How To Prepare For A Pre-Employment Physical (With Examples)

By Chris Kolmar
Jul. 5, 2022

Find a Job You Really Want In

When you receive a job offer, it marks the end of the effort you put into finding, applying for, and interviewing for positions. However, there is a good chance there are a few more hoops you have to jump through before everything is finalized, including a pre-employment physical.

In this article, we’ll provide you with an overview of what these physical exams typically entail, as well as what companies shouldn’t be asking you to do.

Key Takeaways

  • Pre-employment physicals are often very similar to your annual physical examination or checkup.

  • Your employer may want you to complete a few tests in addition to your physical, such as physical ability tests, drug and alcohol tests, psychological tests, or human performance evaluations.

  • Your employer is legally not allowed to ask you to take a physical exam before they give you a job offer.

  • You can lose a job offer based on the results of your physical examinations, but there are strict guidelines in place to protect you from discrimination that employers must follow.

How to Prepare for a Pre-Employment Physical

What Is a Pre-Employment Physical?

A pre-employment physical is a physical medical exam that an employer requires you to take before your employment can be finalized. This is a common step in the hiring process, especially for positions that require some kind of physical exertion.

Companies want to make sure that you’ll be able to fulfill the physical and mental responsibilities of the role they’re hiring you for without putting yourself or anyone else in danger.

How to Prepare for Your Pre-Employment Physical

While you can’t change your health overnight, there are a few ways to prep yourself for a physical.

Be sure to gather:

  • A list of medications, medical conditions, allergies, and past surgeries

  • A valid form of ID, such as a state ID, passport, or driver’s license

  • Aids you might need, such as hearing aids and glasses

  • Any paperwork your employer has given you detailing the services and lab orders they need

  • Loose, comfortable clothing

It’s also a good idea to read up on your future employer’s expectations for your physical abilities as it relates to your particular role and what tests they’re planning to have you complete. You can often find this information in your job offer documents or by asking the HR representative who has been working with you.

Doing a little research such as reading this article is also a good way to prepare, as it will help you know what to expect from each type of test and what your legal rights are so you can fight back with confidence if something isn’t above board.

Types of Physical Tests

The standard pre-employment physical is usually similar to your annual checkup. Your doctor will check your heart rate, blood pressure, and temperature and visually examine you for any signs of anything that might be awry. They may also take bloodwork to test the levels of iron, cholesterol, and vitamins in your system.

Many employers may require additional tests as well, however, depending on the nature of the job. These include:

  1. Physical Ability Tests

    Physical fitness tests may cover a candidate’s ability to perform specific tasks, as well as their overall fitness and stamina.

    Example requirements and commonly tested factors include:

    • Stamina, strength, and flexibility

    • Ability to lift a certain amount of weight

    • Muscular tension, endurance, and cardiovascular health

    • Balance and mental fortitude while performing physical labor

    Physical tests are commonly the subject of contention in employment-related legal battles.

    Individuals with disabilities or health conditions are entitled to certain accommodations during physical tests. Health conditions such as high blood pressure, heart issues, and asthma are covered differently under the ADA.

    Minorities, senior citizens, and women are also commonly held to uneven and illegal testing standards.

    Under unfair conditions, employers may be held liable for any physical injuries resulting from examinations.

    Consider some of the following ADA-cited requirements for employers conducting physical ability exams:

    • Any physical fitness or agility tests must only test for items required to perform the essential duties of the job.

    • The initial job description must contain the essential job duties for which physical exams are testing.

      If the position doesn’t have a job description, the applicant must be made aware of the physical requirements before applying.

    • Only physical abilities may be tested. Tests should not be administered to check for physiological responses.

    • All test results must be made confidential. Records must be kept separate from other employment-related records.

    • The location where tests are held must be accessible. Candidates with disabilities must be given reasonable accommodation to enable them to take the test.

    Employers should keep in mind that they’re testing a candidate’s abilities to perform the job, not their abilities to take the test.

    For example, a test for a job that does not require the ability to hear must provide a sign language interpreter if a candidate is deaf.

    However, if the job does require the ability to hear, the employer is not expected to have to employ an interpreter at all times.

  2. Alcohol and Drug Tests

    Drug tests are commonly required prior to employment, as well as during random intervals after employment.

    Companies may require drug tests to improve productivity, reduce absenteeism, and protect themselves from liability.

    These tests can take a variety of forms, such as:

    • Sweat drug screening

    • Drug and alcohol testing

    • Saliva drug testing

    • Urine drug testing

    However, there are many legal hazards set by the ADA that employers must avoid.

    Pre-Offer Alcohol and Drug Testing

    The ADA strictly prohibits companies from requiring drug and alcohol tests before extending a job offer.

    Although employers are technically allowed to ask applicants whether they drink alcohol, there are certain pieces of illicit information they’re not allowed to know.

    The rules pertaining to what constitutes illicit information are complicated. For these reasons, employers are better off avoiding the topic of alcohol entirely at this stage.

    Post-Offer Alcohol and Drug Testing
    Job offers are allowed to contain conditions relating to alcohol and drug usage, as well as require tests. However, there are legal hazards at this stage as well.

    Any requirements and testing regarding drugs and alcohol must apply to all applicants who receive job offers in the same job category. Employers must also have reasons for requiring these tests that are “job-related and consistent with business necessity.”

    For example, an executive assistant who spends the workday at their desk should not be required to be able to lift heavy weights.

    If a job offer is revoked due to the results of an alcohol test, employers must be able to prove one of the following objectively:

    • The applicant was unable to perform the essential functions of the job due to their alcohol test results.

    • The applicant posed a direct threat (a significant risk of substantial harm) to themselves or others based on the alcohol test results. Additionally, the threat could not be eliminated or reduced by any reasonable accommodations.

  3. Psychological Tests

    Some jobs can be physically demanding, but even more so, they can be psychologically taxing. For this reason, pre-employment exams may also include a psychological element.

    These tests may be simple, such as an online Myer-Briggs survey to establish an applicant’s personality profile.

    Others may be conducted by a psychologist in person. Employees are often asked questions about their history of depression or mood fluctuations.

    Consider the following tips for how to behave during a pre-employment psychological screening:

    • Don’t expect the worst. The psychologist’s job is not to judge you for your personality flaws. These tests are usually just standard procedure to screen out candidates who are clearly not suited for the job.

    • Be honest. There’s no benefit in lying or trying to hide anything. It’s best to find out sooner rather than later if a position is suitable for you.

    • Ask questions. Don’t be afraid to speak up if you don’t understand how to answer a question posed by an evaluator or on a written test. They’ll gladly answer any reasonable question that they’re allowed to.

  4. Human Performance Evaluations

    In addition to pre-employment physicals, some employers will conduct human performance evaluations (HPEs). Both are designed to assess an employee’s capabilities, but there are a few differences.

    • Assessor. During a physical exam, you’re being assessed by one or more licensed healthcare professionals. During an HPE, your assessor will usually be a licensed therapist. However, both the medical professional(s) and therapist(s) are trying to do the same thing — determine whether you can meet the needs of the role.

    • Tasks vs. tests. While a pre-employment physical is dedicated to, well, mostly physical things, an HPE is about identifying strengths and liabilities for the particular duties of the job. These tests can identify potential trouble areas and make suggestions to an employee’s form. This can help reduce the risk of injury or error once employment begins.

Most rules regarding pre-employment physical exams are covered under the Americans With Disabilities Act (ADA). These rules apply to private companies employing 15 or more people.

They also apply to government agencies and labor organizations.

The ADA disallows employers from requiring a physical examination before extending a job offer. However, they are allowed to require an exam after a conditional job offer is accepted.

These pre-employment examinations typically include a physical exam in addition to inquiries made about your health. These inquiries may consist of psychological tests, drug tests, and mental health examinations.

Employers are also allowed to set fitness and health requirements for a job. This is common for physically demanding roles such as firefighters, construction workers, and police officers.

One crucial factor is that any physical exam required by a company must be given to all applicants for the same type of job.

They must also make “reasonable accommodations” for any candidates with disabilities.

State Pre-Employment Physical Laws

In addition to federal protections employees are entitled to, different states have their own labor laws.

These laws define proper practices relating to pre-employment physical ability tests and factors such as minimum wage.

If you’re an individual seeking employment or a business owner, it’s essential to stay up to date with the laws in your specific state.

For example, Hawaii disallows private and public employers of any size to require employees to submit a genetic test.

If you work in Florida, employers are allowed to request a “follow-up” drug test if you’ve participated in a drug rehabilitation program during the last two years.

The point is that each state has their own laws surrounding pre-employment physicals, so take the time to research your state’s guidelines to understand the finer details.

Failing a Pre-Employment Physical

Contingent job offers may be withdrawn if candidates fail their pre-employment physical test. However, there are several legal requirements:

  • All aspects of the physical test are consistent with the essential duties of the position, or the candidate poses a direct threat to themselves or others’ health and safety.

  • There are no reasonable accommodations that the employer could make to allow the candidate to perform the essential duties.

  • Providing the necessary accommodations would cause the employer undue strain or hardships.

What legally constitutes a “direct threat to health and safety” under the ADA is also strictly defined. In a legal dispute, an employer would be asked to identify the following factors:

  • The duration of the risk

  • The severity and nature of the potential harm

  • The likelihood that potential harm would occur

  • The imminence of potential harm

Employment offers also cannot be legally withdrawn due to speculation of a candidate’s use of benefits or future attendance.

How To Prepare For A Pre-Employment Physical FAQ

  1. What is included in a pre-employment physical exam?

    A pre-employment physical exam may include a drug test, psychological tests, and health exams. What is included in your exam and what is legally allowed can vary by location and the type of job you’re applying for.

    Remember that you cannot be asked to complete a physical exam before you are offered the job. If you’re offered the job, they can then make a physical a contingency for hiring – meaning you can have the job if you take and pass the physical exam.

    Generally, a pre-employment physical will take a health history, and you’ll have a brief visit with a physician or a nurse that covers the basics. Much like a scaled-back doctor’s visit. Expect the following:

    • To be asked questions about your health history and your family health history

    • To be asked many questions about your lifestyle, fitness, and health-related choices

    • To have your weight and height recorded

    • To have your temperature and blood pressure recorded

    • To be screened for drugs and alcohol

    • To have your vision and hearing checked

    Let’s assume that the position you’re applying for requires a certain level of physical fitness. If so, it’s possible that you will be tested on the following:

    • Stamina, strength, and flexibility

    • Ability to lift certain weights

    • Muscular tension, endurance, and cardiovascular health

    • Balance and mental fortitude while performing physical labor

  2. What should I wear to a pre-employment physical?

    Wear comfortable clothes to your pre-employment physical. If you’ve been asked to take a pre-employment physical, you’ve already been offered the job, and there’s no need to dress in your best clothes to make a good impression.

    You’ll actually want to go the opposite route and dress like you normally would for a visit to the doctor. Wear comfortable clothing.

    If you know your pre-employment physical will require some physical exertion, then wearing workout clothing and proper shoes is important. You’ll be told this before the physical so you’ll have time to prepare.

  3. Can an employer require a physical?

    Yes, an employer can require a physical. The key is that you have to have been offered the job before they request the physical. It’s a post-offer, pre-employment situation, and that means you need to pass the physical to actually be hired, but they’re willing to hire you if you do.

    It’s important to note that a drug or alcohol test is not considered part of a medical exam. You’re likely to get one with your medical exam, but because it’s a different classification, a potential employer can require this test outside of the exam and before they offer you any job.

    But because some medications can alter a drug test, most employers wait until post-offer for this so they can get the whole picture.

    Some other rules come into play when a physical is required for a job. It needs to be a requirement for all people who are potentially being offered the job, and if someone has a disability, appropriate accommodations must be made for them to take the physical also.

    Beyond that, your medical record is still confidential and kept separate from other employment records.

  4. Are pre-employment physicals covered by insurance?

    No, your personal insurance probably will not cover a pre-employment physical. But if you’re wondering if you’ll be out any money, the answer is usually no. The employer is typically responsible for covering the costs of any pre-employment screening they require.

    It’s not a bad idea to discuss this with the employer before your physical to make sure it’s covered. It’s also a good idea to call your insurance to see if they have any specific instructions for you.

  5. Can you fail a pre-employment physical?

    Yes, you can fail a pre-employment physical. If a job requires you to perform certain tasks or lift a specific amount of weight and you can’t, you will fail the physical, and the contingent job offer will be redacted. Failing a drug test can also remove you from the list of viable job candidates.

    If you feel that you “failed” because you have a disability and the appropriate accommodations were not made, then you may have a case against the employer according to the Americans with Disabilities Act (ADA).

    This law is set up to provide exactly this sort of discrimination from occurring, and you should talk to an attorney about your next steps.

Final Thoughts

Many Americans are regularly denied job opportunities or incur injuries due to illegal pre-employment physical testing standards. If you’re part of a protected group or have health problems, it’s important to know how the ADA covers you.

The information in this article gives a detailed outline of the legal guidelines but is not comprehensive. Make sure you continue your research to learn more about the specific state and local laws regarding pre-employment physicals.

Just remember that a medical examination isn’t as important as your performance during an interview with a hiring manager or a recruiter. Being able to sell yourself as a cultural fit is often just as important (if not more so) as being physically fit.

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Chris Kolmar

Chris Kolmar is a co-founder of Zippia and the editor-in-chief of the Zippia career advice blog. He has hired over 50 people in his career, been hired five times, and wants to help you land your next job. His research has been featured on the New York Times, Thrillist, VOX, The Atlantic, and a host of local news. More recently, he's been quoted on USA Today, BusinessInsider, and CNBC.

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