Pre-Employment Physical - page 2

I have a friend who is concerned about a pre-employment physical. Does she have to tell them she has cardiomyopathy? What about medications? Do you need to give the complete list? How would a... Read More

  1. by   brissygal
    I am so shocked with the comments made regarding this post. I can't believe that some threads have indicated not to tell the truth in fear of not getting the job in the first place. Think about what you are doing, you are falsifing a legal document. I would be worried about litigation and the ramifications.

    Don't assume you will not be selected on the basis of your health. I wouldn't go in blind either, asked for a letter from your own Doctor that states that you are fit and healthy to perform the job (don't submit - have it as back-up information if you need to produce it later). I would seek out information from privacy acts and discrimanation acts, do you home-work which in hindsight might be what you are doing by posting this thread in the first place.

    Surely you have access to Legal Nurses who would be able to guide you - especially with your laws in the USA. I have always thought honesty is the best policy, by lying only shows you as a person up in a negative light and maybe taint who you really are and what you are about.

    I think if you were not selected on the basis of your health and you were infact deemed suitable to apply for the position by your own Doctor then I would think their would be basis on discrimation to fight that process, afterall most employers are EOE. Do your homework first!

    All the best
  2. by   EwwThat'sNasty
    Let's first look at your terminology. In some companies there is a pre-hire physical and drug screening. In this case the nurse cannot (unless the person wants) even take a blood pressure reading. Then the person is interviewed, and if hired, there is a post-hire physical which looks to the need for possible accommodations.

    If this is truly a pre-hire physical and the nurse is asking detailed medical questions I believe that this company is acting improperly and could run afoul of ADA (Americans with Disability Act) and be liable in a Court action.

    Usually there is a post-hire physical only (except for the prior go/no go of a drug test) which is performed after the person is hired. I will assume that you are talking about this type of post-hire physical:

    You answered your question when you said she "is capable of the assignment."

    If your statement is true then what does lying get her? Management is never told "Oh Ms. X has cardiomyopathy." Management is only told one of two things: 1) Fit for the job description. Or, 2) Unfit for job description, but would be fit for the job with the following restrictions/accomodations: (example: not to carry more than 100 boxes per hour up the stairs with a maximum weight of 22lbs.")

    The company is bound by law to accommodate an employee that needs restriction(s), though there are limits. A 500 employee company where a worker needs a $1000 chair due to morbid obesity will simply have to pay for it. A very small company where a worker needs an accommodation that costs, let's say $50,000 probably will not and in that case the employee may be turned away. But that is not the issue as she "is physically capable of the assignment." It is wise to remember that the nurse is looking out in the best interest of the employee first, as well as the employer. Let's say the nurse says: "This employee needs accommodations and it will cost $1000." Well, the employer might grumble, but can quickly be shut up with the comment: "Ok, no accommodation, we'll just deal with the soon to be appearing Workers' Compensation case that will cost us $120,000, not to mention an "Americans with Disability Act" lawsuit that will cost us a quarter million.."

    Finally, though it does not seem logical, a wise Occ Health RN in some states realizes that cardiomyopathy could be considered (though it seems odd) to be what is known as a "Second Injury Opportunity."

    In the early part of the 20th century a worker in New York state was using a grinding wheel which blew up and blinded him in one eye. At a prior job he just happened to have been blinded in the other eye. If the Workers' Comp payout scale is (let's say) $120k for one eye, it is NOT $240k for both eyes (or the second eye loss). Total blindness is far more devastating that losing one eye, so the payout for the loss of the second eye might be $380k (the numbers are just a guess). Well, the company argued that they should not be responsible for the higher payment as the man had lost another eye elsewhere, so they contested the case. Later the NY Workers' Comp Board found for the employee. The next day, in New York State, thousands of one eyed, one armed, one legged workers were let go. There was a furor all around. The answer that came out of this was called the "Second Injury Fund." A small percentage of payments into the fund were diverted to this "held by the state" Second Injury Fund. When a worker had a prior injury or illness that "could" have been a factor one half of expenses was paid by this fund. This protected both the employee and the employer to a great extent.

    Many companies self-insure, and even for those who do not self-insure, a 50% reduction in pay out by their fund or by the insurance company for a claim translates into a big savings for the company. I have saved companies tens of thousands of dollars per year utilizing this fund in NH. Though cardiomyopathy is not likely to be the cause of, let's say, a slip and fall with a back injury, the medications "could be a contributing factor (possibly due to dizziness)." So a claim (in NH) probably would be allowed. (Remember only some states have a 2nd Injury Fund). So if your friend is deceptive the outcome could be destructive.

    Worse, if an employee is deceptive to the point to where a nurse would have advised accommodations but did not due to deception, and an injury occurs, the worker could lose the case for Workers' Compensation under the argument that if she were honest, the accommodations would have been given, and the accident would not have occurred.

    A worker that needs accommodations is likely to be hurt by not having them. Even if the company weasel's out of giving an accommodation they will have to, in essence, fire her. (And "at will" employment firing immediately after the post-hire physical will NOT get the company "off the hook," it will put them "on the hook.") Then I would suggest her calling the ADA people as they are very aggressive and will intervene and probably she would be promptly rehired with an apology and compensation in short order.

    Hope this helps.
  3. by   caliotter3
    I had a DOCS who came to work at 10 in the morning and was gone by one in the afternoon and everyone talked about her horrendous medical condition for which she was on disability. She got disability and only had to work half time and could come and go as she pleased if she said she was having "symptoms". I wonder what this gem of an employee put on her hiring paperwork?
    Last edit by caliotter3 on Nov 8, '09
  4. by   EwwThat'sNasty
    Quote from lagill55
    my physical was changed to this tuesday and what is the physical re lifting entail?
    Generally lifting requirements vary from the question: (an example: "Can you lift and carry 25lbs 200 feet, ten times an hour?" To: Please pick up that box, and carry it to the end of the hall, and bring it back." So it depends upon what the requirements of that job can be.

    Here is an example of an accomodation recommendation that might be an outcome of such a test:

    To safely and competently perform required job duties the employee needs the pallet of boxes to be placed such that the bottom of the lowest box to be lifted is no less than 18" from the floor.

    In some cases this can be a very easy accommodation requiring maintenance to build an 18" "table." In other cases this could be much more difficult (as in an assembly line) or even impossible without extreme expense. In that case the worker is unfit for the job, however the company must attempt to find her alternate appropriate work. It might seem unfair that a person might actually lose their job because an accommodation might not be reasonably effected but think of the alternative. (Severe chondromalacia or patella-femoral syndrome due to stress caused by lifting with existing leg problems). It is better to have no job then be unable to walk and in constant pain, so as hard as it may be, sometimes being turned away creates a more appropriate outcome.
    Last edit by EwwThat'sNasty on Nov 8, '09 : Reason: html problems
  5. by   EwwThat'sNasty
    Quote from JerseyLilly
    Agree with Mike above! They don't need to know EVERYTHING! Check out this link-- What questions a prospective employer may and may not ask during an interview regarding disabilities:
    Hmm.... the is an unabashed "hire me" advertisement with little real substance.

    The other one is more helpful but consider please that a six million dollar fine is about 1/3 of one percent of Sears gross income in 2007. If a nurse earns $50k a year that equates to a fine of $176 dollars. It is wise to look at things in scale. Still it is nice that EEOC is holding Sears to the line!

    There must be some good links to what is appropriate for pre-hire and post-hire physicals from good sources--anyone know of some really good ones?
  6. by   amg5686
    Quote from JerseyLilly
    Agree with Mike above! They don't need to know EVERYTHING! Check out this link-- What questions a prospective employer may and may not ask during an interview regarding disabilities:
    I have a question. I was offered a job with a LTC facility. They expect me to pay for my criminal background check and my preemployment psysical. I am having second thoughts about the job. Because it should be the employer who pays for the preemployment requirements. I think if they are this cheap now, what would they be like to work for. Any ideas let me know.
  7. by   JerseyLilly
    Quote from raymoss1
    I have a question. I was offered a job with a LTC facility. They expect me to pay for my criminal background check and my preemployment psysical. I am having second thoughts about the job. Because it should be the employer who pays for the preemployment requirements. I think if they are this cheap now, what would they be like to work for. Any ideas let me know.
    It is more common for companies to offer post-offer employment physicals and a background criminal check. Unfortunately, as far as I know, there are no mandatory rules that state a company must provide it. Many companies in an effort to decrease adminstrative costs often make the prospective employee pay. I believe if they are "penny" pinching in adminstrative costs then, they are penny pinching everywhere else in the facility. There are budget cuts all over. The question to ask is are there other opportunities that you have to choose from and if not, perhaps, you could see if they could negotiate or recommend a low-cost clinic or criminal background check company.
  8. by   Nurselizy
    Im new to this site and joined b/c I was researching advantage of obtaining COHN.
    I came upon this question and thought I could give some insight. I have been working
    as an Industrial Nurse for 3 years now and an employer CANNOT discriminate against you for any
    disabilities. You have to be fit and able to work the job you interview and are hired for.
    Falsifying on Pre-employment H/P's can lead to termination. If for some reason you are hurt
    at work, Workman's Comp adjusters can find out anything about you including: past car wrecks,
    hospitalizations, previous work related injuries and such. It is always better to be truthful upfront.
    Hope this helps
  9. by   JerseyLilly
    I wanted to note that there is a huge difference between "falsifying information" and making a full disclosure of a health situation. According to ADA guidelines there are some things an employer needs to know in terms of placing a prospective employee in a job so that they may perform the essential duties of the position, however, an employer does not need to know every detail of a person's health history if it does not relate to the essential functions of the job. Check out the EEOC's website that I referred to in a prior post. ADA guidelines is the law of the Land and the gold standard in terms of employee rights and disclosure of health information.
  10. by   Nurselizy
    Thanks for the clarification...I may have worded my post oddly, yet in no way did I try to imply that an employer needed (every detail) of a persons health history. I've only done this for 3 yrs, I know many nurses on this board have loads of experience on me My intent was to make some aware that if a pre-employment H/P asks a specific question related to the specific job , and a potential employee is not truthful, in my limited experience it was not a good outcome.
  11. by   JerseyLilly
    Nurse Lizy! Thanks for your post! I was trying to clarify the orginal post by Barby Ann and not yours! I am am not sure if her original post was fully answered? I think many people do not know the law or are unclear about what it truly states. There are some illness that are private, and that have stigmas attached. If it is not relative to performing the essential functions of the job, the employer has no need or right to know.

    Again, thanks for your great post!
  12. by   Sister Fox
    I'm curious - here in the UK, OHNs are required to maintain all medical records of employees as strictly confidential - that is, not for the eyes of any member of the management. All management gets after a pre-employment medical is a paper stating that this person is either "FIT" or "UNFIT" for the proposed job. Nothing more, certainly they never get sight of the forms the individual has filled in. Any issues considered pertinent to be revealed to the management require the employee's written consent beforehand but they are at liberty to withhold that consent if they choose to though that would probably mean they wouldn't be offered the job.

    The only time medical issues can be discussed with the management is when a manager has referred an employee for a sickness absence review and even then, we may only discuss the condition(s) causing the absence. Thus, if a person has absence due to back pain problems and depression, then that is all we discuss.
  13. by   deb1ohn
    If the employer is following ADA and EEOC guidelines, then the personal issues will not even come up in the post-offer exam. It is only wise for an employer to ask about issues related to the essential functions of the position... and those are usually only musculo-skeletal questions. Questions regarding past fractures, hip or knee replacements, etc. Do not lie on those, you will get terminated!

    But on the other hand, don't volunteer stuff that isn't asked! An employer doesn't need to know all the little stuff, and if you share too much that isn't asked, you might not get the job! We had an applicant that shared that he had a "really bad sinus problem" and he was "waiting to get on somewhere with good insurance" before he had surgery. TMI !!!