Respirator Medical Evaluation Program for Employers - OSHA 1910.134 Compliant, Physician-Led, Built for Workforce Scale
OSHA requires every employer to provide a medical evaluation before any worker is fit tested or uses a respirator on the job. Occucare delivers a complete, end-to-end respirator medical evaluation program for construction and industrial employers – board-certified physician review, same-day clearance letters, workplace-specific compliance documentation, and audit-ready records managed at the employer level across every site you operate.
Board-Certified Occupational Medicine Physicians – PLHCP Compliant Under 1910.134
93% Onsite Injury Management Rate
Serving Construction and Industrial Employers Across Texas and the Gulf Coast
3,000+ Clinic Network for Follow-Up Coordination
End-to-End Employer Program Management
Clinic Hours
- Monday - Friday 7:30 AM - 4:30 PM CST
- +1 713 802 0801
What OSHA Requires From Employers Under 29 CFR 1910.134
Under OSHA’s Respiratory Protection Standard, the employer – not the worker – carries five mandatory responsibilities before a single respirator is worn on your job site:
Step 1
Identify a PLHCP
You must select a Physician or Licensed Health Care Professional to review all medical evaluations. This cannot be an algorithm or an automated scoring system under the standard.
Step 2
Provide workplace-specific information
Before evaluations begin, the employer must provide the PLHCP with the respirator type, weight, usage duration, physical exertion level required, and environmental conditions workers will face. Most online portals skip this step entirely – creating a compliance gap from the start.
Step 3
Ensure confidentiality
Medical evaluations must be administered during working hours. The employer cannot review individual worker responses to the questionnaire. Occucare manages this confidentiality requirement on your behalf within our program structure.
Step 4
Cover all costs
The employer must pay for every evaluation, including any follow-up examinations required. Occucare’s program pricing is structured at the employer account level – predictable, auditable, and inclusive of follow-up coordination.
Step 5
Obtain written clearance
The PLHCP must issue a written recommendation confirming whether each worker is cleared, and noting any medical limitations on respirator use. Occucare issues same-day clearance letters organized by worker and stored in your employer account.
If any one of these five steps is missing or incomplete, your respiratory protection program is non-compliant – regardless of whether workers passed fit testing.
The Sequence Employers Must Follow - And the Compliance Failure Most Get Wrong
Medical evaluation under 1910.134(e) must be completed and written clearance issued before fit testing under 1910.134(f) begins. These are two separate obligations under two separate subsections of the standard. Running workers through fit testing before medical clearance is a direct OSHA violation – even if the fit test result is documented and on file.
Occucare’s program enforces the correct sequence by design. Workers cannot proceed to fit testing in our program workflow until physician-reviewed medical clearance has been issued. Your compliance record reflects the correct order automatically.
How Occucare's End-to-End Respirator Medical Evaluation Program Works
Occucare’s program is built for employers managing crews – not for individual workers arranging their own clearances.
Step 1
Employer Program Setup
Occucare establishes a dedicated employer account with your company profile, active project sites, respirator types in use, worker exposure levels, and physical demands data. This workplace-specific information is provided to our physicians before any evaluations begin – satisfying the OSHA requirement most portals ignore.
Step 2
Worker Completes OSHA Appendix C Questionnaire
Workers complete the mandatory OSHA Respirator Medical Evaluation Questionnaire digitally from any device – on site, at home, or in the field. No clinic visit required. No lost production time.
Step 3
Board-Certified Physician Review
Every submission is reviewed by an Occucare board-certified occupational medicine physician – a qualified PLHCP under 1910.134. Clinical review focuses on cardiovascular and pulmonary capacity, anxiety, claustrophobia, and any condition that affects safe respirator use under your specific workplace conditions. This is physician judgment, not algorithmic scoring.
Step 4
Same-Day Written Clearance Letter
Upon physician approval, a written clearance letter is issued specifying which respirator types the worker is cleared to use. Turnaround is same business day in most cases – keeping your project mobilization timeline intact.
Step 5
Flagged Cases Coordinated Through Occucare's Clinic Network
Approximately 2–3% of evaluations identify a concern requiring follow-up – typically a pulmonary function test or in-person occupational medicine examination. Occucare’s physicians coordinate that next step through our 3,000+ clinic network. The employer is notified. The worker has a clear pathway. Your project does not wait on a worker who was told to “see their own doctor.”
Step 6
Audit-Ready Documentation Managed at the Employer Level
All clearance records are stored in your employer program account – organized by worker, site, and project. When OSHA audits, you produce complete documentation immediately. No scattered emails. No missing records from workers who used different portals on different projects.
Step 7
Integration With Medical Direction and OSHA Surveillance
Respirator medical evaluations integrate directly into Occucare’s Medical Direction program, providing ongoing occupational health oversight that includes OSHA medical surveillance, injury case management, and return-to-work coordination – all under the same board-certified physician team managing your respirator program.
Portal vs. Program - Why the Difference Matters for Your Liability
RespSafety, RapidMEQ, Respclearance, and similar platforms offer individual clearances starting at $20 per worker. For a single worker arranging personal compliance, that may be adequate. For an employer running a respiratory protection program under 1910.134, it is a different risk picture entirely.
These platforms do not collect workplace-specific information from the employer before evaluations begin – which is an OSHA requirement. They score questionnaire responses algorithmically – not through physician clinical judgment. When a worker flags a cardiovascular concern, they tell the worker to see their own doctor – leaving your clearance record incomplete with no resolution pathway.
OSHA violations under the Respiratory Protection Standard start at $15,000 per violation. A missing or improperly administered clearance program across a 100-worker crew is not a $20-per-person problem. It is a program liability problem. Occucare builds the program.
Who This Program Is Built For
- General contractors managing multi-trade crews before confined space entry, spray operations, or hazmat work
- Industrial employers running annual respiratory protection programs across manufacturing and processing facilities
- Oil and gas operators requiring clearance for refinery, pipeline, and offshore personnel
- EHS managers who need centralized, audit-ready documentation across multiple Texas project sites simultaneously
- Safety directors replacing scattered individual portal clearances with a physician-led employer compliance program that satisfies all five OSHA 1910.134 employer requirements
Frequently Asked Questions
Under 29 CFR 1910.134(e), employers must identify a PLHCP to conduct evaluations, provide workplace-specific information to the PLHCP before evaluations begin, ensure evaluations are administered confidentially during work hours, cover all costs including follow-up exams, and obtain written clearance letters for every worker. All five steps are mandatory. A program that satisfies only some of them is non-compliant.
Yes. OSHA permits the mandatory Appendix C questionnaire to be completed digitally and reviewed remotely by a qualified PLHCP. Occucare's program delivers fully OSHA-compliant evaluations via telemedicine - with board-certified physician review and same-day written clearance letters - eliminating clinic visits and minimizing worker downtime.
Yes. Medical evaluation under 1910.134(e) must be completed and written clearance issued before fit testing under 1910.134(f) can occur. This sequence is mandatory under the standard. Conducting fit testing before medical clearance is an OSHA violation regardless of whether fit test records are documented.
The employer must provide the PLHCP with the respirator type and weight workers will use, duration and frequency of respirator use, physical exertion levels required, and temperature and humidity conditions of the work environment. Occucare collects this information during employer program setup - before any worker evaluations are processed.
Approximately 2–3% of evaluations require follow-up examination - typically a pulmonary function test or in-person occupational medicine assessment. Occucare's physicians coordinate the follow-up through our 3,000+ clinic network. The employer receives notification and the worker's clearance pathway is managed to resolution - not left open-ended.
All clearance records are maintained in the employer's program account, organized by worker, project, and site. Safety directors can access complete, audit-ready documentation for every worker across all active locations at any time. When OSHA requests records, you produce them immediately - not from scattered worker emails or multiple vendor portals.
Respirator medical evaluations integrate directly into Occucare's Medical Direction program, which provides comprehensive occupational health oversight including OSHA medical surveillance, injury case management, and return-to-work coordination. Respirator clearance becomes one component of a complete employer workforce health system managed by the same board-certified physician team.
Build a Compliant Respirator Program Before Your Next Project Starts
OSHA violations under the Respiratory Protection Standard start at $15,000. A $20 portal is not a program. Occucare builds the end-to-end employer program that satisfies all five OSHA 1910.134 requirements – physician-reviewed, audit-ready, and managed across every site you operate.
Serving construction, industrial, and oil and gas employers in Houston, Texas, and across the Gulf Coast.