The Independent Psychiatric Fitness-for-Duty Examination is performed to obtain unbiased psychiatric information concerning the ability of an employee to safely and effectively perform the essential functions of their job. The purpose of a Fitness-for-Duty Examination is to protect the individual, their coworkers, and the community at large.

It is imperative that employers, EAPs, agencies, and licensing boards take reasonable steps to maintain a safe environment, protect the community, the index individual as well as co-workers from the possibly devastating impact of individuals in the workplace who may suffer from psychological difficulties that may be potentially dangerous. Employers and EAP professionals can safeguard the workplace with psychiatric Fitness for Duty Evaluations and psychiatric Risk Assessments. A Fitness-for-Duty Examination is requested to evaluate and determine if an individual’s behavior poses a potential threat to the work environment or community at large. The Occupational Safety and Health Act of 1970 (OSHA) requires employers to provide a workplace free from recognized hazards likely to cause death or serious harm. Fitness-for-Duty Examinations provide an avenue for agencies to comply with OSHA.

The Independent Fitness For Duty Evaluation is requested at the employer’s discretion and is permitted because of the employer’s responsibility to maintain a safe workplace. The psychiatric Fitness for Duty/Violence Risk Assessment is performed primarily to help employers make managerial decisions, based in part on an individual’s psychological status. The central purpose of a Fitness-for-Duty Examination is to determine whether the individual is able to safely and effectively perform his or her essential job functions.” The objective of a Fitness-for-Duty Examination is to provide the client with an assessment of the evaluee’s fitness-for-duty, including the degree of dangerousness that may be present. The psychiatric examiner’s objective is to help the employer maintain a safe workplace in a process that is fair to the individual being evaluated.

The individual is the evaluee. A third party, the client, is the entity that is requesting the Fitness-for-Duty Examination for the individual. The client in an FFDE is usually an employer or a professional licensing board. An independent physician who is not involved in the examinee’s medical care performs the Fitness-for-Duty Examination. The sole purpose of the FFDE is to provide the client with the examiner’s unbiased psychiatric opinion concerning the evaluee’s ability to safely and effectively perform their essential job functions. The purpose is not to provide psychiatric care to the evaluee. The client may use the resulting psychiatric opinion as information in administrative proceedings concerning an employee’s ability to work or provide services to the community at large. The examining psychiatrist owes an ethical duty to both parties, the client as well as the evaluee, to be fair, objective, accurate and impartial, as well as to honor the parties’ respective legal rights and interests.

The Fitness-for-Duty Examination is used to assess a persons’ ability to safely and effectively work in the presence of problems such as depression and anxiety, as well as conflicts with co-workers. Employers and EAPs request Risk Assessments when an individual, because of psychological difficulties, might present a risk of self-harm or danger to others.

A Fitness-for-Duty Examination can be triggered by a perceived threat in the workplace or by a reasonable suspicion that the individual has a psychological problem that might affect his work performance.

A psychiatric Fitness-for-Duty Examination is warranted in the following situations:

  1. Applicants with a known or suspected history of psychiatric disorder.
  2. Employees returning to work after an episode of emotional illness or substance abuse.
  3. Employee’s demonstrating potential threats to workplace safety and productivity.
  4. Safety-sensitive occupations.
  5. Situations when an employee is demonstrating behavioral problems on the job: alcohol or substance abuse, family or relationship issues, psychiatric trauma, maladaptive personality traits, or stress-related symptoms which are affecting the ability to perform the job in a safe and effective manner.
  6. Employees referred to the EAP or Human Resources by management for evaluation of performance decrement, chronic absence, abrupt indebtedness, unusual behavior, inappropriate or threatening behavior.
  7. Situations when risk assessments are needed in order to ascertain the reliability, trustworthiness, and mental stability of employees or prospective employees in the hiring process.
  8. Individuals being evaluated for high stress or high-risk jobs.

The completed FFDE synthesizes and integrates the information obtained from all available sources. The purpose of a Fitness-for-Duty Examination to provide a professional psychiatric opinion concerning the diagnosis, etiology, and presence or absence of functional limitations in the evaluee. It concludes with an opinion of whether the evaluee is able to safely and effectively perform the essential functions of their job. The Fitness-for-Duty Examination report should be comprehensive and address the client’s specific referral questions in clear language understandable to the non-mental health professional using the available data to substantiate the logical conclusions in a fair, accurate, and legally defensible manner.