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The Ins and Outs of Fitness for Duty Exams

fitness for duty exams

There's a simple way for employers to avoid work comp claims: Don't put the wrong worker to work. (Simple, but not easy, right?) The wrong worker is anyone who is physically unready or unable to perform essential job functions. Fitness for duty exams can help you ID the wrong worker. These exams can protect this individual from injury and you from your next work comp claim.

Many Types of Fitness for Duty Exams

Many different tests are considered fitness for duty exams, including the following examinations:

1.) Return to work: Conducted if you doubt whether an employee is ready to come back after an injury, even though the worker's doctor has given the all clear.

2.) Job performance: Conducted if you're concerned that an employee cannot perform the essential functions of the job or that an employee can't perform up to the standards of other workers.

3.) Post-offer physical examinations: Sometimes called pre-placement exams. Includes extensive questionnaire for employee to complete, musculoskeletal assessment, drug screen, and medical surveillance. Physical abilities testing is a type of post-offer screening. [We'll cover more specifics of PAT in an upcoming blog post!]

Employers also may hear about functional capacity evaluations (FCE), which are interchangeable with fitness for duty exams. Enhanced physicals is another term tossed around when talking about screening worker health. Physical abilities testing would cover the same ground as an enhanced physical. Regardless of the name or acronym, taking any steps to head off a work comp claim is good risk management.

Are Fitness for Duty Exams Legal?

Employers do have a legal right to perform fitness for duty exams. According to the Americans with Disabilities Act, you cannot discriminate against hiring a disabled worker  but his disability cannot prevent him from doing the essential functions of the job. For example, you can't not hire someone because he is in a wheelchair if he can do what the job requires. A desk job could be just fine for someone in a wheelchair. If he wants to apply to be a carpenter (a job that requires climbing, hammering, and lifting), however, the candidate in a wheelchair may not be able to perform those essential functions.

Fitness for duty exams lean on the Americans with Disabilities Act for two primary guideposts:

1.) Can the worker perform the essential functions?

2.) Does the worker have a medical condition that poses a direct threat to the safety and health of the worker or to the people around the worker?

The answers to these questions will guide decisions regarding whether an employee is ready to work. Also be aware of reasonable accommodations in complying with ADA. This comes into play with ancillary job tasks. For instance, say you are a manufacturer, and you have an employee who is short in stature. A platform to increase height would be a reasonable accommodation for this employee if she could do most essential job functions but was held up on some task because of her height. Reasonable accommodations can't be overlooked in fitness for duty exams.

The Family and Medical Leave Act and work comp laws both allow for employers to request an independent medical opinion about a worker's fitness for duty. In short, employers are empowered to use these screening tools.

Recipe for Fitness for Duty Exam Success

The ultimate goal of fitness for duty exams is to determine whether a worker is up to the physical demands of a position. Fitness for duty exams help discover an employee's capacity for work, sometimes following a medical leave of absence. Keep that framework in mind as you consider the following best practices for a fitness for duty exam:

  • Remember that each case is individual. Just because an individual has a particular medical history (for instance, an organ transplant), that doesn't necessarily mean the worker can't perform the job. An organ recipient could be the poster child for successful implantation and have many years of work ahead of him. You never know!
  • Information, information, information. The more information the medical professional conducting the fitness for duty exam has, the better. We recommend sharing the following with the medical professional to arrive at the best outcome for the worker and the employer:
    • job description that covers essential functions and physical demands.
    • Medical records. The employee might say one thing — but the records will tell another story. Remember: The goal is to avoid an injury and the work comp claim that goes with it.
    • phone conversation to allow the provider to dig deeper about the employee and his job. [It's a good idea to document what was said in the phone conversation in an email or cover letter for a permanent, written record as well!]

Over to you: What questions do you have about fitness for duty exams? What has been your experience with these screening tools? What surprises you about fitness for duty exams? Please sound off in comments!

 FMCSA Information and forms


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Work Comp: When Are Commuting Employees Covered?

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Topics: Construction Transportation Safety / Compliance Manufacturing