Frequently asked questions about Order 45

Yes. The proposed Health Assessment will replace all existing Order 43 medicals (pre-placement and periodic medicals).

Pre-placement medicals are no longer referred to in the replacement Order.

An employer will need to ensure that a coal mine worker has, or has had, a health assessment prior to commencing work. The health assessment must:

• have been completed in the previous three (3) years
• have been assessed against the position and risk category, or a risk category higher than required
• be completed by an approved medical practitioner
• and any required health assessment review(s) have been completed.

If an employer requires a pre-placement medical prior to employment, this will sit outside the proposed replacement Order requirements.

The proposed Health Assessment will replace all existing Order 43 medicals. However, any site- specific requirements and medicals remain at the discretion of the site. Any questions about medical and site access requirements should be discussed directly with the site.

The site access medical is not a requirement of the current Order 43 or the proposed replacement Order.

No, the transitional arrangements apply to Order 43 medicals only where the coal mine worker remains with their current employer following the implementation of the replacement Order. The Site Access medical is not a requirement of the current Order 43 nor the replacement Order.

A deferred health examination occurs when one or more parts of the health assessment are postponed because the approved medical practitioner determines they may be harmful to the coal mine worker’s health at the time. However, the deferred examination(s) must be completed within twelve (12) months of the original health assessment date.

In the proposed Order, the employer is not required to transfer a health assessment. However, the employer must ensure they are satisfied that the health assessment complies with the requirements of the replacement Order.

Yes, if the medical meets the criteria for the transitional arrangements detailed in the replacement Order. The transitional arrangements apply only to coal mine workers who remain with their current employer following implementation of the replacement Order. Coal mine workers who commence with a new employer will be required to undergo a new health assessment.

Under the replacement Order, there is no requirement to register the medical in a new company name. However, there will be a process to notify Coal Services of any change in employment. More information will be released on this at a later date.

Each business will need to review its processes to accommodate this change.

Moving to one health assessment will simplify the process of tracking when coal mine workers are due for their health assessments. CS Health will still provide employers with their updated coal mine worker list annually.

Many employers have their own robust respirator fit testing (RFT) programs onsite, resulting in coal mine workers being tested unnecessarily during an Order 43 health assessment.

During discussions about potential changes to Order 43, stakeholders expressed concerns that removing RFT from the Order altogether could result in some coal mine workers being missed which might lead to inconsistencies across the NSW coal industry.

To address these concerns, it was proposed to make RFT optional and include it in the health assessment only when requested by the employer, reducing this risk.

If a coal mine worker remains employed with their current employer, then they are due for a health assessment at the same interval as when the Order 43 periodic medical would fall due to be completed.

For any coal mine workers who commenced work in the NSW coal mining industry for the first time in the last three (3) years and remain with their current employer, the date of the first pre-placement medical (if there was more than one) sets the interval for when the health assessment is due in the proposed Order.

This means that any coal mine workers who are changing employers once the replacement Order comes into effect will require a health assessment under this Order. This health assessment will then reset the interval of ongoing surveillance.

No, if the position is different then the coal mine worker will require a new health assessment.

Note: For clarity, the terms position and role are considered equivalent. While titles of positions or roles may differ, the inherent requirements (tasks, functions, accountabilities, and responsibilities) must be consistent.

Yes. The network of Approved Medical Providers will remain available to perform health assessments under the proposed replacement Order.

Coal Services Health will be supporting the industry to adapt the replacement Order through:

• information sessions
• fact sheets
• website information
• supporting documents, including a change readiness tool kit
• opportunities to meet with your Industry Health Partner to discuss the Order in relation to your business.

During the stakeholder consultation on the proposed changes to Order 43, concerns were raised about the challenges and implications of health assessment reviews, which aren’t currently addressed in Order 43. There was concern that these reviews should balance coal mine worker wellbeing with industry standards and requirements. Stakeholders agreed that including health assessment reviews to the proposed replacement Order would clarify the roles and responsibilities of coal mine workers, employers, and approved medical practitioners.

It is the responsibility of both the employer and coal mine worker to ensure health assessment reviews are completed within the timeframe given.

Coal Services recommends planning for the health assessment review as soon as you are aware of it, including scheduling necessary appointments in advance. Delayed planning is not considered a valid reason for failing to complete the health assessment review.

A health assessment review is a conditional clearance for the review period detailed on the health assessment certificate. If the health assessment review is not completed by the coal mine worker within the timeframe, the coal mine worker will not be compliant with the Order as the health assessment certificate will have expired. This approach is the same approach that the Rail medical standard has adopted.

Coal Services does not offer “extension” certificates if the health assessment review is not completed in the required timeframe.

A health assessment review is a conditional clearance for the review period detailed in the health assessment certificate. If the health assessment review is not completed within the timeframe, the health assessment certificate is considered expired. An employer must ensure that the health assessment review is completed as part of the onboarding process.

The replacement Order proposes that whenever a coal mine worker is attending a health assessment review for airborne contaminants, hazardous chemicals, or occupational noise exposure investigations, the employer must pay for the coal mine worker’s time to attend, unless they attend in work hours.

If the coal mine worker has a health assessment review for a non-occupational condition, then the coal mine worker needs to attend in their own time and is not entitled to payment.

Under the proposed Order, an employer must pay a coal mine worker for their time to attend any health assessment reviews whenever it is related to airborne contaminants, hazardous chemicals and/or occupational noise investigations. A referral to a respiratory physician would fall under this category.

If the coal mine worker is currently working in the NSW coal mining industry and is referred by Coal Services to a respiratory physician, then the cost of the consultation fees and some testing will be covered by Coal Services.

The information in Schedule 2 of the replacement Order outlines the specific information that can be shared with the employer following the completion of a health assessment, including the health assessment certificate and supplementary reports.

The health assessment certificate will be very similar to the current periodic certificate; however, it will include ‘traffic light’ determinations. The information disclosed on the certificate will be limited to the information detailed in Schedule 2 of the replacement Order.

The replacement Order (Schedule 2) clearly defines what information can be included in a health assessment certificate and supplementary reports. Any information not listed in Schedule 2 requires the coal mine worker’s consent before it can be disclosed to any party.

The change in the Order should not change the timeframes for certificates. The health assessment certificate should be released to the employer within 21 days of the assessment.

Employers should contact the approved medical practitioner to clarify any questions or concerns they may have regarding any health assessment results. If an employer’s concerns are not resolved, they should contact Coal Services Health or discuss with one of the Industry Health Partners.

Under the replacement Order, the employer must give the worker a copy of the approved health assessment certificate within four (4) weeks of receiving it.

Yes. Coal mine workers can continue to request a copy of their health records held by Coal Services. To access this information, they must complete a request to release form, available on the Coal Services website.

There are 3 risk categories, as follows:

• Category A: Safety critical – A coal mine worker or prospective coal mine worker whose immediate action or inaction from an unavoidable and/or sudden medical incapacity may lead directly to a serious incident affecting others in the workplace.
• Category B: Safety sensitive – A coal mine worker or prospective coal mine worker whose immediate action or inaction from an unavoidable and/or sudden medical incapacity may lead directly to a serious incident affecting themselves and is not likely to affect others in the workplace.
• Category C: Non-safety sensitive – A coal mine worker or prospective coal mine worker whose immediate action or inaction from an unavoidable and/or sudden medical incapacity will not lead to a serious incident affecting others in the workplace and their work environment will not contribute adversely to the outcome.

Risk categories were introduced to assist approved medical practitioners in selecting the most appropriate medical investigations when assessing a coal mine worker’s fitness for work, particularly when a medical condition has been identified.

This approach helps reduce unnecessary follow-ups and testing, while supporting health assessments in line with relevant NSW Coal Industry Health Standards.

Employers are responsible for assessing coal mine worker positions and determining their corresponding risk category. This assessment is based on the nature of the tasks performed and the potential consequences to themselves and others if the coal mine worker has an unavoidable and/or sudden medical incapacity. As part of this process, employers may also consult with coal mine workers to help further support and inform the risk assessment.

NSW coal industry contractors should work closely with host site employers to ensure their risk categorisation aligns with the site requirements.

It is a requirement of the replacement Order that an employer provides this information. It is important to clarify the risk category before proceeding with a health assessment.

Yes, provided the position is the same and the proposed risk category is the same or lower than the risk category noted on the health assessment certificate. For example, where a health assessment certificate shows the coal mine worker as working in a Category A: Safety critical position and the prospective position is a Category B: Safety sensitive, then the health assessment can be used.

However, if the proposed risk category is higher than that shown on the health assessment certificate, then a new health assessment is required. For example, where the risk category is for a Category B: Safety sensitive position and the prospective position is Category A: Safety Critical, then the coal mine worker will require a new health assessment.

No, their direct employer is responsible for including them in their coal mine worker list.

The date was adjusted to support employers by providing ample time to plan for their health assessment requirements in the forthcoming year.

Coal Services cannot determine this; it is the responsibility of the employer to understand their workplace exposure hazards and determine areas where someone may not be exposed to airborne contaminants, hazardous chemicals, and occupational noise.

The Coal Services Clinical and Service Standard (Clinical and Service Standard) sets out the requirements for delivering health assessments and is supported by the approved medical practitioner accreditation system, which evaluates approved medical practitioners and approved health professionals against these requirements.

The Clinical and Service Standard is designed for approved medical practitioners and approved health professionals; however, it may be referenced by other Industry stakeholders.

The Clinical and Service Standard informs health assessments by referencing regulations, guidelines, and best practice standards. It supports approved medical practitioners and approved health professionals to comply with the necessary accreditation, approvals, certification, and quality assurance processes to deliver high-quality health assessments.

The Clinical and Service Standard clearly defines the roles and responsibilities of approved medical practitioners and approved health professionals in fulfilling the health assessment requirements.

The Clinical and Service Standard details Coal Service’s management of non-compliance by approved medical practitioners or approved health professionals with the Order clauses or the Standard’s requirements.

Coal Services has identified this as an IT improvement requirement and are currently reviewing options. However, this enhancement will not be available when the replacement Order comes into effect.

Coal Services will provide approved medical practitioners mandatory educations sessions regarding changes to the Order to ensure all approved medical practitioners are aware of their obligations and responsibilities. However, if you are currently an approved medical practitioner under Order 43, your approval will be recognised for the replacement Order.

The list of approved audiometry courses and all other approved courses is published on the Coal Services website. This is updated from time to time and should always be referenced when planning training and development.

The list of approved spirometry courses and all other approved courses is published on the Coal Services website. This is updated from time to time and should always be referenced when planning training and development.