Fitness for Duty Declaration and Register
A daily record, made before the shift starts, that each worker has declared themselves fit to work: not under the influence of alcohol or drugs, not fatigued and with no medical condition that affects the work. The supervisor keeps the register and records what was done about anyone who was not fit.
Every shift, at the start, before anyone goes underground, onto the plant or into a vehicle or machine. Kept with the shift records.
What is in the template
Declaration (one per worker)
- Name
- Employee number
- Shift and start time
- I declare that I am fit for duty: not under the influence of alcohol or drugs, not fatigued, and with no medical condition that affects my work today
- Medication declared (name and who prescribed it)
- Signature and time
The worker fills this in and signs it themselves. A declaration filled in by the supervisor on the worker's behalf is not a declaration.
Shift register
Columns: Name · Employee no · Fit / not fit · Medical certificate valid to · Alcohol test result · Signature · Supervisor initials · 16 rows per page
One row per person on shift, contractors included. The medical certificate date comes from the certificate of fitness issued under the medical surveillance programme; an expired certificate is "not fit" until renewed.
Supervisor action
- Persons declared not fit (names and employee numbers)
- Action taken (sent home, assigned to light duty, removed from the machine)
- Referred to (clinic, occupational medical practitioner, employee assistance programme)
- Supervisor name and signature
- Time
How to fill it in
- 1Hand the declaration to each worker at the start of the shift and have them read, complete and sign it before they are allocated work.
- 2Record every person on shift in the register, including contractors and visitors who will enter the working area, and check the medical certificate date against the certificate itself.
- 3Where the site tests for alcohol, record the result on the row. A positive result or a refusal is "not fit".
- 4Do not allocate work to anyone marked "not fit". Record what you did and who you referred them to, and sign it.
- 5File the register with the shift records. A regulator or an investigator will ask for the day's register after an incident.
A general template, not legal advice. Check it against the Act, the regulations and the codes of practice that apply to your site, and against your own safety management system. Under the OHS Act, General Safety Regulations regulation 2A prohibits a person who is, or appears to be, under the influence of intoxicating liquor or drugs from entering or remaining at a workplace, and section 14 places duties on every employee to take reasonable care and to obey the health and safety rules. Under the MHSA, section 22 places the equivalent duties on employees at a mine, and the regulations on medical surveillance require certificates of fitness for work in the occupations they cover.
Convert this template into a digital form
Run it on an Android phone with no signal, attach photos as evidence, and every failed item raises an issue with an owner and a due date.
The same record in Inspecable
On paper the register is only as current as the last person who updated it. In Inspecable the same record keeps going:
- Time and attendance runs a fitness-to-work check at clock-in against medicals, tickets and required courses, and returns pass, warn or block. On the Operations plan.
- A readiness board of worker medicals and licences carries the expiry dates, so the medical certificate column is checked against one record rather than a folder. On the Operations plan.
- A worker found unfit, or a fatigue concern on the crew, is logged as an incident or an observation on Android, offline, with photo and video, and feeds the corrective-action register.
Questions
Is a fitness for duty declaration required by law in South Africa?
Not by that name. General Safety Regulations regulation 2A under the OHS Act bars anyone under the influence of alcohol or drugs from the workplace, and the OHS Act section 14 and the MHSA section 22 place duties on employees to take care. A signed declaration is the common way to show both were applied.
What should a worker do if they are on medication?
Declare it on the form before the shift. Many prescribed and over-the-counter medicines cause drowsiness or slow reactions. The supervisor then decides, with the occupational medical practitioner where needed, whether the worker can do the day's task or should be given other work.
Can a supervisor send a worker home for being unfit?
A supervisor must not allocate work to someone who is not fit to do it safely. Whether the worker is sent home, given light duty or referred to the clinic follows the site's procedure and its disciplinary and medical policies. Record the decision and the referral on the register.
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