Assessing Fitness-for-Duty in a Medical Framework

Blink, MD, MPH, Robert C.
(American College of Occupational and Environmental Medicine, Member; Western Occupational and Environmental Medicine Association, Member)

Safety professionals are often called upon to help determine an employee’s fitness-for-duty due to concerns about medical or psychological fitness. These concerns may arise in a variety of circumstances and contexts. The purpose of a fitness-for-duty evaluation is to assess whether an employee has the physical, mental and emotional capacity to perform assigned tasks competently and in a manner that does not unreasonably threaten safety, health, or property. An employer has not only the right but often the duty to conduct a fitness-for-duty evaluation if there is a reasonable belief that an employee is impaired and cannot perform the job safely and effectively. An integrated medical perspective frames this manuscript to provide guidance on how to walk the tightrope of balancing the employee’s and employer’s interests (and, at times, those of the public) when conducting a fitness-for-duty evaluation. An employer has a legal obligation to mitigate unreasonable health and safety risks posed by an unfit worker. At best, impaired workers can disrupt work processes, burden co-workers and drain productivity. At worst, an impaired employee can become a threat to his/her own safety, or to that of co-workers and/or the public. Regardless of the cause of impairment – which may include disease, injury, prescription medication usage, mental health disorders, substance abuse, or family issues – fitness-for-duty evaluations must be conducted using an approach that balances the privacy interests of the employee with the employer’s goal of ensuring the safety of co-workers and the public. Using real-life examples, participants will learn how impaired workers impact safety, methods of identification, and strategies for effectively dealing with this problem.

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