WorkComp Advisory
newsletter archive case studies articles

Fitness for duty exams

Fitness for duty exams are used by employers for a number of reasons, including:

1. A return to light duty or full duty after being out on a Workers Compensation claim.

2. As a pre-hire medical examination to assess the ability to do the job with or without limitations.

3. To determine fitness for duty after returning from family medical leave for a serious medical condition.

4. To help manage a disability accommodation issue.

5. When there is concern that the employee may be a threat to himself or others and unable to perform the job safely or productively, either because they're under the influence or for some other medical reason.

Our strategic partner, HR That Works! offers the following guidance:

"The employer should pay for this exam, as well as for the employee's time in taking it. When requesting fitness for duty exams, always provide the physician with a copy of either the employee's job description or their essential job functions. In general, fitness for duty exams should be limited solely to the medical information necessary to see if the employee is fit for duty. For example, if they've had a shoulder injury, no medical information should be forwarded about a family history of diabetes.

"Perhaps the most difficult area to define is when you suspect that there's 'something wrong' with an employee and then take the risk of asking them to have a medical examination. As long as the employer is "reasonable" in their concerns or suspicions, the employee would be insubordinate for not taking the exam and be subject to discipline or termination. Courts have ruled that it's reasonable for employers to request fitness for duty exams when employees engage in outbursts and other erratic behavior, threats of violence, continued insubordination, a history of stress-related absences, appearing hung over, intoxicated, or high on the job, falling asleep at work, complaining of dizziness, and other activities."

To read the DOL's position on Pre-Hire Exams go to

As always, employers should involve legal and medical experts when making these difficult decisions.