Organizational Wellness

Pre-Employment Physicals: The Complete Guide For HR Teams

Jan 9, 2023
Last Updated May 9, 2024

For most people, the words “pre-employment physical” probably conjure up images of white rooms, white gloves, and cold, sterile lighting.

But while a physical exam can feel like yet-another-pre-employment hurdle to clear (and let’s face it—not anyone’s favorite past-time), these exams help to ensure that candidates are capable of meeting the physical requirements of the job they are applying for.Additionally, they allow the employer to make suitable accommodations for the new employee.

There are a few things that HR teams should keep in mind when administering these tests. From pre-employment screenings to common reasons for candidate test failure this guide will cover it all. By the end, you’ll be able to confidently oversee this vital step in the hiring process.


What Is a Pre-Employment Physical?

A pre-employment physical is a physical examination that is administered to prospective employees before they are hired.

This exam typically includes a variety of different tests and assessments, ranging from basic health screenings to more in-depth diagnostic procedures. The purpose of the pre-employment physical is to help employers determine:

  • If candidates are physically able to meet the demands of the role.
  • If the employer needs to make any accommodations to the role, responsibilities, or workplace environment, to accommodate the employee.

Pre-employment physicals are part of the employee onboarding process, and are typically arranged after a candidate has received a job offer.

Why Are Pre-Employment Physicals Important for Employers and Employees Alike?

Although few candidates will get excited at the idea of a physical exam, they’re useful for both employers and employees:

For Employers

On the employer’s side, pre-employment physical exams can provide reassurance that a potential employee is physically fit to perform the duties of the job they are applying for. This can help reduce workplace accidents and incidents by ensuring that individuals are capable of performing dangerous or physical activities safely.

Pre-employment physicals also help protect against potential workers’ compensation claims resulting from an injury sustained during employment, and make it possible for employers to identify any necessary workplace accommodations they may need to make before the prospective employee begins.

Some states require pre-employment physicals to ensure compliance with laws on workplace safety, making them important for business operations as well as individual well-being.

For Prospective Employees

From an employee’s point of view, a pre-employment test can provide reassurance about their overall health by evaluating for possible disabilities or contagious illnesses. It can also provide confidence that the role they’re applying for is something they are well-equipped to tackle

What Jobs Require a Pre-Employment Physical?

Here are some jobs where pre-employment physicals are typically mandated:

  1. Regulated Employers: In industries where safety is paramount, such as commercial trucking, pre-employment physicals are a must. For instance, prospective commercial truck drivers are required to undergo a thorough medical examination and receive a certification to ensure they're fit to operate these heavy vehicles, as mandated under 49 CFR, part 391 § 391.43.
  2. Law Enforcement: Local, state, and federal law enforcement agencies have their own sets of regulations. These agencies often demand pre-employment physicals to guarantee that police officers are in good physical condition to carry out their crucial duties. These requirements can vary from place to place.
  3. Construction Workers: Because physical labor is a key component of jobs in construction, an employer may require a physical. This is to ensure you meet a certain level of health and fitness that is required for your safety and the safety of others.
  4. Firefighters: Firefighters, like law enforcement officers, have physically demanding roles. The safety of both the firefighters and the public relies on their physical abilities. Hence, most local and state jurisdictions include pre-employment physicals as a prerequisite for individuals aspiring to become firefighters.
  5. Healthcare Workers: Certain roles within healthcare involve lifting and moving patients, as well as the need to be free from communicable diseases that could pose risks to patients. To mitigate the risk of workplace injuries and protect patients, many healthcare facilities mandate pre-employment physicals for healthcare workers.

Overall, pre-employment physicals are generally required to help safeguard both employees and the communities they serve.

What Types of Tests and Screenings Are Included in a Pre-Employment Physical Exam?

The specific tests included in a pre-employment physical will vary depending on the position, industry, and applicable laws or regulations.

As well as adhering to relevant laws, these tests should be structured to answer a crucial question: can this candidate perform the duties of the role?

These employee health tests can include:

General Physical Examination

The most common type of pre-employment physical, the general physical exam includes a series of health screenings to assess the applicant’s overall fitness for work. This is not too different from an annual physical and may include a medical history, review of current medications, basic cardiovascular, blood pressure and urine tests, as well as X-rays or other scans to detect any abnormalities in the body.

Vision Tests

Vision tests are often administered to ensure that the applicant is able to see clearly and safely perform their job duties. This can include tests of visual acuity and color vision, as well as screenings for glaucoma or other common eye conditions.

Hearing Tests

Hearing tests are another key component of pre-employment physical exams, assessing the potential employee’s ability to hear clearly in a variety of environments. Whether they use hearing aids already or require a checkup to acquire them, it’s important to make sure your employees’ hearing needs are met. 

Drug or Alcohol Screening

In many industries, employers will require candidates to undergo drug testing or alcohol testing as part of their pre-hire screening process. This can often be done as part of a criminal background check.

Specific Exams

Other types of pre-employment physical tests include manual dexterity exercises or physical ability tests. Immunizations and vaccinations for communicable diseases may also be necessary depending on the employee’s work duties and travel requirements.

For example, applicants for roles requiring a commercial driver’s license will need to complete a DOT physical (standing for Department of Transport).

Psychological Tests

Finally, some employers may include psychological evaluations as part of their pre-employment physical screening process. These can help to assess an applicant’s emotional stability and overall mental health, which may be important for certain types of work, like social care or policing.

Who Is Responsible for Running the Pre-Employment Physical?

The responsibility for running a pre-employment physical typically falls on HR teams or HR professionals.

Any medical exams should be performed by a licensed medical professional, while non-medical testing related to role-specific responsibilities (like the Human Performance Evaluation process, or HPE, used by the United States Nuclear Regulatory Commission) may be able to be carried out on-site directly by the employer.

This may involve coordinating with external medical providers, such as clinics or hospitals, to administer and review the results of various tests and screenings. In some cases, an applicant’s existing healthcare provider may be able to provide these services in coordination with the employer.

How to Help Candidates Prepare for Their Pre-Employment Physical

A pre-employment physical can feel intimidating for prospective employees and new hires. To help quell any concerns and ensure that the examination is useful for both candidate and employer, it’s beneficial to share some general expectations with candidates:

  • Communicate the purpose and scope of the exam in advance. This will help applicants understand what to expect and allow them to prepare any necessary medical records or documentation.
  • Advise candidates to prepare for the physical by getting plenty of rest, staying hydrated, and eating a healthy diet in the days leading up to the exam.
  • Encourage candidates to ask questions during the exam. This can help them feel more comfortable and ensure that their concerns are addressed fully and appropriately.
  • Offer support and resources following the exam. This may include providing access to additional  resources on common health conditions, or connecting applicants with appropriate mental health support in the case of psychological evaluations.
  • Continue to communicate with candidates throughout the pre-employment process,including after their physical exam. This can help subdue any concerns or confusion they may be experiencing and ensure that their application moves forward smoothly.
  • Remind candidates to bring any relevant medical records or documentation with them when they visit the testing facility.

Common Reasons for Candidates to Fail Their Pre-Employment Physical

If a candidate fails their pre-employment physical, it may be necessary to document the failures and rescind the job offer. Common reasons for failing a physical include:

  • Certain medical conditions or chronic health issues, such as heart disease, diabetes, or asthma.
  • Failing to disclose relevant medical information during the application process, such as a history of cancer treatment or recent hospitalization.
  • Evidence of current substance abuse that may be affecting the individual’s performance and ability to safely carry out their job duties.
  • Complications from a past surgery or medical procedure, such as a broken bone or infection.
  • Poor physical fitness, which may indicate that the candidate is unable to meet the physical demands of the role, such as lifting heavy objects or standing for long periods of time.

Helping New Hires Be Long-Term Successes

Ultimately, a pre-employment physical can contribute to promote a safe and productive work environment for all involved. Both the candidates and employers can assess each other’s suitability for the role, and ultimately make the best decisions going forward. 

For new hires and long-time employees, maintaining a high level of health and safety is essential. Offering wellness programs that meet the needs of your population is a great way to support the wellbeing of your team. Wellhub gives employees flexible access to gyms, studios, classes, trainers, and wellness apps — all in one benefit.. 

Talk to a Wellbeing Specialist to learn more today! 

Company healthcare costs drop by up to 35% with Wellhub! (* Based on proprietary research comparing healthcare costs of active Wellhub users to non-users.) Talk to a Wellbeing Specialist to see how we can help reduce your healthcare spending!



Wellhub Editorial Team

The Wellhub Editorial Team empowers HR leaders to support worker wellbeing. Our original research, trend analyses, and helpful how-tos provide the tools they need to improve workforce wellness in today's fast-shifting professional landscape.


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