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Medical Exams and Inquiries

Accommodation and Compliance: Medical Exams and Inquiries

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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.

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.

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.

Frequently Asked Questions and JAN Resources


Question: What medical documentation can employers request when employees ask for accommodations?

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?

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.

Events Regarding Medical Exams and Inquiries