A pre-employment physical is one of the few parts of hiring where the timing is regulated as tightly as the content. The Americans with Disabilities Act draws a hard line at the conditional job offer, and an employer that examines candidates before it has a problem regardless of what the examination found. This page sets out the line, what may be asked on each side of it, and what a non-DOT physical actually is.
The line is the conditional offer
Under the ADA an employer may not require a medical examination or ask disability-related questions before making a conditional offer of employment. After a conditional offer it may require an examination, provided it requires the same examination of all entering employees in that job category, and it may withdraw the offer only where the individual cannot perform the essential functions of the job with or without reasonable accommodation, or poses a direct threat. Medical information obtained must be kept in a separate confidential file, not in the personnel record.
What a non-DOT physical is
A non-DOT physical is simply a work-related medical examination that is not the federally specified DOT examination. It has no fixed content: the employer and the occupational health provider agree what is assessed, and it is usually built around the physical demands of the specific role, such as lifting capacity, mobility, vision or respiratory function for respirator use. Because there is no federal specification, two providers' non-DOT physicals can be very different, so agree the protocol in writing rather than ordering by name.
Who performs it
An occupational medical physician or an occupational health service provider does this work, and it is a different supply chain from background screening entirely. The DOT examination may only be performed by a medical examiner listed on the FMCSA National Registry; a non-DOT examination has no such requirement, though using a provider who does occupational medicine as its specialty is worth more than using a general clinic. Fitness for duty examinations for existing employees sit under different rules again, since job-relatedness and business necessity apply once somebody is employed.
What it costs and how it is bought
Occupational health services are priced per examination and quoted against the protocol you specify, and often bundled with drug testing and vaccination programmes because the same clinics deliver all three. None of the twenty-five screening providers on this site publishes a price for it: the five that publish anything publish record search pricing, and physicals are a separate purchase. Ask providers to quote the same written protocol, since otherwise you are comparing different examinations.
Questions people ask about pre employment physical
When can an employer require a medical examination?
After a conditional job offer, under the ADA, and only if the same examination is required of all entering employees in that job category. Requiring one before the offer is unlawful regardless of what it finds.
What is a non-DOT physical?
A work-related medical examination that is not the federally specified DOT examination. Its content is agreed between the employer and the provider and is usually built around the physical demands of the role.
Can an offer be withdrawn after a physical?
Only where the person cannot perform the essential functions of the job with or without reasonable accommodation, or poses a direct threat. A finding of a disability is not by itself a lawful basis.
Where must medical records be kept?
In a separate confidential medical file, not in the general personnel record, with access restricted. That is an ADA requirement rather than best practice.