Tier 4 HAVS Medical Assessment

PEMS Health provides physician-led Tier 4 HAVS assessments for employers across the UK.
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.

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 normally issued within a few working days 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

When should a Tier 4 HAVS assessment be arranged?
As soon as symptoms or abnormal screening results are reported so employers can make safe exposure decisions.

Can an employee continue using vibrating tools before assessment?
This depends on symptoms. A precautionary approach is usually taken until clinical advice is provided.

How long does a Tier 4 HAVS appointment take?
Typically around 40–60 minutes.