An employer has the right to ensure employees can perform their job duties safely and effectively. This right is significantly limited by federal law, which protects applicants and workers from discrimination based on disability. The legality of an employer-mandated physical examination depends entirely on the timing and the stated purpose of the medical inquiry. The law divides the employment relationship into distinct phases, each with its own rules regarding medical disclosure.
The Americans with Disabilities Act and Physical Exams
The Americans with Disabilities Act (ADA) is the primary federal statute governing when and how an employer can require a medical examination or ask health-related questions. The Equal Employment Opportunity Commission (EEOC) enforces the ADA and separates medical inquiries into three distinct time periods: pre-offer, post-offer, and during employment. This phased approach prevents an applicant’s potential disability from being considered before their non-medical qualifications are evaluated. The fundamental standard for all permissible medical inquiries is that the required exam must be “job-related and consistent with business necessity.” This standard requires a sound, non-discriminatory justification, and the scope of the examination must not be broader than necessary to meet the identified business need.
Requirements Before a Conditional Job Offer
The period before a conditional job offer is the most restrictive phase for medical inquiries. During this stage, an employer cannot require any medical examination or ask any disability-related questions of an applicant. This prohibition applies even if the employer intends to review the results only after an offer is made. The employer is also prohibited from asking questions likely to reveal the existence or nature of a disability. Instead, the employer must focus solely on the applicant’s ability to perform the essential functions of the job, such as asking about lifting capabilities or required attendance.
Requirements After a Conditional Job Offer
Once a conditional offer of employment is extended, the rules governing medical examinations become broader. An employer may require a medical exam or ask disability-related questions, and the inquiry does not necessarily have to be job-related or consistent with business necessity. The only requirement is that all entering employees in the same job category must undergo the same examination or inquiry.
Withdrawing a Conditional Offer
If the post-offer exam results lead the employer to withdraw the conditional offer, the employer must then meet the strict “job-related and consistent with business necessity” standard. The employer must demonstrate that the individual cannot perform the job’s essential functions, even with a reasonable accommodation. Furthermore, the employer can only screen out an individual if they pose a “direct threat”—a significant risk of substantial harm to themselves or others that cannot be eliminated through reasonable accommodation. The employer must consider the individual’s current ability to perform the job safely, not speculation about future injury or increased costs.
Exams for Current Employees
For current employees, the standard for requiring a medical examination reverts to the strict “job-related and consistent with business necessity” requirement. The employer must have a reasonable belief, based on objective evidence, that the employee’s medical condition impairs their ability to perform essential job functions or poses a direct threat to safety. This evidence must be more than speculation or rumor. A “Fitness for Duty” exam is permissible when an employee exhibits performance or safety problems reasonably believed to be caused by a medical condition. A “Return-to-Work” exam may also be required after medical leave, but only to assess the employee’s current ability to safely resume essential job functions.
Handling Sensitive Medical and Genetic Information
Confidentiality Requirements (ADA)
All medical information collected by an employer must be kept strictly confidential. The ADA requires that medical records be stored separately from the employee’s general personnel file, typically in a locked cabinet or secure digital location. Access must be restricted to specified individuals, such as safety personnel or supervisors who need to be informed of necessary work restrictions. This protects the individual’s privacy and prevents misuse of the information in employment decisions.
Genetic Information Nondiscrimination Act (GINA)
The Genetic Information Nondiscrimination Act (GINA) imposes an additional layer of protection. GINA strictly prohibits employers from requesting, requiring, or purchasing an employee’s or applicant’s genetic information. Genetic information includes an individual’s genetic tests, a family member’s genetic tests, and any family medical history. Employers must ensure that third-party medical providers conducting required physical exams do not collect family medical history.
Related Testing: Drug and Alcohol Screens
Drug and alcohol testing is treated differently under the ADA, creating an important legal distinction. A test for the current illegal use of drugs is explicitly not considered a medical examination under the ADA. Consequently, an employer may require a drug test for illegal substances at any stage of the application or employment process, even before a conditional job offer is made. In contrast, testing for alcohol use and inquiries about lawfully prescribed medications are classified as medical examinations. Therefore, these tests are subject to the same ADA restrictions as any other medical exam, including the “job-related and consistent with business necessity” standard for current employees.
What to Do If You Are Required to Take an Exam
If an employer requires a physical examination as a condition of employment, they must bear all associated costs, including any necessary follow-up testing. Requiring the employee to pay for the exam or deducting the cost from wages is a violation of the law. An applicant or employee should confirm the purpose and scope of the examination when asked to take one. Refusal to take a lawfully required medical examination will generally result in the withdrawal of a job offer or termination. If you suspect an employer is violating the ADA or GINA, you may file a charge of discrimination with the EEOC.