Mandatory Health Checkups in Japan: Foreigner's Guide | MyKyoten

Last verified: 2026. This guide is based on Immigration Bureau regulations, Ministry of Health Labour and Welfare guidelines, and standard Japanese administrative practice. It is informational only and does not constitute legal advice. Consult a licensed immigration attorney or official government sources for case-specific guidance.

If you skip your company's mandatory health checkup in Japan, your employer is legally required to track non-compliance. That creates paperwork, creates friction with HR, and in some cases creates a quiet but real pressure on your employment standing. On top of that, you are walking away from early detection screenings your health insurance effectively covers at no cost to you. This is not a bureaucratic checkbox. It matters.

Why Is Your Company Legally Required to Give You a Health Checkup?

The legal foundation is Article 66 of the 労働安全衛生法 (Industrial Safety and Health Act). This law requires employers to conduct annual general health checkups for all employees, including foreigners, regardless of visa type or nationality. The WHY matters here: Japan's labor framework treats health monitoring as an employer obligation, not an employee privilege. The burden of organizing, funding, and recording the checkup sits entirely on the company, not on you.

The law applies to all full-time employees, and also to part-time workers who work 30 hours or more per week (at least three-quarters of the standard full-time hours at that company). Basically, if you are a regular employee under a Japanese employment contract, you are covered.

Beyond the standard annual checkup, certain workers qualify for special health checkups (特殊健康診断) based on job category. These include people who work with organic solvents, radiation, lead, or specific noise environments. If your job involves hazardous conditions, these checkups are required more frequently, sometimes every six months. Your employer is responsible for telling you which category applies to you.

→ Use the Document Decoder to translate and understand your Japanese administrative documents.

What Does the Standard Annual Checkup Actually Include?

The 一般健康診断 (general health checkup) has 11 legally required examination items under Ministry of Health, Labour and Welfare regulations:

1. Medical history interview 2. Physical measurements (height, weight, BMI, vision, hearing) 3. Blood pressure 4. Chest X-ray 5. Sputum test (if indicated by chest X-ray) 6. Liver function blood test (GOT, GPT, gamma-GTP) 7. Blood lipids (cholesterol, triglycerides) 8. Blood glucose 9. Complete blood count (CBC) 10. Urine test (glucose, protein) 11. Electrocardiogram (ECG, added for employees 35 and over)

Here is the part nobody tells you: employees aged 35 and over enter what is effectively a tiered system. The ECG becomes mandatory, and some clinics and employers add additional screening items for this age group. If you are 35 or older, expect the appointment to run longer and involve a few extra steps.

Workers under 35 in certain years (specifically ages 20, 25, 30) may have some items abbreviated by employer discretion under a specific Ministry exception. The full 11-item panel always applies at 35 and above.

[Reality Check] The chest X-ray surprises a lot of people from countries where annual X-rays are not standard. It is routine here and covered under the employer's checkup obligation. If you have concerns about radiation exposure from annual X-rays, speak with the examining physician. You have the right to ask questions.

How Does the Process Actually Work, Step by Step?

Step 1: HR sends you a notice. Usually by internal email, group announcement, or paper notice. This typically happens 2 to 4 weeks before the scheduled checkup period. The notice will state the date, location (on-site or external clinic), and any preparation instructions (such as fasting before blood tests).

Step 2: Confirm your slot. Some companies assign you a time slot automatically. Others ask you to sign up via an internal system or paper sheet. If you are on a work visa and have scheduling concerns, you can request an alternative date within the same checkup period. Do not simply ignore it.

Step 3: Prepare what to bring. - Residence card (在留カード) - Health insurance card (保険証) - Prior year checkup results if your HR requests them - Fasting is required for blood tests: typically no food for 10 hours before the appointment. Water is usually acceptable. The notice will specify.

Step 4: Attend the checkup. On-site checkups typically take 30 to 60 minutes. Clinic-based checkups may take 1 to 2 hours including waiting time. You do this during working hours. That time is paid time. You are not expected to use paid leave.

Step 5: Receive your results. Results are typically mailed to the company within 2 to 4 weeks and distributed to you directly. Some clinics now offer results via sealed envelope or secure online portal.

[Step-by-Step Checklist]

• Receive HR notice and confirm your scheduled date
• Check whether fasting is required (usually yes for blood tests)
• Bring: residence card, health insurance card, prior results if requested
• Attend during working hours (this is paid time)
• Receive sealed results within 2 to 4 weeks
• Review your grade codes (explained below)
• Schedule follow-up if you receive grade D or E

What Are Your Rights as a Foreign Employee?

Three things your employer cannot ask you to do:

1. Pay for the checkup. The cost is legally the employer's responsibility. The average cost of a standard 一般健康診断 at a clinic ranges from approximately ¥5,000 to ¥15,000. Your company absorbs this entirely. If anyone asks you to pay upfront and "expense it later," that is a gray area worth pushing back on.

2. Attend outside of working hours. If the checkup is scheduled on a Saturday or after your shift ends, that is legally problematic. The time must be treated as working hours and compensated accordingly.

3. Share your results with unauthorized parties. Your results are confidential under personal information protection law. Your employer receives aggregated data for workplace safety reporting, but your individual results cannot be shared without your written consent.

If you are asked to pay or attend outside working hours, the phrase to use with HR is:

「健康診断は就業時間内に実施し、費用は会社が負担するものと理解しています。」 ("I understand that the health checkup is to be conducted during working hours and the cost is to be borne by the company.")

Say it calmly and in writing if possible.

A Filipino civil engineer on an Engineer/Specialist in Humanities/International Services visa, working for a mid-sized construction firm in Osaka, received a company health checkup notice in April. The notice was entirely in Japanese. He attended the on-site checkup, which took 45 minutes. His results arrived 3 weeks later in a sealed envelope. He received a Grade C on his blood pressure reading. His company's occupational health physician (産業医) sent him a written recommendation to monitor his blood pressure monthly. He was not required to take leave or see a doctor immediately, but it was documented in his occupational health file.

This is a standard outcome. Grade C does not mean a crisis. It means watch it.

If you receive documents from your employer related to health checkup results that you cannot read, the Document Decoder can help you understand what is written before you respond to HR.

Japanese health checkup results use a grade code system. The most common format:

| Grade | Meaning | What You Should Do | |-------|---------|-------------------| | A | Within normal range | No action needed | | B | Slight abnormality, within acceptable limits | Monitor; no immediate treatment needed | | C | Requires monitoring or lifestyle change | Follow occupational physician's advice | | D | Requires medical examination | Schedule a doctor's appointment within weeks | | E | Requires immediate treatment or already under treatment | See a doctor promptly; inform your physician |

Some clinics use numbers (1 through 5) or different letter systems. If your results form looks different, check the legend on the form itself, usually printed in the footer.

[Warning Box] Grades D and E carry employer obligations. Under the Industrial Safety and Health Act, if your result triggers a D or E grade, your employer's occupational health physician is required to provide a formal opinion on whether you need work restrictions or reassignment. This is not punitive. It is a legal protection. Do not ignore a D or E result.

What if you cannot read the results form? You have the right to request an explanation from the examining clinic. Some urban clinics offer limited English support. Based on common experience reported by foreign residents, requesting a simple verbal explanation of your grades at the clinic window is almost always accommodated, even without formal interpreter services. For written translations or summaries, you can request this from the clinic directly, though a fee of approximately ¥1,000 to ¥3,000 may apply depending on the facility.

What if you want an English-language summary? Ask HR to contact the clinic and request an English summary. Not all clinics provide this, but larger medical centers in urban areas often can. Alternatively, bring someone who reads Japanese to help you review the document, or use a document translation tool.

Edge case 1: You change jobs mid-year. If you completed a health checkup at a previous employer within the past year, your new employer can accept those results instead of requiring a new checkup, as long as the results are recent enough. Bring a copy of your prior results when you onboard. Some HR departments do not proactively ask for this, but it is your right to submit them. This matters especially if you are switching jobs quickly. See the guide on job change reporting for related compliance steps.

Edge case 2: You are pregnant. Pregnant employees have specific health checkup rights and scheduling protections under the Labor Standards Act. Chest X-rays are typically deferred or replaced with alternative screening. Inform your employer and the examining physician before the appointment. Do not assume the standard process applies automatically.

How This Connects to Your Broader Status in Japan

This is where people mess up. Some foreign employees treat the health checkup as optional because nobody follows up aggressively in the first year. But employer non-compliance is reportable to the Labor Standards Inspection Office, and individual non-participation is recorded in occupational health files. If you are working toward permanent residency, your employment record needs to show stable, cooperative participation in workplace compliance. Gaps or refusals create unnecessary noise in your file.

If your visa stability or employment history is something you are tracking carefully, the Immigration Risk Checker gives you a structured way to assess where you stand. Understanding your health insurance obligations connects directly to this: see the health insurance guide for the full picture of what your coverage actually includes.

Your next step: locate the health checkup notice from your HR department, confirm your scheduled date, and verify in writing whether the appointment is on-site or at an external clinic. If you have not received a notice and have been employed for more than 12 months, email HR directly and ask when the next 一般健康診断 is scheduled.

Can my company force me to do the checkup if I refuse? Your employer cannot physically compel you, but they are legally required to document your refusal and may face administrative penalties for non-compliance with Article 66. Refusal also creates a record in your occupational health file. There is no practical benefit to refusing, and based on common experience among foreign employees, refusal tends to create unnecessary tension with HR.

What if I am a short-term contract worker or on a fixed-term visa? The obligation applies to fixed-term contract employees who work at least 30 hours per week and whose contract is expected to last at least one year, or who have already been employed for one year. If your contract is shorter, check with HR directly. The rules around work visas and employment stability are worth reviewing in parallel.

Do I need a My Number card to attend the checkup? No. Your health insurance card and residence card are sufficient for identification. My Number is not typically requested at workplace health checkups. If a clinic asks for it, it is not a legal requirement for this specific process.

If the documents you received from the clinic or your HR department are in Japanese and you are not sure what they mean, the Document Decoder is built for exactly this situation. You upload or enter the Japanese text from your health checkup notice, results form, or HR memo, and it explains what each section means in plain English. It does not replace a physician's advice, but it gets you oriented before you have to respond.