Work Doctor OH
HAVS Tier 4: Formal Diagnosis & Clinical Assessment
Service Details
What is a HAVS Tier 4 Medical?
A HAVS Tier 4 Medical is the formal clinical stage of health surveillance for Hand-Arm Vibration Syndrome. While Tiers 1–3 focus on screening and identifying potential symptoms, Tier 4 is a statutory diagnostic assessment conducted by an HSE-approved Occupational Health Physician.
During this consultation, the physician carries out a detailed clinical examination to provide a definitive diagnosis, determine the “staging” of the condition (using the Stockholm Workshop Scale), and issue a formal fitness-to-work recommendation. It is the final and most authoritative level of HAVS surveillance required by law when a suspected case is identified.
Key Benefits
- Definitive Diagnosis
- HSE Compliance
- Risk Mitigation
- Professional Staging
Who Is This For?
- Employees with Positive Tier 3 Results
- Organisations using High-Vibration Tools
- Health & Safety Managers
- Legal & HR Departments
Pricing for HAVS Tier 4
Our HAVS fee structure follows the HSE-recommended tiered approach to health surveillance:
Tier 4: Formal Diagnosis
Diagnosis and fitness-to-work decision by an HSE-approved OH Physician.
Book Your HAVS Tier 4 Medical
Questions
When exactly is a Tier 4 assessment required?
A Tier 4 assessment is required by law if a Tier 3 assessment (conducted by an OH Nurse) identifies symptoms that are new, worsening, or suggest a formal diagnosis of Hand-Arm Vibration Syndrome (HAVS) or Carpal Tunnel Syndrome. You cannot legally confirm a HAVS diagnosis without a Tier 4 Physician assessment.
Is your HAVS Physician HSE-Approved?
We have an urgent RIDDOR deadline; how quickly can we get a report?
We understand that a Tier 4 diagnosis often triggers a RIDDOR reporting requirement (which usually must be done within 10 days of a written diagnosis). We offer priority scheduling for Tier 4 cases and aim for a fast turnaround on clinical reports to ensure your organisation remains within its legal reporting windows.
Can a Tier 4 assessment be done remotely?
No. Because Tier 4 requires a formal clinical diagnosis, it involves specific physical examinations (including sensory and vascular testing of the hands) that must be conducted in person. We provide these at our clinics or can arrange on-site visits for multiple assessments.
What is the difference between Tier 3 and Tier 4?
Tier 3 is a screening process usually performed by an Occupational Health Nurse to check for suspected symptoms. Tier 4 is the diagnostic stage where an HSE-approved Doctor provides the definitive medical diagnosis and Stockholm Workshop Staging. You move to Tier 4 only if Tier 3 results are “positive” or inconclusive.
What happens if an employee is diagnosed with HAVS?
Our Physician will provide a clear “Fitness to Work” recommendation. This usually involves advice on restricting further vibration exposure and suggestions for workplace adjustments. We will guide you through the clinical findings so you can update your risk assessments and fulfill your duty of care.
Do we need to send the Tier 3 results to you before the appointment?
Yes. To ensure a thorough diagnosis, our Physician will need to review the employee’s Tier 3 clinical notes and vibration exposure history prior to the Tier 4 consultation. This allows for a more accurate comparison of symptom progression.