As part of one of the complaints received, the Ombudsman examined the estimated costs of the work of the Special Medical Commission of the Clinical Institute of Occupational, Traffic and Sports Medicine (KIMDPŠ), which decides on requests for an evaluation of the assessment of compliance with special health requirements for a specific job in the working environment after a preventive health examination. The complainant informed the Ombudsman about a letter from the commission, in which he had been asked to report within five working days at the latest whether he was willing to bear the costs of the entire hearing (presumably around EUR 1,300), because the costs of the assessment by the three-member commission, in accordance with Paragraph 7 of Article 17 of the Rules on Preventive Health Examinations of Workers, are borne by the complainant himself. The commission also wrote that if it did not receive a response from the complainant within five days, it would close the case.

Based on the complainant's statements, the Ombudsman first turned to the commission and asked it to comment on the complainant's allegations, to provide a breakdown of the anticipated costs of the commission's work, and to make available any rules, cost schedules, or other documents governing the commission's work.

From a comparative perspective, the Ombudsman also contacted the Health Insurance Institute (ZZZS) and the Pension and Disability Insurance Institute (ZPIZ) with a request for information regarding the estimated work costs of the committees of the aforementioned bodies (the ZZZS Medical Commission, the first-level disability committee and the second-level disability committee). The Ombudsman was particularly interested in how prices are determined and how the costs of the work of these committees are assessed, what the costs for the work of the aforementioned committees of the addressed bodies include, etc.

Based on the responses received, the Ombudsman found that the amount of the processing costs that an employee must bear if he or she wants an assessment of the assessment of compliance with specific health requirements for a specific job in a working environment by a commission is disproportionate compared to the estimated costs of the work of the commission of the ZPIZ, ZZZS bodies and the approximate costs of the procedure for a repeat medical examination before the commission for drivers after a medical examination,[1] and, in the Ombudsman's opinion, does not provide all employees with equal opportunities to exercise the right to request an evaluation of the assessment of compliance with specific health requirements for a specific job in a working environment after a preventive medical examination.

The Ombudsman informed the MZ of its findings[2] and asked for its response. The Ministry of Health informed the Ombudsman that, within the scope of its competence, it would examine the methodology for determining costs, based on the information provided by both the KIMDPŠ and the ZZZS and ZPIZ, and additionally verify all items and arguments included in the cost of each inspection. The MZ also explained that it had appointed an interdepartmental working group to prepare and update the Rules over a year and a half ago. The draft of the new Rules has been prepared, but has not yet been fully coordinated with the Ministry of Labour, Family and Social Affairs.

The MZ informed the Ombudsman that it had asked the KIMDPŠ to explain the methodology for calculating the commission's work costs. Based on the explanations received and other relevant facts, the MZ established that the amount of costs is influenced by objective reasons. The calculation methodology is uniform for the entirety of UKC Ljubljana (the Clinical Institute of Occupational, Transport and Sports Medicine is an integral part of UKC Ljubljana). The methodology is developed and maintained by the Department of Economic and Financial Activities of UKC Ljubljana. The MZ further explained that, based on the explanations received from the KIMDPŠ, it will strive to regulate the commission's work in a way that ensures appropriate legal security for all stakeholders in the procedure and follows the principle of fairness, which the Ombudsman welcomes. Regarding the draft of the new Rules, the MZ also explained that they are not yet final precisely for the reasons listed above, as the procedure must be carefully regulated, namely in such a way that the worker is provided with treatment that will not excessively interfere with his or her economic situation, while at the same time being legally sustainable.

Although the Ombudsman is not involved in the process of adopting the new Rules, the institution will continue to monitor the activities of the MZ regarding the adoption of the new Rules. 9.4-68/2023

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[1] The Ombudsman has already separately addressed an inquiry to the Ministry of Health (MH) regarding the procedure for issuing medical certificates for drivers after a medical examination and the procedure for a re-medical examination before a commission. In this regard, the Ombudsman received a response from the MH, in which the MH explained that "in accordance with point 5 of the first paragraph of Article 15 of the ZVoz-1, the minister responsible for health appoints a special medical commission (hereinafter: the commission) that performs medical examinations upon the objection of a candidate for driver and a motor vehicle driver who disagrees with the medical certificate of physical and mental fitness to drive motor vehicles, as well as early re-medical examinations. The commission is headquartered at the University Medical Centre Ljubljana, Clinical Institute of Occupational, Traffic and Sports Medicine (hereinafter: KIMDPŠ). The Ministry further explains, regarding the costs of the examination, that according to data obtained from the KIMDPŠ, the price (or costs) of a medical examination before the commission is EUR 277.01. This price includes:

-invitation to a medical examination,

- review of medical documentation,

- medical examination of the candidate by a specialist doctor of the MDPŠ, who also conducts and presents the case

- consultative medical examinations by two specialists of the MDPŠ on the commission,

- medical certificate." The Ministry of Health added that any other necessary examinations or expert opinions of specialists are defined separately. The costs are paid when the medical examination is carried out.

[2] The Commission is a body of the MZ, and the seat of the Commission is at the KIMDPŠ UKCL, which means that UKCL provides administrative and technical support. The Commission's work costs are not regulated by the Rules, but they have concluded business contracts with the members of the PZK. The Commission operates according to the Rules of Procedure on the work of the special medical commission, which was approved by the MZ.