Types Of Physical Exams

Employee physicals are often required for safety-sensitive positions to ensure that workforce safety remains a priority and is enforced to meet compliance. Depending on the industry, physical exams will vary by requirements and procedures. DISA provides a variety of physical exam options to ensure their employees are healthy and fit to perform the job at hand, while also meeting compliance standards with government agencies if necessary.

The Department of Transportation (DOT) has specific requirements set forth by the Federal Motor Carrier Safety Administration (FMCSA) for commercial motor vehicle (CMV) drivers to meet when undergoing a physical exam. This industry-specific exam helps employers determine if an employee is physically, mentally, and emotionally capable of operating a commercial vehicle since their jobs can greatly affect the safety of themselves and others on the road. Specifications are outlined and determined by the DOT and must be filled by the employer prior to hiring. DOT physicals can remain valid for up to 24 months based on the employee’s medical conditions and how well they are managed. If the medical examiner concludes that the individual is qualified to operate a CMV, then they will issue a copy of the results to the individual that was examined and complete a Medical Examiner's Certificate.

A Certified Medical Examiner (CME) will evaluate the following during a DOT physical exam:

• Vital Signs
• Extremities
• Head, Eyes, Ears, Nose, and Throat
• Nervous System
• Back and Spine
• Lungs and Chest
• Heart
• Employee’s ability to manage their medical conditions

Fitness-for-duty physicals are usually performed for more labor-intensive positions within the safety-sensitive industry. They may be performed as part of the hiring process to ensure that the employee is physically capable of performing all job functions or are sometimes performed to determine if an employee can return to work.

Fitness-for-duty exams are very specific to each industry and the job itself and are therefore customized to the employee. Employees might be asked to lift heavy objects overhead, stand, bend, or crouch for prolonged periods of time, be able to maneuver in small spaces, operate heavy machinery, deal with hazardous materials, etc.

A fitness-for-duty exam will evaluate the following:

• Drug and Alcohol Testing
• Vital Signs
• Extremities
• Head, Eyes, Ears, Nose, and Throat
• Nervous System
• Back and Spine
• Lungs and Chest
• Heart
• Psychological Conditions (emotional state, risk tolerance, etc.)
• Employee’s ability to manage their medical conditions

Pre-employment physical exams require an employee to undergo a medical evaluation to determine if they can maintain workplace safety. This can vary by industry and can be customized according to the job. Therefore, there is no standard for a pre-employment physical and is often determined by the employer and/or any requirements set forth by agencies, such as the DOT.

Most physicals will include the following:

• Vital Signs
• Extremities
• Head, Eyes, Ears, Nose, and Throat
• Lungs and Chest
• Existing Medical Conditions
• Previous Medical History
• Heart

For health care workers an annual physical exam is essential in determining if they are healthy and free of any contagious diseases to work with patients. Typically, an annual physical will entail a TB test, drug and alcohol test, and a seasonal flu shot, but can differ according to OSHA standards depending on the job position. Other types of pre-employment physical exams include DOT physicals, drug and alcohol testing, and human performance evaluation (HPE).

A medical surveillance exam searches for problems that may be occurring within the workplace environment that would need intervention. Medical surveillance will often screen a group of employees to look for abnormal health issues and can be based on a single case or a specific work event. For safety-sensitive industries this is extremely vital for employees who are exposed to hazardous working environments with chemicals, radiation levels, smoke, or hazardous waste. Based on OSHA guidelines, health risks, and state and federal laws, occupational health PLHCPs will help provide medical surveillance services designed to meet your company and industry’s needs.

Medical surveillance exams will test for exposure to: