Physical Exams
We perform physical exams for new hires such as police, firefighter and manufacturing. In addition, we provide re-certification exams for commercial drivers, ERT, HazMat, and respirator clearance. Specialized exams such as Fit for Duty are also available.
Check out all of our Physical Exam services here.
Post-Offer
A Post-Offer exam is typically requested by an employer to determine if a medical condition exists that would interfere with the performance of the anticipated work assignment.
Typically these requests are limited to employees whose work is safety-sensitive. Safety-sensitive jobs are ones where impaired performance, for whatever reason, could result in a significant incident affecting the health or safety of the employees, coworkers, the public, critical property, or the environment. There are many jobs that can be considered safety-sensitive but most frequently it includes employees who operate machinery including motor vehicles, who work in extreme conditions such as heights or are who are required to be at optimal mental capacity to minimize the risk of making a catastrophic error. Prior to requesting a Post-Offer exam, the employer ought to have a clear understanding of the physical demands of the job and the essential job functions. Generally, these exams are done after an offer to hire and any disability identified on the exam must be addressed in compliance with the most current version of the American with Disabilities Act Amendments Act (ADAAA).
The Post-Offer exam includes a history and physical intended to identify significant impairments or disabilities that might necessitate work restrictions to address reasonable safety concerns. This includes the risk of injury from exceeding physical capacity. Often a lifting test or screening for cumulative trauma may be included to ensure the employee can perform his or her work without restrictions related to heavy lifting or repetitive work activities respectively. To structure a Post-Offer exam appropriately, the medical provider will need a job description including physical demands.
At the conclusion of the evaluation, employers are advised to use the medical provider’s recommendations or restrictions as a starting point for engaging the new employee in an ADAAA-compliant discussion regarding accommodation and essential job duties. To minimize the likelihood of hiring an individual who is unable to perform the essential functions of the job, it is recommended that prior to offering the position the applicant be asked by the hiring manager to review the job description and anticipated physical demands and advise whether he or she will be able to perform the work and what accommodations, if any, will be needed. Due to the complexity of the ADAAA, employers are advised to consult with human resources or employment law specialists to ensure they handle offers of employment correctly.
Basic Exam
- Complete occupational/medical history
- Vital signs including blood pressure
- Urine testing
- Visual acuity
- Head, eyes, ears, nose, and throat
- Skin and lymphatic system
- Respiratory and cardiovascular systems
- Abdomen & nervous system
- Musculoskeletal examination
Additional components are often performed in addition to the above in accordance with job duties and/or OSHA requirements.
Additional Screening
- Lifting test
- Repetitive motion screening
- Physical demands screening
- Spirometry
- Hearing testing
- EKG
- TB Skin Testing
- Immunizations
- Drug Testing
Fitness for Duty (FFD)
A Fitness for Duty exam is commonly requested by an employer who, based on workplace observations or a decrease in performance, is concerned that due to a medical condition an employee is unable to perform his or her job safely or effectively. The medical condition may be physical or psychological in nature. This medical exam is conducted by an occupational medicine specialist who will review the job description, review specific employer concerns, and conduct a thorough medical interview and examination of the patient.
Following the exam, the provider will release the employee to full duty, work with modifications, or rarely state that the employee ought not to work until the medical condition in question is adequately addressed. Employers need to be cognizant of ADAAA regulations, especially as they apply in engaging the employee in meaningful dialogue regarding essential job duties and the extent to which work accommodations might allow the employee to continue working. Due to the complex nature of these cases, employers are urged to consult human resources or employment law specialists as part of the fit for duty process.
Return to Work (RTW)
A Return to Work exam is typically ordered following an extended absence from work for a personal (not work-related) injury or illness such as surgery or a motor vehicle accident with a significant injury. The need for this exam is largely driven by the physical demands and/or risk associated with an abrupt loss of physical control, for example with operating machinery or vehicles at work. Ideally, these employees will already have been released to work by their personal physician and for the RTW exam, this note will be provided along with a job description including physical demands.
If additional information is required, the employee will be asked to sign a HIPAA release allowing our provider to discuss his or her medical condition with the employee’s personal physician. Ideally, the circumstances under which these exams can be requested by the employer are clearly delineated in company policy and the Employee Handbook.
Respirator Clearance
Respirator clearances are OSHA-mandated to determine if an employee can safely and effectively wear a respirator. Before your employee uses a respirator or is fit-tested, he or she must be medically cleared by a licensed healthcare professional. The clearance process starts with the employee completing Appendix C of OSHA’s Respiratory Protection Standard questionnaire which is available in English and Spanish. This form asks employees to provide information regarding their job and workplace, type of respirator(s) they use, and whether they have any symptoms or diagnoses that might compromise the safe use of a respirator.
If no unreasonable risks are identified, the provider will issue a respirator clearance based on the employee’s responses to the questionnaire. If the physician needs additional information to make a decision regarding the safe use of a respirator, a physical exam and spirometry test will be performed and reviewed. Many employers will routinely require employees to undergo baseline and annual exams and spirometry to ensure objective information supports the employee’s questionnaire responses.
If your employee is new to respirator use, please provide him or her with the following so he or she can accurately complete the questionnaire.
- Type and weight of the respirator
- Number of hours per day he or she will typically be wearing the respirator
- Number of days per month he or she will typically be wearing the respirator
- List of additional personal protective equipment he or she will wear during respirator use
- Identify any strenuous physical work conditions during respirator use
- Identify any temperature or humidity extremes during respirator use
An employee’s questionnaire must be kept confidential, and the employee should be instructed to place the completed questionnaire into a sealed envelope.
The employee should also be provided a copy of the OSHA Respiratory Protection Standard and access to your company’s written respiratory protection program.
Hazardous Material (HazMat) Medical Surveillance
Hazardous materials are generally defined as substances that represent a potential health risk to those who may be exposed to them. Examples of hazardous materials include infectious waste, benzene, mercury, and radioactive materials. There are numerous regulations regarding the containment, handling, transport, and disposal of hazardous materials. These regulations typically mandate a hazardous material surveillance program for employees who work with hazardous materials.
Businesses with employees that work around hazardous materials must investigate the workplace and screen workers for symptoms of potential exposure. Employers are required to identify all hazardous materials in the workplace and through industrial hygiene, testing determines levels of exposure associated with specific job tasks and work areas.
When a measured exposure level for a hazardous material exceeds a substance-specific OSHA or Cal-OSHA standard—referred to as the permissible exposure limit (PEL) for that hazardous material—then training and personal protective equipment (PPE) are required for the employees working in that identified area. Employers must inform their employees about the presence of hazardous materials and train them on the appropriate safeguards intended to minimize exposure including the use of proper work procedures and the correct use of PPE.
Annual medical surveillance examinations are required for these employees intended to identify changes in health that would indicate excessive exposure to the hazardous material in question. Exposure may occur through either direct or indirect contact. Direct contact in the work area could include inhalation, ingestion, or skin contact. Similar routes of entry occur with indirect contact from contaminated tools, surfaces, or clothing as contrasted with direct exposure from the source.
Baseline and annual exams are also used to identify which employees have personal medical diagnoses that limit their ability to work safely while wearing PPE, particularly where respirator use is required, or the work is very exertional or performed in extreme environmental heat or cold. These exams can also identify pre-existing personal illnesses that materially increase the risk of illness when exposed to hazardous substances. An example would be the employee who has chronic hepatitis being advised against work with chemicals that are known to cause liver damage and could predictably and precariously accelerate his/her pre-existing hepatitis.
Exams
- Health History
- Work History with an emphasis on prior exposure or illness from hazardous materials
- Physical exam
- Blood and urine levels to monitor organ function or heavy metal exposure
- Hearing testing
- Spirometry
- Chest X-Rays
- EKG
- Hepatitis B antibody testing and vaccination
Employers are asked to provide
- Employee’s job description
- Past or anticipated exposure levels
- Description of PPE currently in use
- Prior medical evaluation records if available
Post-Offer
Post-offer exams are meant to identify personal health problems that are likely to preclude the safe use of PPE or increase the risk of illness following exposure to hazardous materials.
Baseline Examinations
Per OSHA Standard 1910.120 titled Hazardous Waste Operations and Emergency Responses (HAZWOPER): baseline examinations are required for HazMat team members and hazardous materials specialists.
Yearly Examinations
Per OSHA 1910.120 (f): Annual medical examinations are required for:
- Employees working around hazardous materials where the exposure exceeds the permissible exposure limit (PEL) for that substance for 30 or more days per year.
- HazMat team members who are tasked with responding to actual or potential leaks or spills of hazardous materials
- Employees that may have reasonably suffered actual or potential ill effects from hazardous materials exposure.
Exposure Examinations
Emergency Response Team (ERT) members who exhibit signs or symptoms that may have been the result of exposure to hazardous substances should seek an immediate medical evaluation.
Exit Exams
A final exam is required at termination of employment if the employee has not had an examination within the last 6 months. Similarly, an exit exam is required if an employee is reassigned to a position that no longer requires surveillance. Final exams are in part required to prevent employers from transferring symptomatic employees without determining whether the cause of the illness is due to hazardous material exposure.
Specific Categories of Hazardous Substances
- Toxic or Highly Toxic: produces death based on OSHA criteria for dose and duration of exposure.
- Carcinogen: increases the risk of a specific cancer as a result of exposure.
- Irritant: produces reversible inflammation as a result of direct contact.
- Corrosive: as a result of direct contact destroys or causes permanent changes to body tissues.
- Sensitizer: causes allergic-type reactions in a substantial number of exposed individuals.
- Target Organ Effects: organ-specific dysfunction or damage–most commonly the lungs, nervous system, liver, kidney, or bone marrow.
DMV Physical Exam for Commercial Drivers
Federal guidelines mandate that all commercial drivers pass the Department of Transportation (DOT) physical exam. This exam is required to verify whether an applicant is physically capable of driving safely now and in the near future.
Most medical evaluations are renewed every 2 years; however, due to health-related risks and DOT recommendations, the provider may decide to certify the driver medically for a shorter period of time or until a curable health problem has adequately resolved.
As of May 21, 2014 providers conducting medical certification exams for Commercial Drivers must pass a test and will be listed in the National Registry of Certified Medical Examiners (NRCME).
The providers at FORM Ortho are registered through the NRCME to perform these physicals.
Per the California Department of Motor Vehicles, the basic requirements for passing a DOT physical exam are:
- With or without vision corrections, each eye, as well as both eyes combined, need to have 20/40 vision.
- Ability to distinguish color.
- Hearing needs to be good enough to notice a forced whisper at a minimum distance of 5 feet.
- Maximum allowable blood pressure is 160/100. The use of prescription medication to achieve this threshold is permitted.
- An applicant can have diabetes which is controlled through diet or medication. Diabetes which is controlled though insulin injection is not permitted.
- The maximum level of blood sugar an applicant is allowed to have is 200.
- No use of a Schedule 1 drug, amphetamine, narcotic or any habit-forming drug is allowed.
- In case you are currently diagnosed with cardiovascular diseases such as congestive cardiac failure, collapse, or cardiac insufficiency, then you will be required to present the Medical Examiner with a stress test along with a note from your physician which states that you are able to drive a commercial motor vehicle with no restrictions.
Physical Exams Offered in Fremont, California
At FORM Ortho, we offer Physical Exams to support employers and their employees. Please contact us at (510) 585-2545 to schedule an appointment.
