Labor and Employment Corner - The Americans with Disabilities Act and Medical Examinations - Employer Tests Under the ADA

Sep 18, 2026

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Labor and Employment Corner examines how the Americans with Disabilities Act (ADA) limits employers from requiring medical examinations or making disability inquiries. It explains the ADA’s definition of a medical examination and summarizes Equal Employment Opportunity Commission guidance for identifying whether a test or procedure is medical. The discussion distinguishes healthcare-administered or physiologically measuring tests from non-medical assessments, then applies the framework through the Indergard v. Georgia-Pacific case involving physical capacity evaluations.

LanguageEnglish

CategoryHealthcare

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Labor and Employment Corner

ADA limits on medical exams and disability inquiries

Definition of a medical examination under the ADA

EEOC factors and examples of medical examinations

Tests generally not considered medical examinations

Practical examples and case application

Labor and Employment Corner MichAEl NEwMAN AND FAiTh isEN hATh The Americans with Disabilities Act and Medical Examinations The Americans with Disabilities Act (ADA) an employer’s ability to make inquiries applicants’ and employees’ disabilities or limits about to re- quire them to have medical examinations. The ADA states, in relevant part, “[a] covered entity shall not require a medical examination and shall not make inquiries of an employee as to whether such employee is an individual with a disability … unless such examination or inquiry is shown to be job-related and con sistent with business necessity.”1 This month’s column provides an overview of when an employer’s tests or procedures constitute a medical examination under the ADA. The ADA defines a medical examination as a“procedure or test that seeks information about an individual’s physical or mental impairments or health.”2 The Equal Employment Opportunity Commission (EEOC) provides guidance on how to determine whether a test or procedure is a medical examination. Medical examinations include, but are not limited to, any one of the following factors or combination of factors: • whether the test is administered by a healthcare professional; • whether the test is interpreted by a healthcare professional; • whether the test is designed to reveal an impairment or the condition of one’s physical or mental health; • whether the test is invasive; • whether the test measures an employee’s performance of a task or measures his or her physiological responses to performing the task; • whether the test normally is given in a medical setting; and • whether medical equipment is used to perform the test. The EEOC also provides a list of examples of medical examinations: • vision tests conducted and analyzed by an ophthalmologist or optometrist; • blood, urine, and breath analyses to check for alcohol use; • blood, urine, saliva, and hair analyses to detect disease or genetic marks (for example, to check for conditions such as sickle cell trait and breast cancer); • blood pressure screening and cholesterol testing; • nerve conduction tests (for example, tests that screen for possible nerve damage and susceptibility to injury, such as carpal tunnel syndrome); • range-of-motion tests that measure muscle strength and motor function; • pulmonary function tests (for example, tests that measure the capacity of the lungs to hold air and to move air in and out); • psychological tests that are designed to identify a mental disorder or impairment; and • diagnostic procedures such as X-rays, computerized axial tomography (CAT) scans, and magnetic resonance imaging (MRI) . In addition, the EEOC lists a number of proceduresand tests that employers may require and are generally not considered a medical examination: • tests to determine current use of illegal drugs; • physical agility tests, which measure an employee’s ability to perform actual or simulated job tasks, and physical fitness tests, which measure an employee’s performance of physical tasks, such as running or lifting, as long as these tests do not include examinations that could be considered medical (for example, measuring heart rate or blood pressure); • tests that evaluate an employee’s ability to read labels or distinguish objects as part of a demonstration of the ability to perform actual job functions; • psychological tests that measure personality traits such as honesty, preferences, and habits; and • polygraph examinations. Determining whether a test or procedure is a medical examination is an important inquiry for employers. For example, if an employer requires a job applicant to lift a 30-pound box and carry it 20 feet, that analysis is not a medical examination; instead, it is a test designed to determine whether the applicant can perform a particular task. However, if the employer takes the applicant’s blood pressure or heart rate after such lifting and carr

FAQs

What does the ADA generally prohibit regarding medical examinations and disability inquiries?

The ADA generally bars a covered entity from requiring a medical examination or asking whether an employee is an individual with a disability, unless the examination or inquiry is job-related and consistent with business necessity.

How does the ADA define a medical examination?

A medical examination is defined as a procedure or test that seeks information about an individual’s physical or mental impairments or health.

What kinds of employer tests are often considered medical examinations under EEOC guidance?

Medical examinations can include tests administered or interpreted by healthcare professionals, tests designed to reveal impairments or health conditions, invasive tests, and tests using medical equipment, including many diagnostic procedures like X-rays and MRI.

How did Indergard v. Georgia-Pacific apply the medical examination analysis?

In Indergard, the Ninth Circuit analyzed whether a physical capacity evaluation required before returning from medical leave functioned as a medical examination, focusing on what the occupational therapist recorded and measured during the evaluation process.

Sep 18, 2026

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