Tier 4 HAVS Medical Assessment

PEMS Health provides physician-led Tier 4 HAVS assessments for employers across the UK. Dr Pemberton has been performing these for over 10 years nationwide.

We assess employees who have reported symptoms or abnormal results during vibration health surveillance and provide clear fitness-for-work advice. Employers typically request a Tier 4 assessment after an employee reports symptoms or fails a HAVS questionnaire and guidance is needed on whether exposure can continue.

Why Choose PEMS Health for Tier 4 HAVS Assessments?

PEMS Health provides physician led Tier 4 HAVS assessments throughout the UK.

Employers choose us because we offer:

  • Over 10 years' experience undertaking Tier 4 HAVS assessments nationwide

  • Assessments performed by an Occupational Health Physician accredited in HAVS

  • Clear fitness for work recommendations

  • Practical advice regarding ongoing vibration exposure

  • Fast report turnaround

  • Nationwide coverage

  • Support for employers, health and safety teams and occupational health providers

Our aim is to provide clear, practical advice that supports both employee health and employer compliance with the Control of Vibration at Work Regulations 2005.

When is a Tier 4 HAVS assessment required?

A Tier 4 assessment is needed when screening suggests possible Hand-Arm Vibration Syndrome (HAVS). This usually follows a Tier 2 or Tier 3 questionnaire where symptoms are reported.

Common referral reasons include:

  • Finger blanching (whitening in cold conditions)

  • Tingling or numbness in fingers

  • Reduced grip strength

  • Loss of dexterity

  • Abnormal screening result

If symptoms are reported, employers should arrange clinical assessment. This allows a clear decision to be made about continued use of vibrating tools.

👉 HAVS Screening Service:/havs-screening

What happens during the Tier 4 appointment?

The assessment usually takes around 40–60 minutes.

We will:

  1. Review the employee’s work and vibration exposure

  2. Discuss symptoms in detail

  3. Perform a clinical examination of hands and arms

  4. Decide fitness for vibration exposure

The aim is to provide a practical occupational decision rather than simply a medical diagnosis.

What report will the employer receive?

After the assessment, the employer receives a concise occupational health report confirming:

  • Fitness for continued exposure

  • Required restrictions (if any)

  • Need for redeployment

  • Review intervals

Reports are usually issued within a few working days (often less) so employers can make timely management decisions.

How quickly should Tier 4 be arranged?

Tier 4 assessments should be arranged promptly once symptoms are identified so employers can make safe decisions about exposure.

Our service

We provide:

  • Onsite Tier 4 HAVS assessments across the UK

  • Flexible scheduling

  • Clear management-focused reports

  • Independent assessment supporting employer decision making

Arrange a Tier 4 HAVS assessment

Email: admin@pemshealth.co.uk

Frequently asked questions

Can a worker continue using vibrating tools while awaiting a Tier 4 assessment?

In many cases employees can continue working while awaiting assessment, although this depends on the nature and severity of the symptoms reported. Specific advice should be sought where significant symptoms are present.

How long does a Tier 4 HAVS assessment take?

Appointments typically last between 40 and 60 minutes depending on the complexity of the case and the information available.

What happens after the assessment?

A report is provided to the employer with advice regarding fitness for work, vibration exposure and any recommendations that may be appropriate.

Is a diagnosis always made?

Not necessarily. The purpose of the assessment is to evaluate symptoms, consider possible causes and provide occupational health advice. Some symptoms may have causes other than HAVS.