By Stephen M. Raffle, M.D.

Fitness for Duty examinations are asked for in my practice relatively frequently, and I have performed more than a thousand, for both public and private entities. Sometimes the exam is requested as a pre-employment evaluation because there is a past history of psychiatric illness. On other occasions, an employee has been taken off of work by a treating mental health professional, and the employer wants an independent evaluation of the employee before returning the person to work.

A threat assessment may be a part of the examination where violent threats, violent behavior or concern about the potential for violence exist. Threat Assessments are a unique type of forensic psychiatric examination. See Risk/Threat Workplace Violence Assessment.

This independent Fitness for Duty (FFD) evaluation is at the employer’s discretion and is permitted because of the employer’s need to maintain a safe workplace. It is usually prudent to obtain such an independent evaluation if the employee is in a position of great responsibility, or where the job involves security or safety issues (e.g. work with hazardous chemicals). Often an employee goes off of work because of serious interpersonal problems at the workplace.

When I conduct a psychiatric evaluation I may recommend treatment, in which case a reevaluation by an independent evaluator after the treatment is then indicated in order to make sure the employee can return to the workplace where the alleged work stress first occurred.

I believe it is necessary for the evaluating psychiatrist to be familiar with employees’ legal rights under the Americans with Disabilities Act (ADA) and to be prepared to recommend reasonable accommodations if such are needed.

Independent psychiatric exams—and independent medical exams (IMEs) in general—are often prudent for the employer because the treating doctor often will “go along” with the patient’s request to return to duty in order to maintain the treating alliance that exists between them. Treaters as a group tend not to appreciate the subtlety of workplace stresses and the rights of employees for reasonable accommodations, as well as not being familiar with information obtained from other employees. Sometimes doctors recommend unreasonable accommodations that the employer cannot fulfill, or they may not know what defines “reasonable accommodation” within the context of Title VII and the ADA. In such cases independent examination by an experienced forensic medical examiner is prudent. The result of my Fitness for Duty examination is my rendered medical opinion and recommendations and usually a written report.

Also on this site are other articles I have written which are relevant to this topic, such as:

• When the Workplace Turns Hostile
• When an Occupational Problem is Not Psychopathology
• The Mental Evaluation, and
• How to Read a Psychiatric Report

DISCLAIMER: The information provided on this website does not constitute legal advice. Readers should consult with their own legal counsel for the most current information and to obtain professional legal advice before acting on any of the information presented.

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