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A pre-employment physical is a medical examination commonly required by employers before hiring. The goal of this exam is to ensure that candidates are physically capable of performing the essential functions and responsibilities of the job without posing a safety risk to themselves or others.

This blog will discuss the components typically included in a standard pre-employment physical.

Medical History and Physical Exam

One of the first steps is taking the candidate’s medical history. The physician will ask questions about past or present health conditions, surgeries, injuries, chronic illnesses, etc. They will also inquire about medications, allergies, and family medical history.

After reviewing the medical history, a physical exam will be performed. This involves checking basic health markers like height, weight, blood pressure, pulse, and temperature.

The physician will listen to the heart and lungs with a stethoscope. They may also examine the ears, eyes, nose, throat, neck, skin, lymph nodes, abdomen, extremities, and back/spine range of motion. Any scars, tattoos, abnormalities, or limitations will be noted.

Vision and Hearing Tests

A candidate’s vision and hearing capabilities are tested for certain jobs. For jobs requiring visual or hearing acuity, a basic vision test with an eye chart or whisper test will suffice.

Jobs involving heavy machinery, driving, or medical fields may require more thorough vision and hearing exams. This helps ensure the candidate can safely perform essential tasks and respond appropriately to alerts or instructions in their work environment.

Drug and Alcohol Screening

A drug and alcohol screening via urinalysis is typically part of a pre-employment physical. This is to detect the presence of illegal or unauthorized substances in the body, like marijuana, cocaine, amphetamines, barbiturates, and opiates.

Alcohol tests can detect recent excessive drinking as well. Detecting any substance abuse helps employers comply with anti-drug policies and maintain a safe, healthy, and productive workplace.

Additional Testing

Depending on job requirements, additional tests may be included. For example:

  • Respiratory function tests (respirators for asbestos exposure)
  • Audiometric hearing test (noise hazards)
  • EKG or cardiac stress test (physically demanding jobs)
  • Pulmonary function test (airflow limitations)
  • Functional capacity exam (lifting, carrying, and physical demands)

Industries like transportation, public safety, healthcare, and construction sometimes require specialists like cardiologists for certain assessments.

Laboratory Tests

Blood and urine laboratory tests are also commonly performed. Some examples:

  • Complete blood count (anemia screening)
  • Comprehensive metabolic panel (organ/system function)
  • HbA1c (diabetes indicator)
  • Lipid panel (cholesterol levels)
  • Hepatitis B and C, HIV (infectious disease exposure risk)
  • Drug screen, often repeat of urinalysis
  • Pregnancy test (for safety concerns or handling of exposures)

This helps identify possible underlying health issues, risks, or workplace limitations upfront before hiring. It can also serve as a baseline for future reference.

Medical Evaluation and Certification

Upon completing all tests and evaluations, the physician will review the results, note any abnormalities, and determine if the candidate meets the medical qualifications for the position. The physician issues a written statement verifying whether the candidate is:

  • Cleared for the job without restrictions
  • Cleared with specific restrictions or accommodations
  • Unable to perform essential job functions

The employer receives this certification to finalize the hiring decision and comply with the ADA and other employment laws. Any follow-up care is also documented if abnormalities require Management.


A standard pre-employment physical examines candidates’ medical history, performs related physical and diagnostic tests, and evaluates overall fitness and suitability for work. The breadth of testing depends on job risks and requirements.

This screening helps protect workers and public health and safety while ensuring legal and ethical hiring processes for employers. With proper planning and privacy protections, pre-employment physicals provide transparency and set tangible standards for employee readiness.

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