TMERT V3 protocol step by step: how to apply it at your company

The TMERT V3 protocol (Protocolo TMERT, Chile's protocol on work-related musculoskeletal disorders) is applied in five moves: communicate it, characterize the jobs, do the initial identification, move to advanced identification wherever risk shows up and, if a task ends up in critical condition, intervene within a maximum of 90 days. It has been in force since February 25, 2026. If you already did the identification with V2, you are not starting from zero: you review the jobs against the questions that changed.

This guide follows the order of the protocol and cites its section number at each step. What exactly changed between V2 and V3 we explain in MINSAL approves the update to Protocolo TMERT V3; here we cover how it is applied in a plant or at a worksite.

What does the TMERT V3 protocol require and since when?

Chile's Ministry of Health (MINSAL) approved the Occupational Surveillance Protocol for Exposure to Risk Factors for Musculoskeletal Disorders V3 with Exempt Resolution No. 1,697 of December 26, 2025. It was published in the Diario Oficial (Chile's official gazette) No. 44,385 of February 25, 2026 and, under section 5 of the resolution, it is in force from that publication. Section 6 revokes Exempt Resolutions No. 327 and No. 1,660 of 2024, which supported the previous version.

The reason for the change is in the recitals: the Undersecretariat of Public Health and Chile's Superintendence of Social Security (SUSESO) found wording in the advanced identification stage that could lead to underestimating risk. That is why V3 shows up mostly in the tables for that stage.

The text of the protocol is published by the Instituto de Seguridad Laboral (ISL), Chile's public workplace safety institute. It is mandatory for every employer, regardless of size or industry, and it covers repetitive work of the upper limbs, static or forced postures, manual handling of loads (including pushing and pulling), manual handling of patients or people, and whole-body and hand-arm vibration.

Which advanced identification questions are worth a second look?

Four V3 questions are the ones that most change the result for a job. They are in tables II, III and VI of the protocol:

• Repetitive work, acceptable condition: "Is the total duration of repetitive tasks less than 4 hours in total within the workday?". Exactly four hours no longer qualifies.
• Repetitive work, critical condition: "Is there no more than one break (including lunch) in a 6 to 8 hour shift?". A seven-hour shift with only the meal break falls here.
• Postures: head flexion has to be less than 25° to be acceptable, and the critical condition asks whether it is 25° or more.
• Wrist: the protocol asks explicitly whether extreme deviation (ulnar or radial) is absent.

It is worth running these four questions on jobs where people look at a low screen, work with a deviated wrist or where the repetitive task takes up half the shift or more, such as filleting, packing or data entry.

What we see on site with a wellbeing program

What we can show is the effect of sustaining the measures over time. At Mowi Chacabuco, a wellbeing program with on-site physical therapists and spaces to recover during the workday reached 70% participation, and the plant closed 2025 with 0% accidents, a historic milestone (Mowi case). Participation is what the protocol cannot require in writing, and it is what decides whether an administrative measure works.

TMERT V3 protocol step by step

The order follows the protocol's table of contents. In parentheses is the section that supports each step, so you can show it during an inspection.

1. Communicate the protocol (section 4). Your organismo administrador (the body that administers your work accident insurance under Ley 16.744) communicates it to you, and you communicate it to workers, unions and the Comité Paritario (joint health and safety committee), with a verifiable record that you did.
2. Characterize the jobs and build the similar exposure groups (sections 3.1 and 3.3). The ISL treats this as a prior stage: without that list, the identification is incomplete.
3. Do the initial identification with the checklist in table I (section 5.1.1). The employer is responsible, by job or by task performed. If every answer is NO, this is recorded with annex I and repeated every 3 years or as soon as conditions change.
4. Move to advanced identification for every task with a YES (section 5.1.2). If every acceptable condition question is YES, the task is acceptable. If one is NO, it is checked against the critical condition tables (section 5.1.3). In micro and small companies this stage is done with on-site technical assistance from the administering body.
5. If the task ends up in critical condition, intervene immediately: the maximum deadline is 90 days from that result, and then it is reassessed with the acceptable condition tables (section 5.2.1).
6. If the risk is intermediate, request the assessment from your administering body (section 5.2). It is done by a professional trained in ergonomics, using the methods that section 5.2.1 sets for each factor: ART for repetitive work, OWAS or REBA for postures, MAC and RAPP for manual handling of loads and MAPO for patient handling. If needed, an advanced assessment follows with methods such as the OCRA Checklist, the ISO 11226 standard or the NIOSH equation.
7. Receive the report and share it. The administering body delivers it within a maximum of 30 calendar days from when it reports non-acceptable levels, and you inform workers within no more than 5 days of receiving it (section 5.3).
8. Implement the measures, prioritizing engineering measures over administrative ones (section 7). Breaks, rotation and training are administrative: they help, but they do not replace redesigning the job when that is possible. If the measures come from the administering body's advanced assessment, the maximum deadline is 90 days for administrative measures and 180 days for engineering measures (section 5.2.1).
9. Start health surveillance for those exposed to a non-acceptable condition (section 12). They are assessed every 6 months until the risk is under control.
10. Put the protocol in the Comité Paritario's monthly program (section 11) and complete the training in section 8. Keep everything on paper or in digital form: the health authority can request it.

Frequently asked questions

Do I have to redo everything I did with V2?

Not necessarily. V3 changed questions in the advanced identification; review the jobs you had already assessed with the new tables and redo them where the result could change. The protocol itself states that, if the company had already implemented it, it must review the risk level of the assessed jobs (section 5.2.1).

Who does the initial identification?

The employer, by job or by task. It can rely on its prevention department, the Comité Paritario or trained workers, with a documented and signed process.

How often is the identification repeated?

Every 3 years if there is no risk, and immediately if working conditions change, according to section 5.1.1.

Are active breaks enough to comply?

They are a valid administrative measure, but section 7 asks you to prioritize engineering measures. In a critical job, the break goes along with the redesign; it does not replace it.

What happens if I do not apply the protocol?

Workers and their organizations can notify the health authority or the labor authority that the preventive measures were not implemented (section 9), and the regional health offices (SEREMI de Salud) inspect how the protocol is applied (section 13.3).

The next step

If your advanced identification left jobs in critical or intermediate condition, you have 90 days for the measure to exist and be used. Your company defines the measure with its administering body. Makana does not replace that process; we provide tools that help mitigate the underlying risk: rooms to recover during the workday, physical therapy visits to the teams and symptom tracking in the app, with usage activated and measured by team. Among people who use Makana at least once a month, absenteeism fell 17.5% compared with a control group (UC · ANID study). See how we work with companies.

This content is for information only and does not replace advice from your administering body under Ley 16.744.

Clinical review: Makana team (internal review; physical therapy: Kai Horwitz, physical therapist). Last reviewed: October 17, 2026.