Employee Struggling Physically or Acting Strangely? Fitness-For-Duty Exams Are Defensible if You Follow the Legal Standard
The Americans with Disabilities Act (ADA) prohibits employers from making disability inquiries or requiring employees to undergo medical examinations unless they show the inquiry or examination to be job-related and consistent with business necessity. In a recent case, Nawara v. Cook County, 132 F. 4th 1031 (7th Cir. 2025), the Court of Appeals for the Seventh Circuit underlined that an illegal inquiry or examination counts as discrimination under the ADA. The court also rejected the employer’s arguments against recovery of lost wages. This warrants a refresher on when employers can legally inquire with their employees about their medical condition and require fitness-for-duty exams.
As one court put it, “An employer is generally allowed to use fitness-for-duty exams to determine whether an employee can safely do the job.” Still, an exam that is not job-related and consistent with business necessity violates the ADA. What does “job-related and consistent with business necessity” mean? This standard requires that an employer reasonably believe, based on objective evidence, that the employee’s medical condition will impair their ability to perform essential job functions or that they will pose a threat due to a medical condition. Courts hold that meeting this standard requires more than mere business expediency or convenience.
The ADA does not define permissible causes for concern. When analyzing these cases, courts have held that an employee’s physical violence, or other disruptive or worrisome behaviors can justify a fitness-for duty exam. Similarly, an employee’s inability to perform express job functions is likely sufficient, as may observed interpersonal hostility. Courts have noted that “an employee’s ability to handle reasonably necessary stress and work reasonably well with others are essential functions of any position.”
Critically, however, an employer’s concern must be legitimate. The concern must be more than mere annoyance or inefficiency. Complaints or reports by coworkers or management’s own observations about the employee’s unsafe or aggressive conduct or instability can serve as evidence of legitimate concern, particularly when the safety of co-workers or others with whom the employee interacts is at stake. If the employee’s job is safety-sensitive, such that harm could come to the employee or others if not performed properly, courts tend to view subjecting the employee to a fitness-for-duty exam as reasonable and justified when the employee does not appear physically or mentally well enough to work.
Where can liability arise, then? If the employer’s inquiries go far beyond the employer’s cause for concern, or if circumstances show the employer acted in bad faith (perhaps in the form of unfounded accusations, intent to sabotage, or the like), the employee will possess a valid claim that the employer violated the ADA. If the employer singles out the employee, such as by sending them for an examination but not others outside the protected class who engaged in behavior of the same nature and extent, the court may conclude the employer was not genuinely or reasonably concerned regarding the employee’s ability to safely perform assigned duties. If the exam probes topics beyond what purportedly concerned the employer, or is ordered without explanation, a court may doubt that the exam is job-related or necessary, and may even conclude that some form of illegal discrimination is afoot.
Employers should keep in mind that an employee need not be disabled to make a claim that the employer subjected them to an unlawful medical inquiry. This provision of the ADA applies to all employees, with or without an actual or perceived disability. In other words, unlike for other ADA provisions, the employee need not be a qualified individual with a disability in order to recover damages caused by the inquiry.
To summarize, when employees’ mental and physical medical conditions affect their ability to safely and effectively perform their jobs or pose a threat to the employee or others, employers may seek a fitness-for-duty exam and associated medical inquiries. Employers must take care, however, not to impose these tools impulsively or reflexively. The key is to back up the decision with objective evidence of safety concerns, avoid delving more deeply than called for by the circumstances, and, as always, aim for consistent treatment of similarly situated employees. Consulting with counsel about the employee’s condition and the employer’s concerns may be helpful before taking action.
Source(s):
Employee Struggling Physically or Acting Strangely? Fitness-For-Duty Exams Are Defensible if You Follow the Legal Standard | JD Supra. (2026). JD Supra. https://www.jdsupra.com/legalnews/employee-struggling-physically-or-8031761/