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Fitness for Duty Psychological Evaluation Services in Tennessee

Fitness for Duty Psychological Evaluation Services in Tennessee

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What is a Fitness for Duty Evaluation?

The term “fitness for duty” refers to a person’s ability to carry out their assigned duties competently, safely, and without endangering their own or others’ health, the environment, or property.1

Employers can evaluate a worker’s fitness for duty (FFD) if they are concerned that the employee is unable to perform the essential functions daily. In addition, an employer may require a fitness for duty psychological evaluation to determine whether an employee has any mental or physical impairment that may limit their ability to perform their job safely and effectively.2

Reasons a Fitness for Duty Assessment is Requested

Due to the demanding physical requirements and medical standards associated with their jobs, some employees, such as law enforcement officers and firefighters, regularly receive fitness for duty evaluations. In addition, some businesses have regulatory requirements for FFD tests. For instance, periodic medical examinations are mandated by the Federal Aviation Administration and Occupational Safety and Health Administration (OSHA) for specific jobs, including truck drivers, pilots, and asbestos workers.3

In accordance with the American Disabilities Act (ADA), the Equal Employment Opportunity Commission (EEOC) states that if an employer can demonstrate that the purpose for the examination is job-related and consistent with business necessity, the employer may request a fit for duty assessment.4,5

The following are some reasons why an employer may request a fitness for duty evaluation (FFDE):

  • When a company thinks a worker can’t do the job safely and effectively because of a physical or mental impairment6
  • When an employee returns to work after FMLA leave due to personal illness or injury
  • When a company suspects that a worker’s physical or mental health conditions put them in danger of harming themselves, their coworkers, clients, or the general public
  • Increased carelessness, poor performance, or mistakes
  • Fit for duty evaluations can save an employer a lot of money

Insurance may be able to help cover the cost of therapy or assessments. Find out if your insurance provider can help with the costs by filling in our confidential insurance verification form below.

Fitness for Duty Assessment Process

A medical or psychiatric evaluation, or perhaps both, may be part of a fit for duty assessment. Functional fit for duty tests that imitate a job are also sometimes used to assess workers’ readiness for duty. It depends on your industry and whether the employer thinks these examinations are necessary.

The fit for duty evaluation examines an employee’s physical and psychological well-being and the requirements for the position. Questions may involve learning about any current medical conditions, medications you’re taking, and whether you have a long-term disability that may affect your ability to do your job.7

In many cases, the employer will have access to an employee’s medical background relevant to the job in which they’re undergoing a fit for duty assessment. For example, suppose your work involves loading boxes in and out of a truck, and you’re returning from a lower back injury but also have diabetes. In that case, the employer should only have access to the parts of your medical history involving the lower back injury.

These are the different types of fitness for duty evaluations:

  1. Going Back to Work: used to determine whether an employee is prepared to return to work after an illness or injury
  2. Job Performance: used to determine if an individual can carry out the essential job functions
  3. Post-Offer Physical: also known as pre-placement tests, consists of a thorough employee questionnaire, a drug test, and physical testing

Typically, fitness for duty evaluations consist of three parts:

  • Clinical interview: The conversation between the psychologist and the employee occurs in a quiet office.
  • Collateral Interviews: The psychologist converses with the employees’ close relatives, partners, and, potentially, the employer.
  • Psychological Testing: A psychologist administers, observes, and interprets psychological tests.

The evaluation may include a series of medical and physical testing, including:

  • Physical: hearing, vision, etc.
  • Physiological: exhaustion, use of alcohol and other drugs, exposure at work, etc.
  • Psychological: culture, mental/emotional state, risk tolerance, etc.

A fit for duty assessment should be carried out by an outside qualified mental health specialist, such as a board-certified psychiatrist, to provide an impartial, unbiased review and final report. There are no requirements for further certifications beyond a medical license to evaluate fit for duty. Still, it’s beneficial to have the exam conducted by a professional with experience in FFDEs.

The final report is written by the medical expert who conducted the fitness for duty evaluation after it is complete. The report makes suggestions regarding the employee’s future employment, including whether or not they should keep their current jobs. In addition, the study might offer suggestions for employees whose recuperation is taking place over a short period. Also, the study might suggest specific accommodations for long-term disabled personnel.8

Evaluations are frequently not finished in a single session, necessitating subsequent testing and referrals. The assessor may request a unique medical examination deemed necessary for the work, such as an MRI or a pulmonary function test. The employee’s own doctor or extra specialists may need to be consulted in specific circumstances. Occasionally, a safety officer or industrial hygiene officer from the employer’s business is asked to conduct a safety evaluation.

Some tests, like urine samples, can be completed in as little as 30 minutes. However, it could take between three weeks and three months to complete the initial evaluation, mental health assessment services, any other potential testing, and the final review.

How Much do Fitness for Duty Evaluations Cost?

The employer must pay for any fit for duty assessments the company deems necessary. If the employee decides to seek a second opinion or another evaluation from a different provider, the employee incurs these expenses.9

The out-of-pocket cost for a fitness for duty evaluation in Tennessee varies. Depending on the extent of the evaluation, the initial fit for duty assessment may cost as much as $850+. Any additional evaluations can cost as much as $600.

Insurance companies rarely cover fitness for duty evaluations, especially when they’re solely for a second opinion. However, in addition to specializing in employment consulting services, Athena Care is in-network with most major insurance plans. Therefore, filling out our free and confidential online insurance verification form is the best, most efficient way to determine the specifics of your insurance coverage for mental health testing.

Failing a Fitness for Duty Evaluation

In its most basic form, fit for duty certification declares that employees can perform all necessary tasks for their position and are healthy enough to return to it.

Here are some of the key criteria:10

  • A written copy of the employer’s fitness-for-duty certification policy is required.
    • All employees should be treated equally under that policy in identical circumstances.
  • An employer should give the worker a written list of crucial job responsibilities that must be passed if certification is necessary.
  • Typically, an employer cannot request a second or third opinion regarding a worker’s suitability for duty.
  • Repeated certifications may be necessary for situations where there is intermittent (irregular) leave or reduced work hours.

If the employer has given the employee the required notice and information, the employee must present the certification before reporting to work. Furthermore, the employer can restrict an employee from returning to work after taking FMLA leave due to a significant medical condition until the certification is obtained.

The health professional typically only provides the employer with one of three statements: fit, unfit, or fit with adjustments to the job. The final two outcomes could be described as either temporary or permanent.

However, making accommodations is the employer’s responsibility. This obligation indicates that the employer must make every effort to change the job, its requirements, or the working conditions to keep the employment relationship in a safe environment for all. The medical expert’s report may, upon request, also advise on how to help the employee.11

Examples Where Fitness of Duty Evaluations are Necessary

The supervisor’s observations or the receipt of a trustworthy third-party report about the employee’s potential unfitness for duty may serve as the basis for requesting a fit for duty evaluation.

The following are a few examples of the kinds of impairments that could justify the employer’s request for a fit for duty assessment:

  • Using, having, or being under the influence of alcohol or illicit narcotics
  • Use of legal medications that negatively impact your capacity to perform job duties safely
  • An employee uses dangerous equipment, suffers from severe depression associated with post-traumatic stress disorder (PTSD), and/or is possibly suicidal12
  • Slurred or incoherent speech
  • Spotted vision, awareness, coordination, or dexterity issues
  • Threatening, unpredictable, or aggressive behavior or mood swings
  • Drowsiness or other fatigue-related symptoms
  • Any other physical, psychological, or behavioral issue that interferes with the capacity to perform duties effectively and safely
  • Returning from leave after an injury or illness that could affect job duties, thus resulting in an unsafe work environment for yourself and others


  1. “Fitness for Duty Definition.” Law Insider, www.lawinsider.com/dictionary/fitness-for-duty. Accessed 16 Feb. 2023.
  2. Randazzo, Johnna. “What Is a Fitness for Duty (FFD) Evaluation?” Arrowhead Evaluation Services | Medical Evidence Expertly Reported, 12 Dec. 2019, arrowheadeval.com/what-is-a-fitness-for-duty-ffd-evaluation.
  3. Taylor, Tanisha, MD, MPH, CPE, FACOEM. “04: Fitness for Duty: Introduction: What Is Fitness for Duty?” American College of Occupational and Environmental Medicine (ACOEM), 7 Feb. 2019, ohguides.acoem.org/04-fitness-for-duty-introduction.
  4. Sullivan, Callin. “Fitness for Duty: How to Manage an Employee That Is Unable to Work.” Ppt Download, slideplayer.com/slide/11899769.
  5. “Employment Tests and Selection Procedures.” US EEOC, 1 Dec. 2007, www.eeoc.gov/laws/guidance/employment-tests-and-selection-procedures.
  6. California Medical Evaluators. “The 5 W’s of Employee Fitness for Duty Evaluations.” California Medical Evaluators, 31 July 2016, calmedeval.com/5ws-fitnessforduty.
  7. [vii] BASS Urgent Care. “What to Expect During Your Fitness for Duty Exam.” BASS Urgent Care. 30 Apr. 2020, www.bassadvancedurgentcare.com/post/what-to-expect-during-your-fitness-for-duty-exam.
  8. Arrowhead Evaluation Services. “Fit for Duty Evaluation | Medical Evaluation | AES California.” Arrowhead Evaluation Services | Medical Evidence Expertly Reported, 23 Jan. 2019, arrowheadeval.com/fit-duty-evaluation.
  9. California Medical Evaluators. “Employee Considerations: Sample Fitness for Duty Policy.” California Medical Evaluators, 11 Apr. 2019, calmedeval.com/fitness-for-duty-policy.
  10. Staff, FindLaw. “Return to Work Under the FMLA: Fitness for Duty Certification.” Findlaw, 9 Jan. 2023, www.findlaw.com/employment/family-medical-leave/return-to-work-under-the-fmla-fitness-for-duty-certification.html.
  11. Fit to Work: OSH Answers. Canadian Center for Occupational Health and Safety. www.ccohs.ca/oshanswers/psychosocial/fit_to_work.html.
  12. Staff, Pine Rest. “What Is a ‘Fitness for Duty’ Assessment, and Can My Employer Make Me Take One?” Pine Rest Newsroom, 12 Oct. 2022, www.pinerest.org/newsroom/articles/what-is-a-fitness-for-duty-assessment-blog.

If you suspect that you or someone you love suffers from mental health disorders, contact Athena Care today.

One of our friendly associates will help you get the help you need. Take this first step to feel better and take control. 

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