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Workplace Health Checkups in Japan (Kenkō Shindan)
A workplace health checkup in Japan, the 健康診断 (kenkō shindan), is a doctor-performed examination that your employer must provide to regularly employed workers at hiring and at least once a year, and that you, as a worker, are legally required to attend.12 The results go onto a record your employer keeps for five years, can shape your work assignments, and from age 40 also count toward your health insurer's metabolic screening.123
Procedures, fees, and requirements can change. Confirm current details at the Ministry of Health, Labour and Welfare (MHLW) site. This article is general information, not legal, medical, or employment advice; for your specific case, consult a licensed physician or your company's occupational physician (産業医, sangyōi) to interpret an abnormal result, or a licensed labor and social security attorney (社会保険労務士, sharōshi) or your local Labor Standards Inspection Office (労働基準監督署, rōdō kijun kantokusho) for a dispute over the employer's checkup duty, unpaid checkup time, or discipline for not attending.
Overview
Three overlapping Japanese terms cover this topic, and they belong to two different legal systems. One duty sits with your employer under labor law; the other sits with your health insurer under the law on medical care for older people.13
What many people call the Japan annual health check, or the Japanese company medical exam, is the employer's side of this picture. This article covers who is entitled to the employer checkup, what it tests at each age, what happens on the day, how results and follow-up work, what your employer is allowed to see, and how the Specific Health Checkup for ages 40 to 74 fits in.
Three names, two legal duties
The table below sorts the vocabulary you will see on notices and result sheets.
| Term | Reading | Meaning | Who must provide it |
|---|---|---|---|
| 健康診断 | kenkō shindan | Generic "health checkup"; the term the Industrial Safety and Health Act uses for employer examinations1 | Depends on context |
| 定期健康診断 | teiki kenkō shindan | Periodic (annual) health examination24 | Employer |
| 特定健康診査 (特定健診) | tokutei kenkō shinsa (tokutei kenshin) | Specific Health Checkup, a metabolic-syndrome screening for ages 40–7453 | Health insurer |
| 人間ドック | ningen dokku | Ningen dock, a voluntary comprehensive self-pay checkup6 | No one; you choose it |
The employer duty comes from the 労働安全衛生法 (Rōdō Anzen Eisei Hō, Industrial Safety and Health Act), Article 66(1): the employer must have a doctor examine its workers as set out by ministerial ordinance.1 The 労働安全衛生規則 (Rōdō Anzen Eisei Kisoku, Ordinance on Industrial Safety and Health) makes the periodic checkup annual, requiring it for regularly employed workers 「一年以内ごとに一回、定期に」 (once within every year).2
The insurer duty comes from Article 20 of the 高齢者の医療の確保に関する法律 (Kōreisha no Iryō no Kakuho ni Kansuru Hōritsu, Act on Securing Medical Care for the Elderly), which requires each insurer to give a Specific Health Checkup to members aged 40 and over.3 MHLW frames the target group as ages 40 to 74 and the focus as metabolic syndrome.5
The two duties connect. If you have had, or can have, an equivalent checkup under the Industrial Safety and Health Act, your insurer is treated as having carried out all or part of the Specific Health Checkup.3
For an employee aged 40 to 74, this means one checkup at work normally satisfies both systems; there is no second exam to book.3
How it differs from a ningen dock
A ningen dock is a voluntary checkup rather than a legal duty on anyone. A physician-supervised booking portal describes the contrast this way: company and municipal checkups look broadly for common diseases and their signs, while a ningen dock examines more organs in more detail, generally at your own full expense and outside health insurance.6 Detailed coverage of programs and cancer screenings is in "Ningen Dock and Cancer Screenings in Japan".
Who must get a checkup
The employer's duty to give both the pre-employment and the annual checkup runs to 「常時使用する労働者」 (jōji shiyō suru rōdōsha, "regularly employed workers").2 Whether a part-time or fixed-term worker falls in that class is set by an MHLW administrative notice (通達, tsūtatsu), not by the act itself.478 The act's duties run to workers generally, with no distinction by nationality.1
The flowchart below summarizes the test explained in the sections that follow.
Regular employees and the three-quarters rule
MHLW defines a regularly employed worker as someone whose contract runs one year or more (including expected renewals) and whose weekly hours are at least three-quarters of those of a regular worker doing the same type of work (as of 2026-04; confirm current figures with MHLW or your prefectural labor bureau).4 The Yamanashi Labour Bureau spells out the contract condition as any one of three: no fixed term; a fixed term expected to be renewed to one year or more; or a fixed term already renewed to one year or more (as of 2026-10-09).7
The comparison point is the full-time hours at your own workplace for the same kind of work, not a fixed number of hours. Saitama Prefecture's labor Q&A, restating the MHLW notice, confirms that both conditions must be met (as of 2025-04-01).8
If your weekly hours are below three-quarters but roughly half or more of a comparable full-timer's, MHLW says giving you the checkup is desirable, not mandatory (as of 2026-10-09).7
The pre-employment checkup (雇入時健康診断)
When an employer hires a regularly employed worker, it must have a doctor examine that worker on the statutory items.2 This is the 雇入時の健康診断 (yatoiire-ji no kenkō shindan, "hiring-time health checkup"), held at the time of hiring.4
The hiring checkup has the same 11 items as the annual one, except that the chest test is an X-ray only, with no sputum test. There is no age-based omission rule for it in the ordinance.24
You can sometimes skip it. If you had a doctor's checkup within the three months before your hire date and submit written proof of the results (結果を証明する書面, kekka o shōmei suru shomen), the matching items need not be repeated.2 The window runs backward from the hire date, not forward.
After a hiring checkup, the matching items of the annual checkup may be omitted for one year.2
Dispatch workers, night-shift and hazardous roles
For a dispatch worker, the general checkup is the duty of the dispatching agency (派遣元, hakenmoto), your legal employer. Special checkups for hazardous work are the duty of the client company where you work (派遣先, hakensaki).9
If the client company lets you join its own general checkup, the results still belong to the agency. The client must arrange not to see them, for example by having the doctor send results directly to the agency.9
Workers regularly engaged in certain specified work (特定業務従事者, tokutei gyōmu jūjisha) are examined when assigned to that work and then once every six months.2 The list includes work involving late-night hours (深夜業, shin'yagyō), along with work involving extreme heat or cold, harmful radiation, dust, abnormal air pressure, vibrating tools, heavy labor, intense noise, underground work, harmful substances or gases, and pathogens.2
Separately, workers in hazardous jobs designated by cabinet order receive 特殊健康診断 (tokushu kenkō shindan, "special health checkups") on hazard-specific items.19 Their content depends on the hazard and is outside this article's scope.
Your duty to attend
Attendance is not optional. Article 66(5) of the Industrial Safety and Health Act states that workers must undergo the checkups the employer provides.14
The same paragraph gives you an alternative. If you do not want to use the doctor your employer designates, you may have an equivalent examination by a doctor of your choice and submit written proof of the results.1
Freelancers and NHI enrollees
Without an employment relationship there is no employer duty, because Article 66 runs from employer to worker.1 Freelancers and others on National Health Insurance (NHI) reach checkups through their insurer instead: the Specific Health Checkup from age 40, covered in its own section below.3
Some municipalities also offer checkups to younger residents. Shinjuku City, for example, extends its checkup to residents aged 16 to 39 who have no opportunity for one through school or work (as of 2026-07-09).10
This is one ward's program, so check with your own city or ward office. Who is enrolled in NHI is explained in "Who Enrolls in National Health Insurance".
What the checkup includes
The ordinance sets a minimum list of items for the annual checkup (Article 44) and a near-identical list for the hiring checkup (Article 43).2 Your employer may add more, but cannot go below this floor except where a doctor applies the official omission criteria.
Separately from the item list, the questionnaire is changing through administrative guidance rather than the ordinance: on 2026-04-28 MHLW revised its model general-checkup questionnaire to add questions on women's health issues (as of 2026-04-28; confirm current figures with MHLW).11 The accompanying MHLW manuals name the target conditions as 「月経困難症、月経前症候群、更年期障害等」 (dysmenorrhea, premenstrual syndrome, menopausal symptoms, and similar) (as of 2026-10-09).12
The statutory item list
The table shows the current items, the age rule for the annual checkup, and an amendment promulgated on 2026-04-28 that takes effect on 2027-04-01.13 The age rules are the official omission criteria (as of 2026-10-09).7
| # | Item | What it covers | Age rule (annual checkup) | Until 2027-03-31 | From 2027-04-01 |
|---|---|---|---|---|---|
| 1 | 既往歴及び業務歴の調査 | Medical and work history24 | All ages | Yes | Yes |
| 2 | 自覚症状及び他覚症状の有無の検査 | Symptoms you report and the doctor observes24 | All ages | Yes | Yes |
| 3 | 身長、体重、腹囲、視力及び聴力 | Height, weight, waist, vision, hearing27 | Height omittable 20+; waist omittable under 40 except 35 (and other criteria) | Yes | Yes |
| 4 | 胸部エックス線検査 (及び喀痰検査) | Chest X-ray (and sputum test)2137 | X-ray omittable under 40 except at 20, 25, 30, 35 (with exceptions) | X-ray and sputum | X-ray only; sputum deleted |
| 5 | 血圧の測定 | Blood pressure24 | All ages | Yes | Yes |
| 6 | 貧血検査 | Anemia (hemoglobin, red blood cell count)27 | Omittable under 40 except 35 | Yes | Yes |
| 7 | 肝機能検査 | Liver function2137 | Omittable under 40 except 35 | Yes (named GOT, GPT, γ-GTP) | Yes (renamed AST, ALT, γ-GT) |
| 8 | 血中脂質検査 | Lipids (LDL and HDL cholesterol, triglycerides)27 | Omittable under 40 except 35 | Yes | Yes |
| 9 | 血糖検査 | Blood glucose27 | Omittable under 40 except 35 | Yes | Yes |
| 10 | 尿検査 | Urine sugar and protein27 | All ages (no omission criterion) | Yes | Yes |
| 11 | 心電図検査 | Electrocardiogram (ECG)27 | Omittable under 40 except 35 | Yes | Yes |
| 12 | 血清クレアチニン検査 | Kidney function413 | Omittable under 40 | No | Yes |
MHLW's stated reason for adding creatinine is the link between long working hours and chronic kidney disease risk, and the test's ability to catch kidney decline that the existing items miss.13
Age-based omissions: why 35 and 40+ get the full panel
Blood tests and the ECG are statutory items at every age; they do not "switch on" at 35 or 40. What changes with age is whether a doctor may omit them under the minister's standards.27
The decision is the doctor's, not automatic: MHLW describes it as an overall judgment by the doctor considering your symptoms and medical history (as of 2026-04).4 The current criteria are below (as of 2026-10-09).7
| Item | May be omitted for | As of |
|---|---|---|
| Height | 「20歳以上の者」 (age 20 and over)7 | 2026-10-09 |
| Waist | Under 40, except at 35; pregnant women and others whose waist does not reflect visceral fat; BMI under 20; BMI under 22 if you measured and reported your own waist7 | 2026-10-09 |
| Chest X-ray | Under 40, unless you are aged 20, 25, 30, or 35, work at a facility subject to tuberculosis checks under the Infectious Diseases Act, or are subject to three-yearly pneumoconiosis checks7 | 2026-10-09 |
| Sputum (until 2027-03-31) | No lesion on the X-ray; diagnosed as no tuberculosis risk; or meeting the X-ray omission criteria7 | 2026-10-09 |
| Anemia, liver, lipids, glucose, ECG | 「40歳未満の者(35歳の者を除く)」 (under 40, except at 35)7 | 2026-10-09 |
| Serum creatinine (from 2027-04-01) | Under 40, at the doctor's judgment, for the annual checkup13 | 2026-04-28 |
The practical result: at exactly 35, and at every age from 40, blood tests and the ECG have no age-based omission, so you get the full panel (as of 2026-10-09).7 Under 40 (other than 35), they may be dropped only if the doctor judges them unnecessary.47
Hearing follows a similar pattern. The standard test is audiometry at 1,000 Hz and 4,000 Hz, but for workers under 45 (other than at 35 and 40) the doctor may substitute another method they consider suitable (as of 2026-10-09).27
Extras your employer or insurer may add
The law sets only the floor; anything beyond the Article 44 list is an addition by your employer or insurer.2 Which extras an employer adds, and whether you pay part of the cost, depends on the employer and is not covered by national rules.
Insurers run their own enhanced programs. Kyokai Kenpo (全国健康保険協会, Japan Health Insurance Association) offers employee members a lifestyle-disease prevention checkup (生活習慣病予防健診, seikatsu shūkanbyō yobō kenshin) at ages 35 to 74 with about 30 test items, and in a reduced form without the stomach and colorectal cancer screenings at 20, 25, and 30 (as of 2026-04-01).14 The program includes the employer checkup's general items (as of 2026-04-01).14
The figures below come from the Ishikawa branch's page and may differ by branch and year (as of 2026-04-01).
| Item | Amount | As of |
|---|---|---|
| Kyokai Kenpo 生活習慣病予防健診 (Ishikawa branch), list price14 | ¥19,635 | 2026-04-01 |
| Same, maximum self-pay14 | ¥5,500 | 2026-04-01 |
Extras also change what your employer may see. Results of non-statutory items (法定外項目, hōteigai kōmoku) need your prior consent before your employer collects them.15 Once the sputum test leaves the statutory list in April 2027, the same consent rule applies to sputum results.13
How checkup day works
Notice, clinic, and scheduling
Your employer arranges the checkup through a doctor, typically a clinic it designates; you may instead use a doctor of your choice and submit the results.1 Where the workplace must appoint an occupational physician, the employer should seek that physician's advice on planning the checkup and should encourage attendance through notices and guidance.9
Before the checkup you usually fill in a 問診票 (monshinhyō, "medical questionnaire"). MHLW publishes a model version for the general checkup, revised to add women's-health questions (as of 2026-04-28; confirm current figures with MHLW).11
Bring any 受診券 (jushinken, checkup coupon) issued by your company, insurer, or municipality. One hospital's instructions warn that without the coupon you may be charged the full cost yourself (as of 2026-10-09).16 Rules differ by clinic, so follow the notice you receive.
Fasting and preparation
Fasting is a clinic instruction, not a legal rule; neither the ordinance nor the MHLW leaflet sets a fasting time.24 Your notice from the clinic is the instruction to follow.
As one example, UNO hospital's preparation sheet gives these instructions (as of 2026-10-09).16
| Situation | UNO hospital's instruction |
|---|---|
| Blood tests | No food for 10 hours before; only drinks without sugar |
| Stomach X-ray or abdominal ultrasound | Finish dinner the evening before by 21:00, water only afterward; one glass of water allowed until one hour before reception |
| Day before | Avoid alcohol and strenuous exercise; no smoking from the morning of the checkup |
| Stool samples | Collect within one week before; for colorectal screening, wait 2–3 days after the last day of a period |
| Regular medication | Ask your regular doctor about taking medicine the day before and on the day |
The same sheet asks anyone pregnant or possibly pregnant, breastfeeding or within six months of stopping, or menstruating to tell reception, because some items cannot be performed (as of 2026-10-09).16
Cost and paid time
Because the statutory general checkup is the employer's legal duty, the employer pays for it regardless of your age; the same applies to special checkups.8 How a checkup you arrange through your own doctor is paid for is not covered by the sources used here, so ask your employer before booking.
Pay for the time is a different question. According to Saitama Prefecture's labor Q&A, an employer is not automatically required to pay wages for time spent on the general checkup; this is for labor and management to agree, and a 1972 Labour Ministry notice says paying those wages is desirable.8
Special checkups for hazardous work are different. They are held during working hours in principle, and if held outside them, overtime premiums must be paid.8
Results and follow-up
Reading your results sheet
Your employer must notify you of your results, whether or not anything abnormal was found.19 The ordinance requires this 「遅滞なく」 (without delay).2
The legal framework works through the doctor's 診断区分 (shindan kubun, diagnostic category), defined in MHLW's guideline as 「異常なし、要観察、要医療等の区分」.9 Follow-up vocabulary on result sheets builds on two further terms.9
| Term | Reading | Meaning |
|---|---|---|
| 異常なし | ijō nashi | No abnormality9 |
| 要観察 | yō-kansatsu | Observation needed9 |
| 要医療 | yō-iryō | Medical care needed9 |
| 要再検査 | yō-saikensa | Re-test (再検査) needed9 |
| 要精密検査 | yō-seimitsu kensa | Detailed diagnostic examination (精密検査) needed9 |
Letter grades such as A to D or A to E are set by clinics and professional bodies, not by law. The Japan Society of Ningen Dock and Preventive Medical Care (日本人間ドック・予防医療学会) uses its own A–E scale and does not recommend printing an overall grade (as of 2026-10-09; confirm current figures with the society).17 In its public-facing version, A means within the reference range, B and C together mean caution needed, and D means abnormal (as of 2026-10-09).17
The employer's follow-up duties
When a checkup shows an abnormal finding, the law requires a sequence of steps from your employer.12 The diagram shows the flow; the details follow.
The employer must hear a doctor's opinion on the measures needed for any worker with an abnormal finding.1 This must happen within three months of the checkup and be recorded on your individual checkup record, or within two months of submission for a checkup that a late-night worker arranged and submitted voluntarily.29
Taking that opinion into account, the employer must take measures where needed, such as a change of workplace or duties, shorter hours, or fewer night shifts.1 Before deciding, the employer should hear your views and seek your understanding.9
MHLW's guideline gives an example scale of 就業区分 (shūgyō kubun, work-fitness categories) for the doctor's opinion.9
| Category | Meaning | Typical measures |
|---|---|---|
| 通常勤務 (tsūjō kinmu) | Normal work is fine9 | None |
| 就業制限 (shūgyō seigen) | Work needs to be restricted9 | Shorter hours, limits on business trips and overtime, lighter load, change of work or workplace, fewer night shifts, move to day work |
| 要休業 (yō-kyūgyō) | Time off work is needed9 | Leave or leave of absence for a period, for treatment |
The employer also has an effort duty to provide health guidance (保健指導, hoken shidō) by a doctor or public health nurse to workers who particularly need it, and you are expected to make efforts to maintain your health.1
Workplaces regularly employing 50 or more workers must appoint an occupational physician (産業医, sangyōi).18 Smaller workplaces should seek opinions from a doctor with occupational-health knowledge, for example through a regional occupational health center (地域産業保健センター, chiiki sangyō hoken sentā).9
Who pays for the re-test
MHLW's guideline states that a re-test (再検査) or detailed examination (精密検査) serves to confirm a diagnosis and is not uniformly required of the employer, except where the special-checkup ordinances for hazards such as organic solvents, lead, or asbestos require it.9 What the employer should do is recommend that you get it and encourage you to share the result with the advising doctor.9
The employer's duty to pay covers the statutory checkup itself, not automatically the follow-up.89 Who pays for a re-test in practice depends on your employer's policy and the clinic, so ask both before booking.
Re-test results also have different privacy status. A re-test on the same items as the statutory list can be collected without your consent, while re-tests on other items and detailed-examination results need your prior consent.15
The workers' compensation secondary checkup benefit
Workers' accident compensation insurance (労災保険, rōsai hoken) funds a free secondary checkup when your latest statutory checkup flags metabolic risk on four fronts at once. The benefit, 二次健康診断等給付 (niji kenkō shindan-tō kyūfu), applies when all of these are found abnormal: blood pressure, blood lipids, blood glucose, and waist measurement or BMI (as of 2026-10-09).19
An occupational physician's finding of abnormality on those items, made in light of the work environment, takes priority even if the checkup doctor found none (as of 2026-10-09).19 People already diagnosed with cerebrovascular or heart disease symptoms, and special-enrollment (特別加入, tokubetsu kanyū) members, are excluded (as of 2026-10-09).19
The benefit has two parts (as of 2026-10-09).19
| Part | Contents |
|---|---|
| Secondary checkup | Fasting lipids; fasting glucose; HbA1c (unless done in the first checkup); stress ECG or cardiac ultrasound; carotid ultrasound; microalbuminuria (only if the first urine protein was ± or +) |
| Specific health guidance | Nutrition, exercise, and lifestyle guidance by a doctor or public health nurse |
It is free at Rōsai hospitals and hospitals designated by the prefectural labor bureau director (健診給付病院等, kenshin kyūfu byōin-tō), and is available once per fiscal year, April 1 to March 31 (as of 2026-10-09).19 Your employer should recommend it if you qualify.9
The claim follows these steps, using claim form 様式第16号の10の2 (as of 2026-10-09).19
- Your statutory checkup finds all four items abnormal.19
- Your employer certifies the claim form.19
- You attend a designated hospital and submit the form there, with proof of the first checkup's results, within three months of the first checkup date.19
- You receive the results and are encouraged to share them with your employer.919
The secondary checkup claim must be made within three months of the first checkup date (as of 2026-10-09). Later claims are accepted only for a natural disaster or where the clinic's results notice was significantly delayed.19
What your employer sees
Your employer does not learn only whether you are fit for work. It must record your statutory results and keep them, and it may collect them without your consent.1215 What the law restricts is who inside the company handles the raw data, and for what purpose.1915
What the company legally receives and keeps
The employer must record checkup results on a 健康診断個人票 (kenkō shindan kojinhyō, individual checkup record, Form 5) and keep it for five years.12 The doctor's opinion on any abnormal finding is written on the same record.2
MHLW's guideline on handling workers' health information (心身の状態の情報, shinshin no jōtai no jōhō) sorts checkup information into three categories.15
| Category | Examples | Rule |
|---|---|---|
| ① | Whether you attended; the doctor's opinion on follow-up measures15 | Employer must handle it directly under the act |
| ② | Results of the statutory items; re-tests on the same items15 | Collectable without consent, but internal rules should limit who handles it and how it is processed |
| ③ | Results of non-statutory items; health-guidance results; other re-tests; detailed-examination results15 | Prior consent required |
Employers regularly using 50 or more workers must report periodic checkup results to the Labor Standards Inspection Office without delay.24 The report is at workplace level (number examined, findings by item, occupational physician details), not individual records.2
When your health insurer requests checkup records under the Health Insurance Act, your employer may provide copies without separate consent from you.15
Limits on how it can be used
Article 104 of the Industrial Safety and Health Act allows the employer to collect health information only as far as needed to protect workers' health, and to keep and use it only within that purpose, unless you consent or there is another legitimate reason.1 Each workplace should set handling rules (取扱規程, toriatsukai kitei) with worker involvement and share them with staff.15
When non-medical staff handle information to arrange work measures, it must be the minimum necessary. They must not be given unprocessed data such as diagnosis names, test values, or specific complaints.9
For dispatch workers, the agency must not pass your general checkup information to the client company without your consent.9 When doctors' opinions are reported to a workplace health committee, they should be aggregated or processed so that individuals cannot be identified.9
The Specific Health Checkup for ages 40 to 74
The 特定健康診査 (tokutei kenkō shinsa), usually shortened to 特定健診 (tokutei kenshin), is the health insurer's duty, not the employer's.3 MHLW asks people in the 40 to 74 band to have it once a year and to take health guidance if lifestyle changes are needed (as of 2026-10-09; confirm current figures with MHLW).5
How you take it depends on how you are insured. An employer may also entrust its equivalent checkup to the insurer and pay the cost.3
Employees: your workplace checkup counts
If you are an employee, your annual workplace checkup counts toward the Specific Health Checkup; the insurer is treated as having performed it, wholly or partly.3 Your employer may pass the records to your insurer on request without separate consent from you.15
If the results show high lifestyle-disease risk, your insurer may offer 特定保健指導 (tokutei hoken shidō, Specific Health Guidance), with support from public health nurses or registered dietitians.5 MHLW's guideline asks employers to encourage workers who received this guidance to share its content with the company's health-guidance doctor or nurse.9 How the two main types of employee insurer differ is covered in "Health Insurance Society vs. Kyokai Kenpo".
Dependents on an employee plan
Family members insured as dependents get a Specific Health Checkup from the employee's insurer, and each insurer runs its own program. Kyokai Kenpo Tokyo's program, as one example, covers family members aged 40 to 74 during the fiscal year, including dependents of voluntarily continued (任意継続, nin'i keizoku) members (as of 2026-09-11).20
In that program the coupon is sent in April to the insured employee's address, is valid from 2026-04-01 to 2027-03-31 for one checkup, and you book by phone with a listed clinic (as of 2026-09-11).20 Self-pay depends on the clinic's contract type (as of 2026-09-11).
| Clinic type (Kyokai Kenpo Tokyo, dependents) | Self-pay | As of |
|---|---|---|
| 集合契約Aタイプ (Type A collective contract)20 | ¥0 | 2026-09-11 |
| 集合契約Bタイプ (Type B collective contract)20 | Up to about ¥5,000 | 2026-09-11 |
A health insurance society (健保組合, kenpo kumiai) or another Kyokai Kenpo branch may set different terms. Dependent status itself is explained in "The Dependent (Fuyo) System".
NHI enrollees and freelancers
If you are on National Health Insurance, your municipality runs the checkup, and the timing, clinics, cost, and items vary by municipality. Shinjuku City's FY2026 program is one example (as of 2026-07-09).10
| Detail | Shinjuku City, FY2026 |
|---|---|
| Eligible | Ages 40–74 on Shinjuku NHI, or receiving public assistance10 |
| Coupon | Mailed late May 202610 |
| Checkup period | 2026-06-01 to 2027-03-3110 |
| Cost | Free10 |
| Where | Clinics designated by Shinjuku City10 |
| Items | Questionnaire, body measurements, blood pressure, urine test, blood tests, and others10 |
Check your own city or ward office's page for its schedule, clinics, and cost.
Good to know
A to D grades are not a national scale
Letter grades on your result sheet come from the clinic or a professional society, not the law. The ningen-dock society's own A–E scale is one example, and it does not recommend an overall grade (as of 2026-10-09; confirm current figures with the society).17 The legally meaningful outputs are the doctor's diagnostic category (異常なし / 要観察 / 要医療) and the doctor's work-fitness opinion (通常勤務 / 就業制限 / 要休業).9
Skipping the checkup has consequences
Attending is a statutory duty, though having your own doctor examine you and submitting the results satisfies it.1 The employer who fails to provide the checkup faces a fine of up to ¥500,000; that penalty article covers the employer's duties, not the worker's.1
Discipline is a separate question. The Supreme Court has upheld, in a public-school case decided under the Local Public Service Act (地方公務員法, Chihō Kōmuin Hō), a principal's order to take the chest X-ray and the disciplinary grounds for a teacher's refusal.21 That ruling concerned a public employee, so its application to private-sector discipline is not settled by the judgment; if you are disciplined, a sharōshi can review your situation.
Changing jobs mid-year
A checkup taken within the three months before your new hire date can stand in for the matching hiring-checkup items if you submit the written results, so keep your last result sheet.2 After a hiring checkup, the matching annual items may be skipped for one year.2
Insurer-subsidized checkups require you to be a member on the checkup date. Kyokai Kenpo's Aichi branch warns that a checkup taken after you lose membership, such as after leaving a job, is not subsidized (as of 2026-10-09).22
Pregnancy and the chest X-ray
If you are pregnant or might be, tell the clinic at reception. One hospital's preparation sheet states that some items cannot be performed in that case, without naming which (as of 2026-10-09).16
The national omission criteria mention pregnancy only for the waist measurement, not for the chest X-ray (as of 2026-10-09).7 Ask the clinic how it handles the X-ray in your case.
The stress check is a separate annual screening
The annual stress check (ストレスチェック, sutoresu chekku) is excluded from the Article 66(1) health checkup by the act's own wording and runs as a separate screening.1 It is currently mandatory at workplaces with 50 or more workers, with only an effort duty for smaller ones (as of 2026-06-10).23
MHLW confirms that an amendment promulgated in May 2025 makes it mandatory for workplaces under 50 from 2028-04-01 (as of 2026-06-10).23 Details are in "Workplace Mental Health Framework".
Getting and keeping a copy of your results
Your employer must give you your results without delay and keep the individual record for five years.2 Keep your own copies of each year's result sheet; written proof of a recent checkup is what a new employer accepts in place of matching hiring-checkup items.2 English-language result sheets are not covered by the sources used for this article; ask the clinic directly.
See also
- Shakai Hoken Overview
- Sickness Allowance (Shobyo-Teate-Kin)
- Health Insurance and Pension for Freelancers
- Employment-Dispute Paths
- Service Overtime and the Karoshi Discourse