What Happens if a Candidate is deemed a High Risk during a Pre-employment Medical Test?

Your occupational healthcare partner

A pre-employment medical test is a workforce risk management tool that often makes up part of the recruitment process. These are especially common in industries and roles which require manual labour, heavy lifting or exposure to toxic gases and fumes on a regular basis.

The test usually involves an assessment of a candidate’s overall health, functional capacity, hearing and vision along with a drug and alcohol screening and examination of their medical history. It enables a potential employer to gain a better understanding of a candidate’s physical and mental state and assess their suitability for the role they have applied for.

Here, we explore what happens during a pre-employment medical assessment, what happens if a candidate fails and how to prepare a candidate for the best outcome.

What Happens During a Pre-Employment Medical?

A pre-employment medical will be conducted in a clinical setting by a trained and qualified occupational health professional. The exact components of each medical will differ between industries and companies, however they usually include a mix of the following:

Medical History Examination
The practitioner will ask the candidate questions to explore their medical history and discuss any health concerns. The questions will cover past and present health conditions, injuries, disabilities, vaccinations and lifestyle habits. 

General Medical Examination
The medical history questionnaire will often be followed by a physical examination. During this part, the practitioner will assess the candidate’s heart, lungs and hearing, along with blood pressure and body mass index (BMI). 

Functional capacity and stamina test
For roles that require physical labour or heavy lifting, the candidate may be required to undertake a functional test to assess their stamina and physical ability to ensure they can carry out the required tasks with minimal risk of injury. This will need to perform a range of exercises and tasks to examine their flexibility, strength, cardiovascular health, stamina and balance.

Audiometry (hearing test)
An audiometry test will evaluate a candidate’s hearing, based on their ability to hear different frequencies, sounds and pitches. It is usually conducted using a machine called an audiometer. During this test, the candidate will wear a set of headphones and be required to press a button each time they hear a sound.

Spirometry (lung function test)
A spirometry test helps to identify any respiratory issues such as asthma. During this part of the examination, the candidate will be required to blow into a mouth piece to assess their lung capacity.

Vision Test
Much like a vision test at the optometrist, the candidate will be required to read letters of various sizes from an eye chart whilst at a distance. The practitioner will make an assessment based on their ability to read the chart.

Pre-employment medicals often require a urine sample that will be tested for any underlying health conditions such as diabetes. 

Drug and Alcohol Screen (DAS)
A drug and alcohol screen will test for any illicit or prescription substances in a candidate’s blood stream. This is usually carried out through a urine, saliva swab or breath test. There are two common types of drug and alcohol screens; an instant test which is carried out in a clinic, and a lab test which is conducted in a pathology clinic then sent to a lab for testing. 

When is a candidate deemed a High Risk during a pre-employment medical?

It is possible for an applicant to be deemed a High Risk during a pre-employment medical if they cannot demonstrated that they can perform the required duties of the role without accommodations. It is important to note that employers cannot use pre-employment medical assessments to screen candidates based on disability – the reasons must be related to the role.

Reasons for being deemed High Risk on the assessment can include:

1. General poor health

If a candidate’s overall health will inhibit them from safely carrying out the requirements of the role, such as an inability to stand or sit for extended periods or an inability to repeatedly lift weight they may fail the pre-employment medical.

2. Positive DAS results

Most workplaces have strict policies when it comes to drug and alcohol use. Therefore, to pass the pre-employment assessment, the drug and alcohol screen results must be clear or consistent with prescribed medication. It is essential that a candidate advises the practitioner of any prescription medication prior to carrying out the DAS.

3. Unable to meet the physical demands of the role

Some roles, especially those that are physically demanding require specific height, weight, functional capacity, or blood pressure ranges. If a candidate does not meet this criteria, they may be deemed a high risk and therefore not be eligible for the role.

A candidate is deemed High Risk on a pre-employment medical – what happens next?

In the event a candidate is deemed High Risk on a pre-employment medical test, the next steps will depend on the test results, nature of the role and company policy. 

If a candidate is deemed High Risk for the role the job offer may be withdrawn. In some cases, a candidate may be referred for a second medical to confirm the results.

How to prepare a candidate for a pre-employment medical

To best prepare a candidate for a pre-employment medical, it is important to provide them with any company specific information, in addition to general preparation tips and what to bring on the day.

  • Encourage the candidate to arrive 10-20 minutes before their appointment
  • The candidate must bring valid photo ID such as a driver’s licence or passport
  • The candidate should bring any aids such as glasses or an asthma puffer
  • The candidate should wear comfortable clothing that allows them to move freely
  • The candidate should be encouraged to avoid caffeine and smoking prior to their assessment
  • The candidate should avoid listening to loud music or being exposed to excessive noise prior to their assessment
  • The candidate should bring any GP letters, documentation, prescriptions and/or further information surrounding their medical conditions/medications 

Logic Health offers employers a range of pre-employment medical examinations, from white collar medicals to rail category and drivers’ medicals. Supported by our centralised booking and results team, we ensure a quick turnaround to make the process as quick and easy as possible for the employee and employer.