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Pre-Employment Physical: A Complete Guide for Employers [2023]

pre-employment physical exam

Employers in many different industries condition job offers on their candidates’ ability to pass pre-employment physical exams.

A pre-employment physical assesses if an applicant has the physical abilities required to perform the duties of their job with or without accommodations.

At iprospectcheck, we coordinate pre-employment physicals for USA-based employers across all states, including California, Texas, and Florida.

Here’s important information you should know regarding pre-employment physicals.

What is a Pre-Employment Physical?

A pre-employment physical is a medical exam that is commonly required as a condition of a job offer for certain types of physically demanding positions.

During a pre-employment physical, a licensed medical practitioner checks the applicant’s weight, blood pressure, pulse, and other important vital signs.

The practitioner might also examine the applicant’s overall appearance, respiratory system, cardiovascular system, and abdominal organs to check for any signs of underlying conditions.

What Jobs Require a Pre-Employment Physical?

It’s common for the following types of employers to require pre-employment physicals:

1. Regulated Employers

Regulated employers that hire employees to work in safety-sensitive jobs must send their employees for pre-employment physicals once they have extended job offers.

For example, commercial truck drivers must undergo pre-employment medical examinations under 49 CFR, part 391 § 391.43 and receive a medical certification before they can be allowed to operate commercial vehicles.

2. Law Enforcement

Local, state, and federal law enforcement agencies also have regulations requiring pre-employment physicals to ensure police officers are physically capable of performing their law enforcement duties.

These laws vary from state to state and jurisdiction to jurisdiction.

3. Private Sector Employers

Private sector employers might still require job applicants to complete pre-employment physicals before finalizing employment.

4. Firefighters

Like police officers, firefighters must be in top shape to handle the physically demanding tasks required of them.

For this reason, most local and state jurisdictions include pre-employment physicals as a requirement for people to become firefighters.

5. Healthcare Workers

Some positions within healthcare require employees to lift and move patients.

Healthcare workers must also be free from communicable diseases that could place their patients at risk.

To reduce the risks of workplace injuries and potential patient harm, many healthcare facilities require healthcare workers to undergo pre-employment physicals as a condition of employment.

Why Are Pre-employment Physicals Important?

Pre-employment physicals are important tools for employers to assess the health and physical condition of their employees.

These physicals offer benefits to both employers and employees.

Employer Benefits

  • Ensure employees have the physical requirements necessary to perform their jobs.
  • Reduce workers’ compensation claims and costs.
  • Prevent workplace accidents.
  • Establish a workplace culture that values health and wellness.

Employee Benefits

  • Understand their overall health.
  • Identify potential underlying health conditions.
  • Learn lifestyle changes that could improve their health.

What Does a Pre-employment Physical Consist of?

Pre-employment physicals generally include checks of the employee’s vital signs and overall physical condition.

The particular tests that might be performed will depend on the tasks of the position for which the applicant has received a conditional job offer.

There are three types of pre-employment physicals, including general physicals, physical ability and stamina tests, and DOT physicals.

General Pre-Employment Physicals

A general pre-employment physical will include the following types of exams and tests:

  • Weight
  • Blood pressure
  • Pulse
  • Temperature
  • Cardiovascular health
  • Respiratory health
  • Reflexes
  • Range of motion
  • Hearing
  • Vision

The medical provider will also look at the candidate’s overall appearance and check for unusual bruising or swelling that could indicate an underlying medical condition.

The candidate might also be asked about their ability to handle stress, the medications they’re taking, and any behavioral or mood changes they have experienced.

Physical Ability and Stamina Test

Candidates for jobs that involve heavy labor, running, lifting, and other demanding tasks might be required to complete a physical ability and stamina test.

This type of pre-employment physical is commonly used for police officers, firefighters, and others who must respond quickly in emergencies.

Construction workers and manufacturing employees might also have to undergo physical ability and stamina tests.

A physical ability and stamina test is used to ensure the candidate is physically capable of handling the job’s physical demands and assesses the following abilities of the candidate:

  • Strength/power
  • Flexibility
  • Cardiovascular health
  • Muscle tension
  • Balance
  • Attitude while under pressure

If a candidate is sent for a physical ability and stamina test, the provider will first perform the general tests of a regular pre-employment physical.

They will then have the candidate perform several exercises through which their physical stamina and abilities can be measured.

DOT Physicals

DOT physicals are required for applicants who are offered safety-sensitive positions with employers that are regulated by the U.S. Department of Transportation (DOT).

These physicals are more comprehensive than other types of physicals and look at a range of health conditions that could disqualify applicants from employment.

Commercial truck drivers, airline pilots, and others in safety-sensitive jobs must complete DOT physicals as a condition of employment as a part of the DOT background check process.

What Would Cause An Employee to Fail a Pre-Employment Physical?

There are many reasons why an applicant might fail a pre-employment physical based on the specific job duties required of the position.

If an applicant can’t perform the duties of the job with or without accommodations, they will fail the physical.

However, employers can’t use pre-employment physicals to screen out people based on their disabilities. Instead, the reasons must be related to the duties of the job.

An applicant might fail a pre-employment physical for the following reasons:

  • Inability to repeatedly lift more than a set weight
  • Inability to perform the tasks of the job
  • Inability to stand or sit for a protracted period
  • Having a chronic communicable disease such as tuberculosis
  • Failing a pre-employment drug and alcohol test

How to Get a Pre-Employment Physical

Most outpatient healthcare facilities and occupational medicine centers perform pre-employment physicals.

You can check with providers in your area or reach out to iprospectcheck to coordinate your pre-employment physicals.

By letting us coordinate this service, you will save time, money, and resources. Contact us today to learn more: (888) 509-1979.

How Can Your Employee Prepare for Their Pre-Employment Physical?

1. Get a Good Night’s Sleep

Employees should make sure they get a good night’s sleep the night before their pre-employment physicals.

Being well-rested can help the employee to perform better during the physical exam.

2. Eat a Healthy Breakfast

On the morning of the exam, the employee should be sure to eat a healthy breakfast.

Skipping breakfast can leave the employee with less energy and harm their performance.

3. Wear Comfortable Clothing

Employees should wear comfortable clothing to their physical exam appointment so that they can easily move.

They don’t need to dress as if they are going to work and shouldn’t do so. They should choose athletic clothing or sweats and wear comfortable tennis shoes.

4. Gather Paperwork

The employee should gather the paperwork their employer gave to them.

This paperwork will detail the specific tests that are being requested, lab orders, and a description of the job duties.

5. Make a List

The employee should make a list of their medications, medical conditions, allergies, past surgeries, and past hospitalizations.

They should bring this list to their appointment and provide it to the medical provider for review.

6. Bring Aids

If the employee uses hearing aids, glasses, or prosthetic devices, they should bring them to their appointment.

7. Bring ID

When the employee arrives, they will need to show a valid identification card so the facility can verify their identity.

This might include a current driver’s license, state ID, passport, employment authorization document (EAD), or employer-issued ID.

Pre-Employment Physical Exam Laws & Compliance Considerations

Employers must comply with both federal and state laws when requiring pre-employment physicals.

Federal Laws

Americans with Disabilities Act (ADA)

The Americans with Disabilities Act (ADA) covers all public employers and private-sector employers with 15 or more employees.

Under the ADA, employers are not allowed to require pre-employment physicals until after they have made conditional job offers.

They also can’t require physicals of candidates unless all other candidates for the same type of job are also required to undergo pre-employment physicals.

Employers are not allowed to use the results of a pre-employment physical to discriminate against applicants who are protected under the ADA.

Employers can withdraw a contingent employment offer based on the results of a pre-employment physical when the reason for the withdrawal is related to the job, is mandated because of a direct safety or health threat, or is made because of a business necessity.

They can’t withdraw job offers based on speculation about the candidate’s use of benefits or future attendance.

The ADA also requires employers to keep the confidential health information of their employees in a separate file from their personnel records and not to disseminate it to others.

Pregnancy Discrimination Act (PDA)

Under the Pregnancy Discrimination Act (PDA), an employer can’t withdraw an offer of employment based on learning that the candidate is pregnant from the results of a pre-employment physical.

The PDA applies to private-sector employers with 15 or more employees.

State Laws

State anti-discrimination laws might also govern pre-employment physicals. Since these laws vary, you should talk to your legal counsel to ensure your compliance with the laws in your jurisdiction.


1. What can I expect at my pre-employment physical?

What you might expect during your pre-employment physical will depend on the duties of the job you were offered.

Your physical will be designed to assess your qualifications to perform the tasks of the job. Because of this, the provider who performs your physical will need to understand the duties and requirements of the job to evaluate your ability to perform them safely.

During your physical examination, you can expect the following to happen:

  • The provider will question you about your lifestyle, general health, and your family medical history
  • Your height, weight, blood pressure, pulse, temperature, and other vitals will be checked.
  • Your vision and hearing will likely be checked.
  • You might be screened for drugs and alcohol.
  • You might have to perform various exercises to test your stamina and strength.

2. What additional tests should I have my employee take?

Many employers also require applicants to take pre-employment drug tests in addition to pre-employment physicals.

You can condition job offers on the results of a pre-employment drug screen as long as you include testing as a component of your company’s drug-free workplace policy and comply with the laws in your state.

Other tests you might consider in addition to a pre-employment physical and a pre-employment drug and alcohol screen include the following:

  • Tuberculosis tests
  • Hearing tests
  • Vision tests
  • Lab tests
  • Titers

3. How long do pre-employment physicals take?

Pre-employment physicals take an average of 30 to 45 minutes. If you opt for physical ability and stamina tests, they will take longer.

4. Who can perform a pre-employment physical?

Licensed medical professionals, including medical doctors (MDs), doctors of osteopathy (DOs), nurse practitioners (NPs), physician’s assistants (PAs), licensed physical therapists (PTs), and advanced practice nurses (APNs) are all qualified to conduct pre-employment physicals.

5. How much does a pre-employment physical cost?

The cost of pre-employment physicals depends on your location but generally averages between $150 and $295.

Typically, employers are responsible for covering the cost of pre-employment physicals they require.

6. What happens if you fail a pre-employment physical?

If you fail your pre-employment physical based on being unable to perform the duties of your job, your employer is legally authorized to withdraw the contingent employment offer.

However, an employer’s reason for withdrawing your offer must be directly related to the duties of the job, a business necessity, or because of a threat to the health and safety of you or other employees.

If you can perform the job with reasonable accommodations, the employer should provide them. However, if they can’t accommodate you because of undue hardship, the employer can withdraw your offer.

7. What forms are needed for a pre-employment physical?

Employers should provide instructions in writing to the medical facility that will perform their pre-employment physicals listing the specific duties of the job.

They should avoid creating their own forms for pre-employment physicals.

Instead, the clinic staff can rely on the written instructions to create appropriate forms that comply with the law and provide them to the employer to give to the applicants.

Applicants should bring the employer-provided forms with them to their appointments.

Applicants should also bring a list of their medications and any previous surgeries or hospitalizations they have had.

Coordinate Your Pre-employment Physical through iprospectcheck Today

Many employers extend job offers conditioned on passing pre-employment physicals.

A pre-employment physical can ensure the employees you hire are able to carry out the physical tasks required for their jobs.

At iprospectcheck, we provide an array of clinical services, including pre-employment and DOT physicals and drug tests.

To learn more about our clinical services and to receive a free quote, call us today: (888) 509-1979

DISCLAIMER: The resources provided here are for educational purposes only and do not constitute legal advice. Consult your counsel if you have legal questions related to your specific practices and compliance with applicable laws.

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About the Author
Matthew J. Rodgers

Matthew J. Rodgers

Matthew J. Rodgers is a highly accomplished business executive with over 30 years of experience providing strategic vision and leadership to companies ranging from the fortune 500 to iprospectcheck, a company which he co-founded over a decade ago. Matthew is a valued consultant who is dedicated to helping companies create and implement efficient, cost effective and compliant employment screening programs. Matt has been a member of the Professional Background Screeners Association since 2009 . When not focused on iprospectcheck, he can be found spending time with his family, fly fishing, or occasionally running the wild rivers of the American west. A lifetime member of American Whitewater, Matt is passionate about protecting and restoring America’s whitewater rivers.