Fitness for Duty Evaluations

Sometimes employees are at work who simply should not be because of behavioral health reasons. Perhaps an employee is returning from FMLA or other leave but can’t yet perform their essential job functions. Or, a change in an employee’s behavior or performance triggers concern.


If you notice abnormal behavior in an employee, you or someone from HR will likely have a conversation with the employee to explore the situation, but that conversation may not lead to any definite conclusion. And, without a standardized assessment, actions you take based on that conversation could leave you defending your position in court.


A fitness for duty (FFD) evaluation can make a critical difference. An FFD is a specialized, formal medical-legal examination administered by a trained evaluator who can help you accurately assess an employee’s ability to perform essential job functions.


A bad hire or a bad day?

Caleb knew it wasn’t good when a second employee popped his head around Caleb’s cubicle wall at 10:00 on Tuesday. “Got a minute?” The problem the second employee expressed turned out to be the same problem the first employee shared when she popped her head around Caleb’s cubical wall at 9:20 that same morning. The issue: What to do about Melanie?


Caleb’s newest employee started work earlier that month as a medical technician. But, Melanie’s behavior at work was causing some concerns. In a word, it was odd. She peeked around corners as if she were playing some sort of spy game and hid behind doors as the lead medical technician toured Melanie around the facility. After witnessing the behavior, himself, Caleb pulled Melanie into his office to discuss it.


“I’m so sorry,” she’d apologized repeatedly. “I haven’t been sleeping well these last two days. I guess I’m a little off from being tired,” she explained.


Caleb remembered Melanie from her initial interview and had been impressed with her credentials and earnestness. She mentioned having a teenaged daughter and had spoken with pride about the girl’s athletic accomplishments—a sentiment that resonated with Caleb, who had teenagers too.


Caleb decided to send Melanie home for the day. Let her rest and start again the next day. When Melanie returned to work, she looked more relaxed and didn’t display any unusual behavior for a few months. Until this week.


Only this time, it wasn’t just peeking or hiding. Melanie accused a co-worker of using her personal password and altering patients’ files. Melanie swore the data in the files was not information she had entered. She occasionally stared into space and wouldn’t respond to questions. She mumbled to herself, and when her supervisor or co-workers asked if she felt okay, Melanie complained that everyone was trying to get her fired.


Caleb didn’t know what was causing Melanie’s behavior, but he knew that he couldn’t have her interacting with patients or handling patient files. He needed to call his EAP for advice.


The FFD evaluation

When R3c receives a referral for a fitness for duty evaluation, we conduct an initial review of the case to ensure there is no threat of violence present.  If none is detected, an FFD evaluator will thoroughly evaluate the situation, which includes:

  • Conducting a face-to-face clinical interview of the employee
  • Performing valid and reliable psychological testing and assessments to determine if the employee has the functional capacity to work
  • Reviewing the employee’s diagnosis, prognosis, treatment plan, and timeframe for recovery, if medical records are available.
  • Evaluating work capacity (mental and physical) and delineated workplace restrictions if necessary
  • Conferring as needed with current treatment team and management


Based on the evaluation, the evaluator will develop one of three conclusions about the employee: fit for duty, not fit for duty, or fit for duty with restrictions or modifications.


A clear resolution is reached

It was not a surprise that in the FFD evaluator’s opinion, Melanie was unfit for duty. Caleb knew that was the right conclusion, but it was still disappointing. He had liked her and felt for her family—especially her daughter. In fact, had it not been for the evaluation from R3c, Caleb could see himself giving Melanie third and fourth chances to improve her performance—chances that ultimately would have only dragged out an untenable situation that had the potential of putting patients at risk.


This was better in the long run, Caleb thought. Get that independent analysis, address the situation efficiently and fairly, then move on for the good of everyone.


The FFD: protection for everyone involved

A fitness for duty evaluation gives you the clarity and understanding you need to make informed, unbiased decisions about your employee’s job status.

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