SIPTU is to ballot 30,000 of its members for strike action, saying the Department of Health and the HSE are in breach of the national public service agreement.
The union wants the reintroduction of a job evaluation scheme which it says could result in its members getting more pay.
Those affected include hospital porters, security and catering staff as well as home help.
SIPTU health division organiser Paul Bell said it is deeply regrettable that our members feel compelled to take this action and said the dispute had been brought about by the HSE and the department refusing to implement fully the binding provisions of the Lansdowne Road and Haddington Road agreements.
In a statement this after the HSE said it "is disappointed that SIPTU has taken the decision to ballot support staff for strike action.
"The HSE is open to the reintroduction of a job evaluation scheme for support staff subject to management discussions regarding costings for such a scheme."
SIPTU is also due to ballot emergency department workers.
They are seeking similar concessions that were given to nurses working in emergency departments that have not been extended to other grades.
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