Stress checks become mandatory for workplaces with fewer than 50 employees from April 2028. What small workplaces should prepare

In short: Stress checks are based on Article 66-10 of the Industrial Safety and Health Act. At present, workplaces with 50 or more ordinarily employed workers are mandatory, while workplaces with fewer than 50 are a best-effort obligation. Under the Act Partially Amending the Industrial Safety and Health Act and the Working Environment Measurement Act (Act No. 33 of 2025, promulgated May 14, 2025), the obligation to conduct stress checks will be extended to workplaces with fewer than 50 employees, which were previously a best-effort obligation, from April 1, 2028 (the enforcement date is set by Cabinet Order No. 195 of 2026, promulgated June 10, 2026). A stress check is conducted once a year at subject workplaces, so conducting it once in April 2028 is not the end of it. This "50" is judged by workplace, not by company, and "people counted in the 50" do not necessarily match "workers subject to the stress check." The Ministry of Health, Labour and Welfare has published an implementation manual for small workplaces (published February 25, 2026), and by the time of enforcement, companies must, in order, "confirm the workers and headcount → decide the implementation method and person who conducts the check → notify results and manage records → establish a route for interview guidance for high-stress workers." This article organizes the scope of the mandate and the procedures small workplaces should prepare.

This article is written for managers and HR/personnel staff of workplaces with fewer than 50 workers (judged by workplace). Its purpose is to answer "what changes from April 2028," "is our workplace subject," and "what should we prepare now."

What changes in stress checks from April 2028?

A stress check is an examination to grasp the degree of psychological burden on workers, and it is conducted once a year at subject workplaces (in statutory terms, "at least once within each period of one year, on a regular basis"; Article 52-9 of the Ordinance on Industrial Safety and Health). Under the current system, workplaces using 50 or more ordinarily employed workers are subject to the obligation, while workplaces with fewer than 50 have been a "best-effort obligation."

Under the 2025 amendment to the Industrial Safety and Health Act, the obligation to conduct stress checks will be extended to workplaces with fewer than 50 employees, which were previously a best-effort obligation. The enforcement date is April 1, 2028 (set by Cabinet Order No. 195 of 2026). It is not the case that conducting the check once in April 2028 is sufficient; implementation every year becomes the subject.

However, this does not mean "all workplaces and all workers are uniformly made mandatory." While the implementation obligation for workplaces is extended, workers subject to the check have separate requirements (described later). In addition, there are points, such as the obligation to report the implementation results to the Labor Standards Inspection Office, where the treatment differs between workplaces with 50 or more and those with fewer than 50.

Item	Workplaces with 50 or more ordinarily employed workers	Workplaces with fewer than 50 (from April 1, 2028)
Conducting the stress check	Mandatory	Mandatory (a best-effort obligation until then)
Frequency	Once a year (at least once within each period of one year, on a regular basis)	Once a year (at least once within each period of one year, on a regular basis)
Physician interview guidance when a worker meeting the requirements requests it	Mandatory	Mandatory
Group tabulation and analysis, workplace environment improvement	Best-effort obligation	Best-effort obligation
Reporting the implementation results to the Labor Standards Inspection Office	Mandatory	Not applicable

How is "50" counted by workplace? Is it different from the workers subject to the check?

The judgment of "50" is in principle by workplace, not by company. Even if the head office has 30 workers and a sales office has 25, you do not simply add them up across the whole company and judge "50 or more."

A workplace is judged mainly as a locational unit. However, it is not the case that a different location is always a separate workplace. Even where locations are separate, a branch or sub-office that is extremely small in scale and lacks the degree of independence required to be regarded as one workplace, judged by its organizational connection and administrative capability, may be treated together with the next-higher organizational unit as a single workplace (Enforcement of the Industrial Safety and Health Act, Hatsuki No. 91 of September 18, 1972). Which category your own site falls into should be confirmed against the actual situation.

In addition, this headcount is not simply a count of regular employees. Part-time and casual workers who work even one day a week may be included in the headcount if they are continuously employed and used as a regular practice.

On the other hand, workers legally subject to the stress check are, in principle, workers who meet both of the following.

• They are employed under an employment contract without a fixed term (including those whose contract period is one year or more, those expected to be used for one year or more through contract renewal, and those who have been continuously used for one year or more)
• Their weekly working hours are at least three-quarters of the prescribed weekly working hours of a regular worker engaged in the same type of work at that workplace

In other words, "people counted in the 50" and "workers subject to the stress check" are not the same. Even for short-time workers below three-quarters, if they meet the contract-period requirement and their weekly working hours are roughly one-half or more of the prescribed weekly working hours of a regular worker, it is desirable to conduct the stress check for them.

Who conducts the stress check, and what is the procedure?

The person who conducts the stress check is a physician or a public health nurse. In addition, dentists, nurses, psychiatric social workers, and certified public psychologists who have completed the prescribed training can also conduct the check (Article 52-10 of the Ordinance on Industrial Safety and Health). The person conducting the check does not necessarily have to be an occupational physician. It is not the case that "only an occupational physician can conduct it."

Based on the Ministry of Health, Labour and Welfare's manual for small workplaces, the flow of the stress check can be organized roughly into the following five stages.

1. Preparation for implementation (confirming workers and headcount, considering the implementation method)
2. Building the system (deciding the in-house person in charge, the person who conducts the check, and the person who handles the administrative work)
3. Conducting the stress check (mandatory)
4. Physician interview guidance and post-measures (mandatory when a worker meeting the requirements requests it)
5. Group analysis and workplace environment improvement (best-effort obligation)

For small workplaces, outsourcing to an external organization is in principle recommended from the viewpoint of privacy protection. However, outsourcing does not mean the employer's responsibility to implement disappears. It is necessary to decide in advance the division of roles among the in-house person in charge, the external person who conducts the check, and the person who handles the administrative work.

How are results notified and privacy protected?

The individual results of the stress check are notified by the person who conducts the check directly to the worker themselves. The individual results must not be provided to the employer without the worker's consent.

If the worker consents, the employer prepares a record of the results and keeps it for five years (Article 52-13, paragraph 2 of the Ordinance on Industrial Safety and Health). If there is no consent, the employer cannot receive the individual results, so the person who conducts the check or the person who handles the administrative work keeps them appropriately. Where there is no consent, it does not follow that the employer has a uniform statutory obligation to keep the records for five years. In either case, the employer must establish an appropriate management system, such as the storage location and security. The employer must not coerce the worker into consent.

Note that if the worker requests interview guidance, the worker may be treated as having consented to the provision of results, provided the handling has been notified to the worker in advance (Stress Check Guidelines).

Workers do not have a legal obligation to take the check. What is imposed on the employer is "the obligation to conduct the stress check." In addition, disadvantageous treatment for the following reasons is prohibited.

• Not taking the check
• Not consenting to the provision of results to the company
• Requesting interview guidance
• Not requesting interview guidance

What does a company do when a worker is judged to be a high-stress worker?

The fact that a worker is judged to be high-stress does not automatically lead to physician interview guidance. The flow is as follows.

1. The person who conducts the check judges the necessity of interview guidance
2. The worker is informed of the interview guidance
3. The worker requests interview guidance
4. The employer implements physician interview guidance
5. The employer hears the physician's opinion on necessary measures
6. The employer considers employment measures as necessary

The time guidelines are as follows. In statutory terms each step must be taken "without delay," and the "within approximately one month" figures below are practical guidelines shown in the Ministry of Health, Labour and Welfare's manuals.

Step	Practical guideline	Statutory wording
The worker requests interview guidance	Within approximately one month after notification of the results	Without delay after receiving the notification (Ordinance Article 52-16, paragraph 1)
The employer implements physician interview guidance	Within approximately one month after the request	Without delay when a request is made (Ordinance Article 52-16, paragraph 2)
The employer hears the physician's opinion	Within approximately one month after the interview guidance	Without delay after the interview guidance is conducted (Ordinance Article 52-19)

Interview guidance and medical judgment are performed by a physician. The employer must not engage in disadvantageous treatment on the grounds of requesting interview guidance.

For small workplaces with fewer than 50 workers, the Regional Occupational Health Center may be usable for physician interview guidance for high-stress workers and others. Under the current MHLW guidance, this interview guidance is free of charge. However, the Regional Occupational Health Center does not itself conduct stress checks. Its use is mainly as a receiving point for interview guidance.

Are group analysis and workplace environment improvement mandatory or best-effort?

Within the stress check system, the mandatory and best-effort obligations are divided as follows.

• Conducting the stress check → mandatory
• Physician interview guidance when a worker meeting certain requirements requests it → mandatory
• Group tabulation and analysis, and workplace environment improvement → best-effort obligation (Article 52-14 of the Ordinance on Industrial Safety and Health)

In addition, under the Ministerial Ordinance Partially Amending the Ordinance on Industrial Safety and Health (Ministry of Health, Labour and Welfare Ordinance No. 112 of 2026, promulgated June 30, 2026), from April 1, 2027, it will be expressly provided that group analysis, when conducted, must be carried out in a way that cannot identify a specific individual (amendment to Article 52-14, paragraph 1 of the same Ordinance; enforcement circular Kihatsu 0630 No. 2). This puts the existing interpretation into express wording, but because small workplaces with fewer than 50 have fewer people, particular attention to privacy is necessary.

Do workplaces with fewer than 50 need to report to the Labor Standards Inspection Office?

From April 2028, the implementation obligation of the stress check will be extended to workplaces with fewer than 50. However, the obligation to report the implementation results to the Labor Standards Inspection Office applies only to employers using 50 or more ordinarily employed workers (Article 52-21 of the Ordinance on Industrial Safety and Health). The reporting obligation has not been extended to workplaces with fewer than 50. Do not confuse this point.

What should a workplace with fewer than 50 prepare now?

Preparation before enforcement proceeds in the following 10 steps.

1. Confirm the number of workers in your own workplace, by workplace
2. Identify the workers legally subject to the check
3. Decide the in-house person in charge
4. Decide whether to outsource or conduct in-house
5. Decide the person who conducts the check and the person who handles the administrative work
6. Establish rules for privacy and record management
7. Conduct the stress check (once a year)
8. Establish a route for high-stress workers to request interview guidance
9. Confirm how to use the Regional Occupational Health Center and other resources
10. Also consider group analysis and workplace environment improvement (best-effort obligation)

Note that the obligation to appoint an occupational physician is not uniformly extended to workplaces with fewer than 50. The person who conducts the stress check and the appointment of an occupational physician are separate systems.

四葉社会保険労務士事務所 can advise on organizing the labor-management aspects of introducing the stress check system, in-house rules and regulations, management of eligible workers, and in-house operations. The person who conducts the stress check is a physician or other person meeting the legal qualification requirements, and interview guidance and medical judgment for high-stress workers are the domain of a physician. Consultation is free, and fees are set out in the fee schedule. For the steps of the process, see How consultation and contracting work. Individual disputes are the domain of a lawyer (Bengoshi), and tax matters are the domain of a tax accountant. If a different professional is needed, each is contracted separately, and there is no referral fee.

Frequently asked questions

Q. Are stress checks mandatory for workplaces with fewer than 50 from April 2028?
A. Yes. The obligation to conduct stress checks will be extended to workplaces with fewer than 50 employees, which were previously a best-effort obligation, from April 1, 2028. It is conducted once a year at subject workplaces (at least once within each period of one year, on a regular basis), so conducting it once in April 2028 is not the end of it. However, workers subject to the check have separate requirements.

Q. Is "50" counted across the whole company?
A. No. In principle, it is judged by workplace, not by company. You do not simply add the head office and a sales office across the whole company and judge "50 or more." A workplace is judged mainly as a locational unit, but a branch or sub-office that is extremely small in scale and lacks independence may be treated together with the next-higher organizational unit as a single workplace.

Q. Are the people counted in the 50 the same as the workers subject to the check?
A. They are not the same. The headcount may include part-time workers who are continuously employed and used as a regular practice, but workers legally subject to the check are, in principle, those who meet both "an employment contract without a fixed term (including an expectation or record of use for one year or more)" and "weekly working hours of at least three-quarters of the prescribed weekly working hours of a regular worker engaged in the same type of work."

Q. Can a stress check be conducted without an occupational physician?
A. Yes. The person who conducts the check is a physician or public health nurse, or a dentist, nurse, psychiatric social worker, or certified public psychologist who has completed the prescribed training. It does not necessarily have to be an occupational physician, and the obligation to appoint an occupational physician is not uniformly extended to workplaces with fewer than 50 either.

Q. Must employees take the check?
A. Workers do not have a legal obligation to take the check. The obligation is for the employer to conduct the stress check. Disadvantageous treatment on the grounds of not taking the check is prohibited.

Q. Can the company see the individual results of the stress check?
A. Individual results are notified by the person who conducts the check directly to the worker themselves. They must not be provided to the employer without the worker's consent. If the worker consents, the employer prepares a record and keeps it for five years; if there is no consent, the person who conducts the check or the person who handles the administrative work keeps it.

Q. If judged high-stress, is interview guidance mandatory?
A. Being judged high-stress does not automatically lead to interview guidance. The person who conducts the check judges the necessity and informs the worker, and if the worker requests it, the employer implements physician interview guidance. As practical guidelines, the request is within approximately one month after notification of the results, the interview guidance within approximately one month after the request, and hearing the physician's opinion within approximately one month after the interview guidance.

Q. Do workplaces with fewer than 50 need to report to the Labor Standards Inspection Office?
A. The obligation to report the implementation results to the Labor Standards Inspection Office applies only to employers using 50 or more ordinarily employed workers (Article 52-21 of the Ordinance on Industrial Safety and Health). The reporting obligation has not been extended to workplaces with fewer than 50.

Sources for this article

• Industrial Safety and Health Act, Article 66-10 (examinations to grasp the degree of psychological burden)
• Act Partially Amending the Industrial Safety and Health Act and the Working Environment Measurement Act (Act No. 33 of 2025, promulgated May 14, 2025) — extension of the implementation obligation to workplaces with fewer than 50
• Cabinet Order setting the enforcement date of part of the Act Partially Amending the Industrial Safety and Health Act and the Working Environment Measurement Act (Cabinet Order No. 195 of 2026, promulgated June 10, 2026) — extension of the obligation to workplaces with fewer than 50 takes effect April 1, 2028
• Ordinance on Industrial Safety and Health, Article 52-9 (at least once within each period of one year, on a regular basis) / Article 52-10 (person who conducts the check) / Article 52-13, paragraph 2 (consent and five-year retention of records) / Article 52-14 (group tabulation and analysis = best-effort obligation) / Article 52-16, paragraphs 1 and 2 (request for and implementation of interview guidance) / Article 52-19 (hearing the physician's opinion) / Article 52-21 (reporting = 50 or more ordinarily employed workers)
• Ministerial Ordinance Partially Amending the Ordinance on Industrial Safety and Health (Ministry of Health, Labour and Welfare Ordinance No. 112 of 2026, promulgated June 30, 2026, effective April 1, 2027) — express provision that group analysis is conducted in a way that cannot identify a specific individual (Article 52-14, paragraph 1). Enforcement circular Kihatsu 0630 No. 2 (June 30, 2026)
• Enforcement of the Industrial Safety and Health Act (Hatsuki No. 91 of September 18, 1972) — how the unit of "workplace" is determined
• Ministry of Health, Labour and Welfare, "Small Workplace Stress Check System Implementation Manual" (February 2026; published February 25, 2026)
• Ministry of Health, Labour and Welfare, "Guidelines on examinations to grasp the degree of psychological burden, the implementation of interview guidance, and measures employers should take based on the results of interview guidance," and "Stress Check System Q&A"
• Public materials confirmed on August 19, 2026

This article does not decide whom to consult. 四葉社会保険労務士事務所 can advise on organizing the labor-management aspects of introducing the stress check system, in-house rules and regulations, management of eligible workers, and in-house operations. The person who conducts the stress check is a physician or other person meeting the legal qualification requirements, interview guidance and medical judgment for high-stress workers are the domain of a physician, individual disputes are the domain of a lawyer (Bengoshi), and tax matters are the domain of a tax accountant. If a different professional is needed, each is contracted separately, and there is no referral fee. For frequently asked questions, see the FAQ.

This article is general information. Whether the system applies and individual determinations are made by a qualified professional after a consultation, in light of the latest primary sources (the Ministry of Health, Labour and Welfare, Prefectural Labour Bureaus, etc.) and individual circumstances. Written by Joji Uramatsu (Shakai Hoken Roumushi, Gyoseishoshi, Registered Real Estate Transaction Specialist).