What is a pre-employment physical exam?

A pre-employment physical exam is a medical assessment conducted by an employer to evaluate a prospective employee’s health and fitness for a specific job. The primary purpose is to ensure that people in specific roles can perform their tasks safely and effectively while also identifying any potential health concerns that may affect their ability to work in the future. 

Additionally, these exams help employers comply with occupational health regulations and reduce workplace injuries and associated liabilities. Many positions require these exams by law under OHS or DOT regulations, so it’s essential that employers and HR managers gain a solid understanding. 

This guide will provide all you need to know about implementing pre-employment physical exams at your workplace so you can maintain regulatory compliance and ensure your new employees are healthy and able to perform their duties effectively.

Types of pre-employment physical exams

Pre-employment physicals can be categorized generally as exams for physically demanding jobs, for jobs with specific health requirements, and for jobs involving hazardous materials. 

There is a wide range of positions that may require you to administer pre-employment physicals to candidates, depending on the nature of the job and specific industry standards. The following exam types target specific roles and capabilities. All of them can help you ensure your candidates are fit for their roles, thereby promoting safety and efficiency in your workplace.

• DOT (Department of Transportation) physicals: Required for commercial drivers, these exams ensure that candidates meet the health standards set by the DOT, focusing on vision, hearing, and overall physical condition.
• Drug screening tests: Many employers choose (or are required) to conduct drug tests to ensure their employees are not using illegal substances, which is particularly important in safety-sensitive or high-liability positions.
• Firefighter/Police physicals: These are designed for candidates applying to emergency services, focusing on physical fitness and health standards relevant to the job.
• Immigration physicals: Required for certain visa applications, these exams ensure that individuals meet health requirements set by immigration authorities.

Note that these pre-employment physicals can be similar or identical to the regular periodic health exams that your current employees take for ongoing compliance.

What activities does a pre-employment physical exam include?

The exams typically include a review of the candidate’s medical history, various physical examinations, and possibly drug testing. The following is a more detailed list of possible testing activities:

• Vital signs assessment: This includes measuring height, weight, blood pressure, and heart rate and evaluating the cardiovascular, respiratory, and musculoskeletal systems.
• Medical history review: Candidates will need to provide a comprehensive documentation of previous illnesses, surgeries, medications, and any chronic health issues.
• Vision and hearing tests: Many positions necessitate good situational awareness; therefore, candidates may need to demonstrate their visual and auditory capabilities.
• Lab tests: Depending on industry regulations, state laws, and your organization’s policies, job candidates may be required to undergo drug screenings or blood tests to detect certain health conditions. 
• Physical fitness tests: Candidates may need to demonstrate a variety of capabilities relevant to a job’s physical demands, including:
  • Strength tests to simulate job tasks, such as measuring hand grip strength, pushing or pulling resistance, and lifting and carrying objects of various weights over a distance
  • Cardiovascular endurance assessments, such as a treadmill test or step test to evaluate ability to sustain physical activity
  • Range of motion exercises to assess flexibility and joint movement, and functional movement tests such as bending, reaching, and squatting
  • Balance and coordination tests that may involve standing on one leg or performing other agility tasks

Note that while the pre-employment exam can include the above physical fitness tests, it is not the same as the functional capacity evaluation (FCE). The FCE is a more thorough assessment of an individual’s physical abilities taken over several hours. Learn more about FCEs here. 

How long does a pre-employment physical take?

Basic occupational health or DOT pre-employment physical exams take from 30 to 45 minutes. However, if the candidate is required to undergo physical ability and stamina tests, it may extend the total time to one hour or more. Also, if the candidate has a complex medical history, the time spent reviewing it can increase the overall duration.

It’s important to communicate to your candidates the possibility of the appointment going longer than expected. 

Why are pre-employment physical exams important for employers?

Beyond promoting workplace safety and satisfying your regulatory obligations, pre-employment physicals can play a vital role in enhancing productivity and reducing long-term costs.

The productivity gains are obvious, since healthy employees typically have more energy, are more engaged in their work, and call in sick less often. Additionally, the results of the physical exams make it easier to place employees in roles that match their capabilities, leading to improved performance and job satisfaction.

Cost reductions include those for healthcare, since pre-employment physicals will identify potential health issues early, enabling less-expensive proactive treatment. If workplace injuries are a risk factor at your operations, monitoring physical fitness will reduce the likelihood of accidents related to physical tasks and endurance. This, in turn, reduces expensive workers’ compensation claims and absenteeism due to health issues.

Assessing the health of your workforce also empowers you to make better hiring decisions and enjoy lower turnover rates. Test results provide crucial information that help you choose the best candidates, particularly for physically demanding roles. And, by ensuring that the right candidates are in the right roles, you can reduce turnover and the associated costs of hiring and training new employees.

Finally, implementing pre-employment physicals can generate reputation benefits for your organization, because you are publicly indicating that you foster a safety-oriented workplace culture. Current and future employees will recognize your commitment to a safe and healthy environment and be more inclined to prioritize safety and take responsibility for their health. 

What to expect during a pre-employment physical exam

Many job applicants will feel anxiety about a mandatory physical exam. As the employer, it’s imperative that you allay these concerns by being able to answer the question: What does a pre-employment physical consist of?

The steps in a typical pre-employment physical exam include the following:

At the end of the exam, the candidate will receive documentation of their exam results, which may be required for their employment paperwork. 

Compliance considerations for employers

When implementing pre-employment physical exams in accordance with OHS or DOT regulations, compliance is crucial. You should have a solid understanding of the legal requirements governing these exams, which will help you navigate the regulations effectively. The three main concerns here are privacy, inclusivity, and recordkeeping. 

First, it is essential to safeguard the privacy of the candidate’s health information throughout the exam process, in accordance with applicable laws. You are also legally required to accommodate individuals with disabilities or pre-existing conditions, ensuring that all candidates can participate fully. Finally, maintaining accurate records for all your employees’ physical exams is vital for ongoing compliance and to monitor the health and safety of your workforce over time. 

What reasons would cause someone to fail a pre-employment physical?

A candidate might fail their physical for a variety of reasons, depending on the requirements of the job and the standards set by you as the employer and/or your compliance obligations. Here is a list of typical potentially disqualifying factors:

Medical diagnoses

• Chronic ailments such as diabetes, obesity, hypertension, or heart disease
• Certain communicable diseases, especially in relation to roles in the healthcare, transport, or food service sectors

Physical limitations

• Mobility issues, reduced endurance, or a lack of physical strength that prevents the candidate from performing essential functions
• Deficiencies in vision or hearing that are critical for job safety and performance

Psychological factors

• Mental health conditions that affect the candidate’s ability to perform job functions safely and effectively, such as anxiety or depression
• Drug tests that indicate use of prohibited substances or misuse of prescription medications

Noncompliance

• Failure to appear, inadequate preparation, or failure to submit required medical records
• Failure to follow exam instructions (e.g., refusing to perform an activity or fast before a blood test)

How to prepare employees for pre-employment physical exams

To prepare your candidates for their pre-employment physical, it is essential to communicate the purpose and expectations of the exam and ensure candidates have the required forms and documentation well in advance. As mentioned above, the candidates must be ready to answer the examiner’s questions and address their concerns to help alleviate their anxiety about the process.

It is also important to inform new hires about the potential for future periodic physical exams, so they understand the culture of health and safety at your workplace.

Here’s a checklist to use for ensuring your employment physicals are delivered efficiently and transparently:

• Establish your policies

Develop comprehensive SOPs outlining the purpose of your pre-employment physical exams, including the types of tests that you will conduct and the criteria for evaluations. Ensure that the policy complies with relevant laws and regulations.

• Choose qualified medical providers

Partner with certified medical professionals or clinics experienced in conducting pre-employment physical exams. Verify their credentials and ensure they understand the specific requirements of your industry.

• Communicate with your candidates

Inform job applicants about the exam process during the hiring stage. Create and provide all necessary forms and documentation, including medical history questionnaires, consent forms, and any specific tests required.

• Schedule exams efficiently

Set up an exam schedule that accommodates both the candidates and the medical provider. Ensure that candidates are aware of their scheduled times and any preparations they need to make.

• Ensure privacy and confidentiality

Maintain strict confidentiality regarding the medical information gathered during the exams. Ensure that results are securely stored and only accessible to authorized personnel.

• Plan for ongoing physicals

Consider implementing a plan for periodic physical assessments for your employees, especially for roles that require physical fitness and health monitoring.

By following these steps, you can ensure that your pre-employment physical exam process is efficient, transparent, and compliant with legal standards. This will ultimately lead to better hiring decisions and a healthier, more productive workforce.

A secure and efficient work environment is crucial for any business

Pre-employment physical exams are essential tools for ensuring the health and safety of your workforce. By understanding the types of exams available, what they entail, and how to comply with legal requirements, you can create a safer and more productive workplace while minimizing potential health risks and liabilities. 

Since various factors are at play, it can be helpful to consult with legal counsel and industry experts to select the most appropriate pre-employment physical exams for your needs.

For more information about 3bExam and how we can help, schedule a free demo. As the leading innovator in OSHA and DOT exam management across the United States, we’ll take the guesswork out of assessing your employees’ physical capabilities.