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Introduction
Title I of the Americans with Disabilities Act (ADA) limits an employer's ability to make disability-related inquiries or to require medical exams at three stages of employment: pre-job offer, post-job offer, and during employment. The following discusses when employers can ask disability-related questions or require medical exams and provide guidance regarding the scope of medical inquiries and exams.
General Rules
The following are the general rules for each stage of employment. There are exceptions to these general rules that can be found in the related publications.
Stage 1: Job Applicants
General rule: Employers cannot ask medical questions or require medical exams at this stage.
- For more information, see Preemployment Disability-Related Inquiries and Medical Exams (EEOC Guidance)
Stage 2: Job Offer Made, Hasn’t Started Working
General rule: Employers can ask any medical questions or require any medical exams they choose as long as all entering employees in the same job category are subjected to the same questions or exams, regardless of disability and the medical information obtained is kept confidential. Medical questions and examinations do not have to be job related and consistent with business necessity at the post-offer, preemployment stage.
- For more information, see Preemployment Disability-Related Inquiries and Medical Exams (EEOC Guidance)
Stage 3: Employees
General rule: Disability-related inquiries and examinations of employees must be "job-related and consistent with business necessity.” A medical inquiry or examination is job-related and consistent with business necessity when:
1. an employer has a reasonable belief, based on objective evidence, that an employee's ability to perform essential job functions will be impaired by a medical condition, or
2. an employer has a reasonable belief, based on objective evidence, that an employee will pose a direct threat due to a medical condition, or
3. an employee asks for a reasonable accommodation and the employee's disability or need for accommodation is not known or obvious, or
4. required in positions that affect public safety, such as police and fire fighters.
- For more information, see Disability-Related Inquiries and Medical Exams of Employees (EEOC Guidance)
Frequently Asked Questions and JAN Resources
Employers
Question: What medical documentation can employers request when employees ask for accommodations?
- A Flexible Approach to ADA Medical Documentation
- Medical Inquiry in Response to an Accommodation Request and Sample Form
- Requests for Medical Documentation and the ADA
- To Ask, or Not to Ask? – Knowing When to Request Medical Information
Question: Are there standard forms employers should use when requesting medical documentation and if not, is it okay to use sample forms to create standard, in-house forms?
Question: Does HIPAA limit an employer’s right to request medical documentation under the ADA?
Question: What healthcare professionals can provide medical documentation to support an employee’s accommodation request?
Question: Can employers ask for medical information when employees with disabilities request flexible work arrangements?
Question: What steps can employers take to help ensure that employees provide medical documentation in a timely manner?
Question: Can employers ask employees whether they need accommodations?
Question: Can employers periodically ask for new medical documentation to support a long-term accommodation?
Question: Can employers ask whether a job applicant has a disability for affirmative action or when giving hiring preference to applicants with certain types of disabilities?
- Affirmative Action and Disability: What Can Employers Ask?
- Giving Hiring Preference to People with Disabilities
Healthcare Providers
Question: What type of information can be provided to support a patient’s accommodation request?
Individuals with Disabilities
Question: When are employers allowed to ask medical questions or require medical exams?
Question: What can employees do if they think their employer is asking for too much medical information?
Question: Do employers have to keep employee medical information confidential?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
JAN Publications & Articles regarding Medical Exams and Inquiries
Publications
Consultants' Corner Articles
Articles
- HIPAA and Consent to Obtain Medical Information for ADA Purposes
- Medical Documentation: Think about What is Needed and Stop There!
- Mother May I? Must I? Should I?
- Requests For Medical Documentation and the ADA
- Return to Work After Hospitalization for Mental Health Treatment
- The Use of Sample Forms under the ADA
- To Ask, or Not to Ask? – Knowing When to Request Medical Information
- What Does "Sufficient" Mean? - A Deconstructive Series for ADA Terminology
- Who Can Provide Medical Documentation for ADA Purposes?
- Workplace Flexibility, the ADA, and Requesting Medical Information