• The ADA has strict requirements when it comes to employers requesting medical inquiries and exams.

The Americans with Disabilities Act (ADA) does not prevent employers from obtaining medical and related information necessary to:

• Evaluate the ability of applicants and employees to perform essential job functions, or
• Promote health and safety on the job.

However, to protect individuals with disabilities from actions based on such information that is not job related and consistent with business necessity, including protection of health and safety, the ADA imposes specific and differing obligations at three stages of the employment process:

• Before making a job offer, employers may not make any medical inquiry or conduct any medical examination.
• After making a conditional job offer, but before a person starts work, employers may make unrestricted medical inquiries, but may not refuse to hire an individual with a disability based on results of such inquiries, unless the reason for rejection is job related and justified by business necessity.
• After employment begins, any medical examination or inquiry required of an employee must be job related and justified by business necessity.
  • Exceptions exist for voluntary examinations conducted as part of employee health programs and examinations required by other federal laws.

A “medical examination” is a procedure or test that seeks information about an individual’s physical or mental impairments or health. The following factors should be considered to determine whether a test (or procedure) is a medical examination:

• Whether the test is administered by a health care professional,
• Whether the test is interpreted by a health care professional,
• Whether the test is designed to reveal an impairment or physical or mental health,
• Whether the test is invasive,
• Whether the test measures an employee’s performance of a task or measures his or her physiological responses to performing the task,
• Whether the test normally is given in a medical setting, and
• Whether medical equipment is used.

Medical examinations include, but are not limited to, the following:

• Vision tests conducted and analyzed by an ophthalmologist or optometrist;
• Blood, urine, and breath analyses to check for alcohol use;
• Blood, urine, saliva, and hair analyses to detect disease or genetic markers (e.g., for conditions such as sickle cell trait, breast cancer, Huntington’s disease);
• Blood pressure screening and cholesterol testing;
• Nerve conduction tests (i.e., tests that screen for possible nerve damage and susceptibility to injury, such as carpal tunnel syndrome);
• Range-of-motion tests that measure muscle strength and motor function; • Pulmonary function tests (i.e., tests that measure the capacity of the lungs to hold air and to move air in and out);
• Psychological tests that are designed to identify a mental disorder or impairment; and
• Diagnostic procedures such as x-rays, computerized axial tomography (CAT) scans, and magnetic resonance imaging (MRI).

Counseling may also be considered a medical exam.