Post-Offer Exam

A Post-Offer exam is typically requested by an employer to determine if a medical condition exists that would interfere with the performance of the anticipated work assignment. Typically these requests are limited to employees whose work is safety-sensitive. Safety-sensitive jobs are ones where impaired performance, for whatever reason, could result in a significant incident affecting the health or safety of the employees, coworkers, the public, critical property, or the environment. There are many jobs that can be considered safety-sensitive but most frequently it includes employees who operate machinery including motor vehicles, work in extreme conditions such as heights, or are required to be at optimal mental capacity to minimize the risk of making a catastrophic error. Prior to requesting a Post-Offer exam the employer ought to have a clear understanding of the physical demands of the job and the essential job functions. Generally these exams are done after an offer to hire and any disability identified on exam must be addressed in compliance with the most current version of the American with Disabilities Act Amendments Act (ADAAA).

The Post-Offer exam includes a history and physical intended to identify significant impairments or disabilities that might necessitate work restrictions to address reasonable safety concerns. This includes the risk of injury from exceeding physical capacity. Often a lifting test or screening for cumulative trauma may be included to ensure the employee can perform his or her work without restrictions related to heavy lifting or repetitive work activities respectively. To appropriately structure a Post-Offer exam the medical provider will need a job description including physical demands.

At the conclusion of the evaluation employers are advised to use the medical provider’s recommendations or restrictions as a starting point for engaging the new employee in an ADAAA-compliant discussion regarding accommodation and essential job duties. To minimize the likelihood of hiring an individual who is unable to perform the essential functions of the job it is recommended that prior to offering the position the applicant be asked by the hiring manager to review the job description and anticipated physical demands and advise whether he or she will be able to perform the work and what accommodations, if any, will be needed. Due to the complexity of the ADAAA, employers are advised to consult with a human resources or employment law specialist to ensure they handle offers of employment correctly.

Basic Exam

  • Complete occupational/medical history
  • Vital signs including blood pressure
  • Urine testing
  • Visual acuity
  • Head, eyes, ears, nose, and throat
  • Skin and lymphatic system
  • Respiratory and cardiovascular systems
  • Abdomen & nervous system
  • Musculoskeletal examination

Additional components are often performed in addition to the above in accordance with job duties and/or OSHA requirements.

Additional Screening

  • Lifting test
  • Repetitive motion screening
  • Physical demands screening
  • Spirometry
  • Hearing testing
  • EKG
  • TB Skin Testing
  • Immunizations
  • Drug testing