6.1 Overview of Legal Obligations

Technical assistance manual on the employment provisions (Title I) of the Americans With Disabilities Act

VI. MEDICAL EXAMINATIONS AND INQUIRIES

Pre–Employment, Pre–Offer

• An employer may not require a job applicant to take a medical examination, to respond to medical inquiries or to provide information about workers’ compensation claims before the employer makes a job offer.

Pre–Employment, Post–Offer

• An employer may condition a job offer on the satisfactory result of a post–offer medical examination or medical inquiry if this is required of all entering employees in the same job category. A post–offer examination or inquiry does not have to be "job–related" and "consistent with business necessity." Questions also may be asked about previous injuries and workers’ compensation claims.
• If an individual is not hired because a post–offer medical examination or inquiry reveals a disability, the reason(s) for not hiring must be job–related and necessary for the business. The employer also must show that no reasonable accommodation was available that would enable this individual to perform the essential job functions, or that accommodation would impose an undue hardship.
• A post–offer medical examination may disqualify an individual who would pose a "direct threat" to health or safety. Such a disqualification is job–related and consistent with business necessity.
• A post–offer medical examination may not disqualify an individual with a disability who is currently able to perform essential job functions because of speculation that the disability may cause a risk of future injury.

Employee Medical Examinations and Inquiries

• After a person starts work, a medical examination or inquiry of an employee must be job–related and necessary for the business.
• Employers may conduct employee medical examinations where there is evidence of a job performance or safety problem, examinations required by other Federal laws, examinations to determine current "fitness" to perform a particular job and voluntary examinations that are part of employee health programs.

Confidentiality

Information from all medical examinations and inquiries must be kept apart from general personnel files as a separate, confidential medical record, available only under limited conditions specified in the ADA. (See 6.5 below.)

Drug Testing

• Tests for illegal use of drugs are not medical examinations under the ADA and are not subject to the restrictions on such examinations. (See Chapter VIII.)