The purpose of asking job applicants to take a medical
examination is to screen out those candidates who would not be
able to properly perform their jobs for medical reasons. If you
don't think there is going to be a serious need for this
information (e.g., the job you're trying to fill is a desk job),
it's probably not necessary, especially when you consider that
if you choose to test people, you'll have to pay for it. Before
you test, make sure that any information you may get is worth
The most obvious instance when this information would be
useful is if the position requires a tremendous amount of
physical activity and exertion.
If a person has a medical condition that would not prevent
that person from doing the job, information about that condition
is not relevant to you or your business. Asking for such
information merely provides grounds for invasion of privacy
suits and disability-based discrimination actions.
If you have 15 or more employees. You are subject to
the Americans with Disabilities Act. As a rule, under the ADA
medical tests may not be administered before a conditional job
offer is extended. Should you decide to test, you have some
issues to take into account.
First, you need to determine whether a test you're thinking
of using is a "medical test."
The Equal Employment Opportunity Commission considers the
following criteria in determining whether a test is
- Was the test administered by a health care professional or
- Was the test given by the employer for the purpose of
revealing an impairment or the state of an individual's
physical or psychological health?
- Was the test invasive (e.g., does it require the drawing
of blood, urine, breath, etc.)?
- Did the test measure physiological/psychological responses
(as opposed to the performance of a task)?
- Was the test normally done in a medical setting?
- Were medical equipment/devices used for the test?
Tests the EEOC would generally consider not to be
- physical agility/physical fitness tests that do not
include medical monitoring
- certain psychological tests such as tests that simply
concern an individual's skills or tastes
- tests for illegal use of drugs
- polygraph tests, even though certain inquiries that are
frequently made before or during the test would be
prohibited pre-offer inquiries
If your test is considered a medical test, the following
guidelines will guide you through the maze of requirements
involved in medical examinations.
- Do not require or request medical exams before you have
extended a conditional job offer.
- Do not ask for a medical history or make
disability-related inquiries before a job offer is made.
- Require all post-offer applicants in a job category to
take the exam; don't just ask those individuals you believe
may have a disability.
- Disqualify only those applicants whose medical exams show
that they cannot, as determined by a medical professional,
perform the essential functions of the jobs that they are
seeking or that they are a direct threat to health and
safety, even after reasonable accommodation.
- Treat all medical information as confidential. Remember
that the medical information must be kept in separate file.
- Do not base employment decisions on paternalistic views
about what is best for a person with a disability.
- Do not ask the doctors who conduct the medical examination
to make employment decisions for you or to decide whether it
is possible to make a reasonable accommodation for a person
with a disability.
- Be diligent in assuring that the examining doctors make
assessments based on testing measures that actually and
reliably predict the substantial, imminent degree of harm
required. A mere statement by a company physician that a
threat of harm exists by hiring a candidate with a
particular disability will not shield you from liability.
- Limit the doctor's role to advising you about a person's
functional abilities and limitations in relation to the
particular job functions.
- Provide the doctors with specific information about the
job the applicant seeks.
- Have your medical advisers document the recommendations
they make to you.
Medical records. If you do require medical tests and
document them, be warned that medical records should not be kept
with other documentation that might be kept in a personnel file.
Separate files must be maintained for records relating
- medical certifications
- medical histories of employees or their family members
This information can be extremely sensitive and should be
treated as confidential, except for limited circumstances
involving work restrictions, necessity for emergency medical
treatment, and compliance investigations.
Complete records of all medical examinations required by law
must generally be retained for the duration of employment plus
30 years, according to the occupational
safety laws. First aid records and records of employees
employed less than one year are exempt from the above
If you do want to conduct medical tests and you
are subject to the ADA, proceed carefully. The ADA and its
requirements are specific and complex. Check with your legal
advisor before requiring medical tests as part of the hiring