In this day and age of highly publicized workplace violence, the interest in fitness for duty (FFD) evaluations is growing. Private companies and governmental agencies are creating crisis response plans. Schools are practicing active shooter and lockdown protocols. Employers are concerned about the potential for violence in the workplace more than ever before and are implementing structured practices to determine when employees are or are not appropriate to be at work. The fitness for duty evaluation is a central component to those practices. But what can an FFD evaluation do and not do? Can an FFD evaluation address whether an employee will be violent in the workplace? The answer is not what you might think.
An FFD evaluation is an independent medical evaluation of an employee that will assess two things: capacity and risk. The FFD evaluation will address whether the employee has the ability to perform the essential duties of the job, and whether he or she can do so without foreseeable risk to self, others, or the employer’s interests. In order to refer an employee for an FFD evaluation, the employee needs to have a performance issue and the employer needs to have reason to believe that the performance issue is due to a physical health or mental health condition. An employee is often referred when some change is observed, such as the onset of paranoid behavior, emotional outbursts, aggressive behavior, memory problems, change in attendance, slurred speech, frequent fatigue, or direct or indirect threats.
An FFD evaluation will address imminent to very short-term risk of violence as thoughts and plans to harm others should always be assessed, much like suicidal ideation is always assessed. That said, a traditional FFD will not address longer term risk or propensity for violent behavior in the workplace in the future. It can’t. This is the purpose of violence risk assessments. In order to address an individual’s risk for violent behavior, there are multiple factors that need to be considered; some of which are not going to change, but many of which are constantly changing. The individual’s level of risk will change as these variables change, and therefore, repeated evaluation and monitoring are needed to provide an accurate assessment of risk level. An FFD evaluation is an in-person evaluation at one point in time and is only able to address the circumstances the employee is in at the time of the evaluation.
That said, an FFD evaluation with Violence Screening (FFD-VS) is a specialized type of FFD evaluation that screens for major risk factors for violent behavior to determine if they can be ruled out or if a more in-depth violence risk assessment is warranted. In most cases, a traditional fitness for duty evaluation is all that is needed. But when the primary concern is related to aggression or violence in the workplace, an FFD-VS evaluation is the way to go.
