- The state is building capacity too: ESIC launched a national free annual check-up programme for workers over 40 in May 2026.
- Good practice goes beyond the minimum: Employers with a 40+ workforce are moving to annual check-ups whatever their sector, for health, retention and audit-readiness.
What does the OSH Code say about annual health check-ups?
The OSH Code consolidates 13 central labour laws, including the Factories Act, 1948. It came into force with India’s other three labour codes on 21 November 2025. Two clauses in Section 6 (Duties of employer) matter here:
- Section 6(1)(c): the employer must provide an annual health examination or test, free of cost, to such employees, of such age or class, or in such class of establishments, as the appropriate Government prescribes (Indian Kanoon).
- Section 6(1)(g): no charge may be levied on any employee for anything provided for safety and health at the workplace, including medical examinations (TaxClue).
The Code itself creates the duty. Rules decide who is covered and how. That distinction is where most confusion comes from.
What do the OSH (Central) Rules, 2026 require?
The Ministry of Labour and Employment notified the OSH (Central) Rules, 2026 on 8 May 2026 (SCC Online). Under Rule 5:
| Question | What Rule 5 says |
|---|---|
| Who must provide it? | Employers of dock work and building or other construction work |
| Which employees? | Every employee who has completed 40 years of age |
| How often? | Annually |
| Who pays? | The employer. The examination is free of charge to the employee |
| Who conducts it? | A qualified medical practitioner (or through ESIC, where applicable) |
| Record | A health examination certificate in Form-VIII |
| Where do these rules apply? | Establishments where the Central Government is the appropriate Government |
The common misconception: Several widely shared HR guides say the law requires a free annual check-up for every employee over 40 in every establishment. The Code allows that to be prescribed, but the notified Central Rules confine it to dock and construction work (TaxClue). Check your state’s OSH rules for factories, shops and other establishments, and take legal advice for your situation.
What has the government done to support it?
On 7 May 2026, a nationwide free annual health check-up programme for workers aged over 40 was launched at the ESIC Medical College and Hospital in Bihta, Bihar (Patna Press; UNI). Officials also pointed to paid leave for workers undergoing annual medical examinations. Policy commentary has since argued for bringing check-ups to the workplace, including mobile occupational health units, because a check-up that costs a day’s wages often goes unused.
Why every employer with a 40+ workforce should act now
Even if your sector is not yet named in your applicable rules, there are strong reasons to put annual check-ups in place:
- Rules are still being notified and revised. Being ready early costs less than catching up later.
- Risk rises after 40. National data shows a very large undetected burden of diabetes and hypertension in Indian adults (see our World Diabetes Day 2026 analysis).
- Contractor and supplier audits increasingly ask for evidence of worker health checks.
- Retention and productivity: Early detection prevents long absences and avoidable claims on group health insurance.
How to deliver annual health check-ups: 5 models compared
| Delivery model | How it works | Employee uptake | Disruption to work | Digital records and audit trail | Best for |
|---|---|---|---|---|---|
| Lab or hospital vouchers | Employees book a test at a partner lab | Often low: needs time off and travel | High (time away) | Varies by lab | Small, office-based teams in cities |
| One-day health camp | A vendor sets up on site for a day | Moderate, but misses absentees and shift workers | Medium | Often paper-based | One-off drives |
| Permanent on-site health kiosk or health lounge | Screening is available on site year-round, with teleconsultation | High: walk-in, a few minutes | Low | Digital and retained for audits; can be ABHA-linked | Factories, campuses, large offices |
| Scheduled Mobile Medical Unit | A fully equipped vehicle visits sites on a schedule | High at remote or multiple sites | Low | Digital | Construction, mining, plantations, distributed sites |
| ESIC route | Covered employees use the ESIC programme | Depends on the facility’s distance and capacity | Medium-high | Held by ESIC | ESIC-covered workforces near facilities |
Uptake and disruption ratings are qualitative comparisons, not measured figures.
Our view: For most mid-size and large employers, a hybrid model works best. Use an on-site kiosk or lounge at main locations for repeat screening, a mobile medical unit for project sites, and a lab referral pathway for confirmatory tests. Compliance is the floor. Utilisation is the goal.
Compliance checklist: 40+ annual health check-ups
- Confirm which rules apply to you. Is your establishment under the Central or a State Government? Have the relevant rules been notified for your sector?
- List eligible employees. Include contract and fixed-term workers aged 40+ wherever your rules cover them.
- Define the test panel with a qualified medical practitioner, adding tests for hazardous processes where relevant.
- Choose a delivery model (see the table above) that reaches shift workers and remote sites.
- Make it free: no deductions and no reimbursement claims that leave employees out of pocket.
- Issue and keep certificates in the prescribed form (Form-VIII under the Central Rules) for every examined employee.
- Set up follow-up for abnormal results through teleconsultation, referral, and re-screening reminders.
- Protect health data: consent, access controls, and no sharing of individual results with managers.
- Report and review utilisation each year, and fix gaps such as missed shifts and sites.
How Clinics On Cloud helps employers comply — and go further
Clinics On Cloud builds on-site preventive healthcare infrastructure for workplaces. Health ATMs, Health Lounges and Health Pods sit on your premises. Mobile Medical Units visit plants, construction sites and distributed teams. Both offer point-of-care screening, teleconsultation, and digital reports you can keep for audits.
Planning your 40+ health check-up programme? Talk to our corporate wellness team and download the compliance checklist.
Sources
- Section 6, Occupational Safety, Health and Working Conditions Code, 2020 — Indian Kanoon
- SCC Online — OSH (Central) Rules, 2026: Key Highlights & Compliance Guide (13 May 2026)
- TaxClue — Rule 5, OSH Central Rules 2026: Annual health examination of employees
- TaxClue — Section 6 OSH Code 2020: Duties of employer
- Patna Press — Free annual health screening for workers above 40 launched at ESIC Bihta (7 May 2026)
- UNI — Free annual health check-up for workers above 40 launched at Bihta ESIC hospital
- Mondaq — OSH Code: One Unified Health and Safety Framework (Feb 2026)
