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Q&A: Medical Examinations During Employment

Hands typing on a laptop with stethoscope beside the computer.

TASB HR Services addresses questions concerning an organization’s ability to require an employee to undergo a medical evaluation to determine whether the employee has an impairment that interferes with their ability to perform required job duties.

Q: Can an organization require an employee to obtain a medical examination for business necessity?

A: Yes. As stated in Policy DBB (LEGAL), the organization may require an employee to obtain a medical examination that is job-related and consistent with business necessity. The organization must ensure the employee can perform job-related functions safely and appropriately when there is a suspicion of an impairment affecting the employee’s ability to do their job.

In accordance with Policy DBB (LOCAL), an employee may be required to undergo a medical examination if information received from the employee, the employee’s supervisor, or other sources indicates the employee has a physical or mental impairment that interferes with the employee’s ability to perform essential job functions or poses a direct threat to the health or safety of the employee or others. A communicable or other infectious disease may be considered a direct threat.

The employee may be placed on leave to visit their physician to obtain the examination and remain on leave pending the results. If the organization chooses to designate the physician for the evaluation, they shall pay the cost of the examination.

Results should be evaluated to determine if the employee has a physical or mental impairment. If an impairment is present and interferes with the employee’s ability to perform the essential job functions or imposes a direct threat to the employee or others, the organization will need to take appropriate action. If the superintendent, president, or designee determines the impairment does not impact job functions and does not pose a direct threat, the employee may be reinstated back to their position.

Q: What if the organization determines the employee has a physical or mental impairment based on the medical evaluation?

A: Following Policy DBB (LOCAL), if the impairment interferes with the employee’s ability to perform essential job functions or poses a direct threat for the employee or others, the superintendent, president, or designee should determine if the employee has disability that requires reasonable accommodation in accordance with the Americans with Disabilities Act (ADA). If the employee has a disability that can be accommodated, additional unpaid leave may be a reasonable accommodation under the ADA. Depending on the circumstance, next steps should follow local leave policy or the ADA interactive accommodation process.

Regardless of the outcome, the organization should ensure ongoing communication is occurring with the employee and key personnel, including the leave coordinator and employee’s supervisor. It is important for the organization to notify the employee of their rights and ensure confidentiality throughout the process.

Q: What paperwork or form should the employee provide to their physician?

A: There isn’t a specific form designed for this type of medical visit. Using the Family Medical Leave Act (FMLA) medical certification or ADA Medical Information Request Form may be premature at this point but would be used if the examination results in a leave of absence or a work accommodation. Sending the employee with an updated job description and a letter requesting a review of the employee’s ability to perform the essential job functions would be the best approach. Failing to provide any type of correspondence from the organization may fail to result in enough information to develop a plan of action moving forward.  

For more information about medical examinations during employment, refer to board Policy DBB (LEGAL) and (LOCAL). The HR Library (member login required) is also a valuable source of information for leaves, employment laws, and the accommodation process under the ADA.


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Jennifer Barton
Jennifer Barton
Senior HR and Compensation Consultant

Jennifer Barton joined HR Services in 2018. She assists with compensation planning and development, staffing reviews, training, and other HR projects. Prior to joining TASB, Barton served for 19 years in Texas public schools as a principal, assistant principal, teacher, and coach.

Barton earned master’s degrees in education and educational leadership from The University of Texas at Austin and Lamar University. She holds a Texas superintendent certificate and is a SHRM-CP.

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TASB HR Services supports HR leadership in Texas schools through membership offerings in specialized training, consulting, and other services.
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