Online vs Clinic Respirator Medical Evaluation
Both options are OSHA compliant. Here's how to choose the right one for your organization.
Both Options Are OSHA Compliant
Important: OSHA 1910.134(e)(5) permits both online and in-person respirator medical evaluations, as long as they're administered by a qualified PLHCP (Physician or other Licensed Health Care Professional). Neither option is "more compliant" than the other—both meet OSHA requirements when done correctly.
The choice between online and clinic evaluations comes down to cost, time, convenience, and your organization's specific needs. This guide provides an objective comparison to help you make the right decision. If you're ready to try the online approach, get your online respirator medical evaluation in 15 minutes.
Detailed Comparison: 12 Key Criteria
Side-by-side comparison of online and clinic-based respirator medical evaluations across the factors that matter most to employers
| Criteria | Online Evaluation | Clinic Evaluation |
|---|---|---|
Cost Per Evaluation | $22-$35 All-inclusive pricing | $75-$250 Varies by location + insurance |
Time Required | 15 minutes Complete anytime, anywhere | 2-4 hours total Includes travel, wait, exam |
| OSHA Compliance | ✓ Fully Compliant 1910.134(e)(5) approved | ✓ Fully Compliant Traditional OSHA method |
| Certificate Delivery | 24 hours (98% instant) Digital download + email | 1-5 business days Mailed or picked up |
| Record Retention | 30 years digital Automatic HIPAA-compliant storage | 30 years (your responsibility) Paper files or manual scanning |
| Multi-Location Scalability | Excellent Centralized dashboard for all locations | Challenging Need clinic in each region |
| Convenience for Employees | High Complete from home, mobile-friendly | Moderate Requires appointment, travel, time off |
| Follow-Up Exam Process | 2% require follow-up PLHCP coordinates with your clinic | Immediate if needed Already at clinic for exam |
| PLHCP Qualifications | Board-certified MD Occupational medicine specialist | Varies by clinic MD, DO, PA, NP (all PLHCP-qualified) |
| Enterprise Features | Built-in Bulk invites, reporting, API, SSO | Limited Manual coordination per employee |
| Best For | • Multi-location companies | • Employees needing physical exam |
| Productivity Impact | Zero downtime Complete during break or at home | 2-4 hours lost Travel + wait time during work hours |
Total Cost Comparison: Beyond the Exam Fee
When comparing costs, most employers only look at the exam fee. But the true cost includes lost productivity, administrative overhead, and travel expenses.
💚 Online Evaluation Total Cost
- Evaluation Fee: $22
All-inclusive, no hidden fees
- Employee Time: $7.50
15 minutes × $30/hr average wage
- Travel Cost: $0
Complete from anywhere
- Admin Time: $0
Automated scheduling & tracking
Total: $29.50 per employee
🟨 Clinic Evaluation Total Cost
- Evaluation Fee: $150
Average clinic exam cost (range: $75-$250)
- Employee Time: $90
3 hours × $30/hr (travel + wait + exam)
- Travel Cost: $15
Mileage reimbursement (30 miles roundtrip)
- Admin Time: $25
Scheduling, record collection, filing
Total: $280 per employee
Time Investment Comparison
⏱️ Online Evaluation Timeline
Minute 0-5: Access questionnaire
Employee receives email link, logs in from any device (phone, tablet, computer)
Minute 5-15: Complete OSHA Appendix C
15 yes/no medical questions, auto-saves progress
Minute 15+: PLHCP review (24 hours)
98% approved instantly, certificate delivered via email
Total Employee Time: 15 minutes
⏱️ Clinic Evaluation Timeline
Week 1-2: Schedule appointment
Wait time for next available slot (varies by clinic availability)
Appointment day: Travel (30-60 min)
Drive to occupational health clinic during work hours
Waiting room: Wait (30-90 min)
Fill out paperwork, wait for provider
Exam: Medical review (20-30 min)
Provider reviews questionnaire, vitals check
Return travel: Drive back (30-60 min)
Return to worksite, certificate mailed in 1-5 days
Total Employee Time: 2-4 hours
When to Choose Online Evaluation
Multi-Location Companies
If you have employees across multiple states or regions, online evaluations provide consistent, centralized compliance tracking without coordinating dozens of local clinics.
Remote or Field Workers
Construction crews, traveling technicians, or work-from-home employees can complete evaluations without disrupting job schedules or requiring travel to a specific clinic.
Rapid Hiring or Scaling
When onboarding 10-100+ new employees quickly (seasonal hiring, new project start), online evaluations eliminate scheduling bottlenecks. No clinic appointment capacity limits.
Cost-Sensitive Operations
For organizations with tight budgets or large workforces (100+ respirator users), online evaluations provide 80-90% cost savings compared to clinic visits.
Enterprise Reporting Needs
If you need instant compliance reports for audits, real-time dashboard tracking across facilities, or automated expiration reminders, online platforms provide built-in enterprise features.
Shift Work or 24/7 Operations
Manufacturing plants, hospitals, or warehouses running multiple shifts can't send workers to clinics during business hours. Online evaluations work anytime, any shift.
When to Choose Clinic Evaluation
While online evaluations work for 98% of employees, certain situations benefit from in-person clinic exams:
Complex Medical Histories
Employees with significant cardiac conditions, severe asthma, or other respiratory diseases may need physical examination, spirometry testing, or specialist consultation that requires in-person evaluation.
Technology Barriers
Workers without internet access, uncomfortable with computers, or who speak languages not supported by online platforms may prefer face-to-face clinic visits with translation services available.
Preference for In-Person Care
Some employees or employers simply prefer the personal interaction of a face-to-face medical visit. This is a valid choice—both methods are equally compliant.
Immediate Follow-Up Needed
If an employee's questionnaire flags a medical issue requiring additional testing (EKG, chest X-ray, blood work), being at a clinic allows for same-day follow-up rather than scheduling a separate appointment.
Hybrid Approach: Best of Both Worlds
Many organizations use a hybrid model that combines online and clinic evaluations based on individual employee needs:
Recommended Hybrid Strategy
- Default to Online for 90% of Employees
Healthy workers with no flagged conditions complete online evaluations (fast, low-cost)
- Clinic Exams for 10% Requiring Follow-Up
When online PLHCP review identifies a medical concern, coordinate in-person follow-up exam
- Employee Choice for Preference
Offer employees the option to choose in-person if they're uncomfortable with online (builds trust)
Try Online Evaluation Risk-Free
See how online evaluations work for your team. First 2 evaluations free—no credit card required.
Frequently Asked Questions
Will OSHA accept an online respirator medical evaluation during an audit?
Yes. OSHA 1910.134(e)(5) explicitly permits medical evaluations conducted remotely, as long as they're administered by a qualified PLHCP. Online evaluations have been accepted in thousands of OSHA inspections with zero compliance issues. The key requirement is PLHCP review of the OSHA Appendix C questionnaire—not the format (online vs paper).
How does the PLHCP review work for online evaluations?
A board-certified physician (Dr. Nader Mikhail, MD) reviews every online questionnaire within 24 hours. He evaluates responses for medical red flags (cardiac conditions, respiratory issues, etc.) and makes one of three determinations: (1) Cleared without restrictions, (2) Cleared with limitations (e.g., recommend PAPR instead of N95), or (3) Requires in-person follow-up exam (about 2% of cases).
What happens if an employee needs a follow-up physical exam after the online questionnaire?
If the PLHCP identifies a medical concern requiring further evaluation (about 2% of employees), we coordinate with your existing occupational health clinic or refer to a local provider for an in-person exam. You only pay for the follow-up if needed—the online evaluation already saved you time and identified exactly which employees require additional attention.
Can employees complete the online evaluation on their smartphone?
Yes. The evaluation is fully mobile-optimized and works on any device (smartphone, tablet, laptop, desktop). Many employees complete it during a break or from home. The questionnaire auto-saves progress, so employees can pause and resume if needed. Average completion time: 15 minutes.
How quickly can I get 50 employees cleared for a new project starting next week?
Online evaluations have no capacity limits. Send 50 invitation emails today, employees complete evaluations tonight, PLHCP reviews within 24 hours, and you have 49-50 certificates by tomorrow afternoon (98% approval rate). Clinic appointments for 50 workers would take 3-6 weeks to schedule and complete.
What if an employee doesn't have internet access at home?
Employees can complete the evaluation at work using a company computer, tablet, or smartphone. If internet access is truly unavailable, you can print the OSHA Appendix C questionnaire and submit it for PLHCP review via fax/scan (slightly longer processing time). For workers without technology access, a clinic visit may be more appropriate.
Are online evaluations cheaper because they're lower quality or less thorough?
No—both online and clinic evaluations use the exact same OSHA Appendix C questionnaire and require PLHCP review. The cost difference comes from eliminating clinic overhead (real estate, administrative staff, scheduling systems) and employee productivity loss (no travel or wait time). The medical evaluation itself is identical.
How do I track compliance across multiple locations with online evaluations?
Online platforms provide centralized dashboards showing compliance status for all employees across all locations in real-time. You can filter by location, department, or expiration date, and export instant compliance reports for audits. With clinic evaluations, you'd need to manually collect and consolidate records from each clinic.
Can I use online evaluations for some employees and clinic visits for others?
Absolutely. Many companies use a hybrid approach: online for healthy workers with straightforward medical histories (90-98%), and clinic visits for employees with complex conditions or those who prefer in-person care. This maximizes cost savings while accommodating individual needs.
What if I've already been using a local clinic for years and have a good relationship?
You can keep that relationship for employees needing follow-up exams (about 2%). Use online evaluations for the 98% of workers who pass the questionnaire screening—this saves you $200+ per employee while maintaining your clinic partnership for complex cases. Many companies transition gradually by starting new hires on online evaluations.
How long are the medical clearance certificates valid?
Both online and clinic certificates are valid for the same duration under OSHA: typically 1 year for employees who continue respirator use, or until the PLHCP recommends re-evaluation. Expiration dates are based on OSHA requirements, not the evaluation method. Online platforms provide automatic expiration reminders to maintain compliance.
Will my workers' compensation insurance or safety audit accept online evaluations?
Yes. Insurance carriers, third-party safety auditors, and OSHA inspectors accept online evaluations because they meet 1910.134 requirements. Your digital certificates include the same information as clinic certificates: PLHCP name/credentials, evaluation date, clearance determination, and OSHA Appendix C compliance statement.