Pre-employment medical tests

When is it appropriate to use medical tests?

Many employers routinely use pre-employment medical tests as part of their selection process.
These tests can be a useful component of the selection process for jobs that require certain
physical or mental attributes.

Physical tests are relevant to jobs involving physical activity. It is less likely that sedentary jobs
will require physical attributes that would justify medical testing.

Where it is necessary to test for specific attributes it is best to only test people who meet all the
other requirements of the job. This is not a legal requirement but it is more cost effective and
protects employers from allegations of discrimination on the ground of disability.

For jobs with legitimate physical requirements it may be useful to establish regular medical testing
of employees to ensure they continue to meet the requirements and are not at risk of injury. It is
important that all employees in this type of job are tested and that age is not a factor in
determining who is tested.

It is vital that a pre-employment medical test relates exclusively and directly to the particular
duties of the job and does not discriminate against people with disabilities. Employers could be
liable for discrimination if they misuse pre-employment medical tests.

Some other examples of misuse of medical information that could make employers liable for
discrimination include:
using medical information about applicants as part of the pre-interview culling process
asking applicants questions at interview about past injuries such as, back injuries and
repetitive strain injury or previous workers' compensation claims as part of the selection
process.

An employer also could be liable under privacy laws if they disclose results of a medical test to
others eg. other employees.
What are the main features of a non-discriminatory medical test?
The main features of a non-discriminatory pre-employment medical test are:
the medical test relates specifically to the particular duties and responsibilities of the job
the specific physical attributes required for the job are accurately identified
the attributes required for the job are reasonable in all the circumstances
ways of accommodating people without these attributes have been considered
any facilities or services required by applicants with disabilities are provided if it does not
cause unjustifiable hardship to do so
any assessment of a person's ability to perform the inherent requirements of the job is
made after these facilities or services have been provided
the test only assesses current ability and does not attempt to predict any future
deterioration. (The pre-employment medical assessment however, can be used at a later
stage to determine any health deterioration, eg. to determine hearing loss in relation to an
industrial deafness claim).

Designing a pre-employment medical test requires a thorough analysis of what the job entails and
a careful matching of medical tests to assess the required physical attributes. This task requires a
high level of expertise.

Developing a pre-employment medical test
When developing a pre-employment medical test employers should:
remove any blanket employment policy concerning disabilities unless they can be
objectively justified as reasonable in all the circumstances.
analyse the requirements of the job and identify which are the essential requirements and
which are the non-essential requirements

It is important to regularly reassess the requirements of the job to take account of any changes to
the job or the way the job is done as changes may affect the type of skills and attributes required
for the job.

Identify the skills of the job:
clarify and separate out those skills relating to the essential duties from those that relate
to the non-essential duties
identify the type and level of attributes required to perform the essential duties of the job
identify the attributes required to perform the non-essential duties of the job
investigate whether there are other ways the job can be performed or designed so that
people without these attributes can perform the job, particularly the essential duties
identify the types of services or facilities that could be used to assist people with
disabilities to carry out the job
identify appropriate/relevant tests for assessing the required attributes.

Using the medical test
Points employers need to consider include:
ensure the medical officer conducting the pre-employment medical is aware of the anti-
discrimination laws and understands that the test must relate to the specific job
requirements
ensure that any applicants with a disability are tested using any service or facility they
routinely use to perform the essential duties of the job. For example, if an applicant uses
a hearing aid be sure the aid is used during the assessment and that an applicant takes
their usual medication
remember that for applicants with a disability, only the attributes relating to the essential
duties of the job can form part of the assessment
ensure that medical tests are not used to screen out applicants with certain past injuries
or disabilities or those who have a family history of certain illness or disabilities as current
ability is the only relevant factor
ensure that medical tests are not used to screen out applicants with past workers'
compensation claims or those considered at risk of making workers compensation claims
in the future as current ability is the only relevant factor
keep all medical records confidential.

Medical tests for determining eligibility to join a superannuation fund are not relevant at the pre-
employment stage. These tests are more appropriately carried out after the applicant has
accepted the offer of the position. Such tests can not be used for other purposes and should not
affect the person's eligibility for employment.

Why is the design and application of the medical test so important?
The importance of having non-discriminatory pre-employment medical tests that are clearly
relevant to the specific requirements of the job is highlighted in the recent decision by the Equal
Opportunity Tribunal in the case of Hurley v The Electricity Commission of NSW (1994) EOT 92-
624.

In this case Mr Hurley applied for and was rejected for cleaner/labourer positions on three
separate occasions. According to two of the pre-employment medical assessments he did not
meet the level of fitness set by the Commission due to his hypertension.

The Tribunal was not satisfied that the Commission's assessment of the complainant's inability to
do the work was based on any real evidence.

The examining doctor had decided that the complainant did not meet the Commission's standard
of fitness for the position because he was hypertensive. The doctor did not consider Mr Hurley's
capacity to carry out the inherent duties.

The Tribunal found that the complainant's hypertension was insufficient reason to assume that he
would be unable to carry out the full duties of the position without a serious risk to his health.

Compiled by:

Mahesh K Prasad
Head- Human Resources