Blog & News

This is a premium post...

If you are not an AIM member - Consider joining. AIM Members receive access to all our premium content online.

If you're an AIM member please login to your AIM account to view this post:

Back to Posts

Ask the Helpline: Who Pays for Employer-Mandated Physical Exam?

Posted on May 12, 2024


We have a machinist whose production has really fallen off recently.  He claims he has a non-work-related shoulder injury that affects his performance, but he has produced no medical documentation.  Can we require him to undergo a physical exam, and if so, do we have to pay for it?


Yes, you can require him to get a physical exam if the need is job-related, and you, as the employer, will need to cover the cost of the exam.

A lesser-known section of the Americans with Disabilities Act (ADA) limits the medical information an employer may request from an employee, even if the inquiry is unrelated to a disability. It prohibits such requests unless the physical exam is “shown to be job-related and consistent with business necessity.”

According to the Equal Employment Opportunity Commission’s ADA enforcement guidelines, an employer meets this requirement if it has  a reasonable belief, based on objective evidence, that:

  1. An employee’s ability to perform essential job functions will be impaired by a medical condition; or
  2. An employee will pose a direct threat due to a medical condition.

A little-known section of Massachusetts law requires employers to pay for any medical exam they mandate. Originally passed in 1949, Mass. General Laws, ch. 149, § 159B says that “[a]ny employer who requests or requires a person who is a present or prospective employee to undergo a medical examination by a physician designated by the employer, as a condition to securing or continuing in employment, shall reimburse said person for the medical expenses requested or required.”

Guidelines for Conducting the Exam

The exam in this case should be limited to the shoulder injury. It may not involve other aspects of the employee’s health.  You should provide the employee with a job description to present to the medical provider, a job description that details the physical requirements of the employee’s position, such as repetitive movements, lifting requirements, etc.

For more information on physical exams, fitness-for-duty evaluations, or other human resource matters, AIM members are encouraged to contact the AIM HR Helpline at 800-470-6277 or

In addition, AIM HR Solutions is always available for detailed HR support and assistance; visit the website at