Medical exams, questions: Employer restrictions (Part I of II in a series)
In this first part of this series, the applicable terms are defined, so employers are aware of what questions they should not be asking, and what exams they should not be requiring of employees.
In the next part of the series, what questions are allowed and when actual medical questions and exams are allowed will be discussed.
Employers might know the basics about disabilities in the workplace; that the federal Americans with Disabilities Act (ADA) prohibits employment discrimination because of a disability. What employers might not know, however, is that the ADA restricts when employers may ask employees medical questions (inquiries) or when they may require employees to undergo medical exams.
The ADA states:
A covered entity shall not require a medical examination and shall not make inquiries of an employee as to whether such employee is an individual with a disability or as to the nature and severity of the disability unless such examination or inquiry is shown to be job-related and consistent with business necessity.
[42 U.S.C. §12112(d)(4)(A); 29 C.F.R. §1630.14(c)] This restriction applies to all employees, not just those with disabilities.
Disability-related inquiries: What employers may not ask
A "disability-related inquiry" is a question (or series of questions) that probes into an employee’s medical situation. The way these questions are crafted likely elicits information about a disability, whether that’s the intent or not.
Disability-related inquiries can include:
- Asking an employee whether they have (or ever had) a disability or how they became disabled or inquiring about the nature or severity of an employee’s disability;
- Asking an employee to provide medical documentation about their disability;
- Asking an employee’s coworker, family member, doctor, or another person about an employee's disability;
- Asking about an employee’s genetic information;
- Asking about an employee's prior workers’ compensation history;
- Asking an employee whether they currently are taking any prescription drugs or medications, whether they have taken any such drugs or medications in the past, or monitoring an employee’s taking of such drugs or medications; and,
- Asking an employee a broad question about their impairments that is likely to elicit information about a disability (e.g., What impairments do you have?).
Medical exams: What employers may not require
A "medical examination" (exam) is a procedure or test that seeks information about an individual's physical or mental impairments or health.
Medical exams include, but are not limited to:
- 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).
Key to remember: Employers risk violating the ADA if they ask employees medical questions or require medical exams and should understand what those terms mean.
