Putting safety first

3 vital considerations when implementing a medical screening program
By Ken Jenkins
|Canadian HR Reporter|Last Updated: 05/30/2019
Screening
Employers can mitigate risk and liability during candidate selection through effective and timely pre-employment medical screening. Credit: Khakimullin Aleksandr (Shutterstock)

Hiring right the first time is a common goal for all HR departments, but for roles in safety-sensitive environments, the hiring process can pose particularly high stakes. Fortunately, employers can mitigate risk and liability during candidate selection through effective and timely pre-employment medical screening.

When implementing such programs, however, candidates’ privacy and even their human rights can hang in a delicate position — meaning organizations must tread carefully.

While it is unacceptable during the hiring process to ask questions about candidates’ physical or mental health, appearance or medical history, it is permissible to require a job-related medical examination — a pre-employment medical screening — after an applicant has accepted an employment offer. This will ensure she can meet the demands of the job physically and mentally, and help the employer gain awareness of any accommodations that will need to be made.

A pre-employment medical screening typically includes health questionnaires, a physical exam and testing based on industry or employer requirements. Given the frequency of musculoskeletal and mental health issues in the workplace, the screening process should include assessments of physical health and issues related to mental health and addictions.

Due to the sensitive nature of this screening, many organizations outsource the process to unbiased, third-party organizations. But how do you ensure the provider relationship is successful? It is essential that the medical screening service provider is familiar with your workforce, has a track record of respecting candidates’ rights and co-operative relationships with your HR department.

There are three vital considerations for employers to consider when implementing a pre-employment medical screening program:

Protect employee privacy

The medical service provider should provide consent forms to confirm the new hires’ privacy and confidentiality will be respected, and only essential information will be shared. The employer should request copies of these and all other medical document templates that will be used during the screening process ahead of time — and ask questions about anything that seems unclear.

Then, the employer should test drive the medical screening process. This will provide a thorough understanding of the evaluation from the new hires’ perspective and ensure the screening is thorough enough to meet hiring requirements.

The goal is to obtain all essential information that could impact a person’s ability to safely meet the demands of his job. This will often prompt additional testing such as psychological analysis to better form an opinion regarding a new employee’s fitness.

Once testing is complete, employers are entitled to know whether individuals are fit, unfit, or fit with limitations to proceed with the job — a determination that is communicated by the medical provider through a fitness certificate, which will also note any identified limitations. This description must be precise to allow for a well-informed decision about necessary accommodations for the employee.

Employers do not, however, have the right to know about a worker’s medical diagnosis, prognosis or treatment plan.

Once a medical service provider shares the fitness status of the employee, the privacy and confidentiality of medical information is of utmost importance. When communicating, both the employer and medical provider must exercise caution to avoid breaching the candidates’ privacy.

Handle red flags with care

If a new employee’s test is deemed unfit or fit with limitations, the medical service provider will recommend which actions should be taken depending on whether it is a chronic condition or an ailment that can be resolved over a set period. The health provider serves as a trusted mediating partner to both the employer and employee, keeping both parties’ interests in mind.

If the outcome is fit with limitations, the employee can successfully start working with adjustments that are made based on the recommendations of the health provider. Ongoing care will be important to mitigate any further damage and maintain a high level of productivity.

To avoid situations like these, however, job applications that reference a job demands analysis (JDA) and a bona fide occupational requirement (BFOR) allow employers to require medical screening before hiring.

A JDA provides a list of all the physical and cognitive demands of the job, while a BFOR tests the essential tasks for a particular job that, if not passed, are deemed a safety hazard to the employee and workplace.

In the event of an unfit outcome when a JDA and BFOR are not in place:

ensure that the employee understands the reasons why she is unfit

• ensure that the employee understands what actions she should take to deal with her health issue

• confirm that the medical services provider has given any relevant documentation to the employee for followup with her primary care provider.

Plan for ongoing screening

Even when an employee has completed a pre-employment screening and has been working successfully, the health and safety risks associated with the job are still present. It is every employer’s responsibility to assess them on an ongoing basis, so periodic health surveillance of employees is vital to prioritize the health and safety of any safety-sensitive workforce.

Professional, ongoing surveillance can identify any changes to the health of workers. Whether working on a construction site with hazardous chemicals or driving, surveillance programs can measure respiratory disease exposure, hearing loss and change in vision, to name a few. Testing semi-annually or annually provides employers with information that can mitigate injuries, disability cases and even death.

All companies should invest in the health and safety of their workforce.

Effective medical screening programs reduce liability for the employer, enhance safety in the workplace, optimize workforce productivity and increase employee satisfaction.


Ken Jenkins is national medical director at Horizon Occupational Health Solutions in St. John’s. For more information, visit www.horizonohs.com.

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