Pre-Employment Medical Exams

Under the federal Americans with Disabilities Act (ADA) and California's Fair Employment and Housing Act (FEHA), employers may require a pre-employment medication examination to determine if an applicant can safely perform the job requirements "after an offer of employment has been made … prior to the commencement of the employment duties... and [may] condition an offer of employment on the results of such examination."

In Leonel v. American Airlines, Inc., the federal Ninth Circuit Court of Appeals held that employers may not require job applicants to "undergo medical examinations before they hold real offers of employment." The case addresses the questions: 1) What constitutes a "real" offer of employment? and 2) Can employers conduct a background check and simultaneously require an applicant to undergo a pre-employment medical exam?

The ADA and FEHA state that an offer of employment is not "real" until the employer has "evaluated all relevant non-medical information which it reasonably could have obtained and analyzed prior to giving the offer." Non medical information may include, but is not limited to, background checks, including employment verification and criminal history checks.

American Airlines initiated a background check and simultaneously required applicants to undergo a medical exam. The company claimed that its recruiting department evaluated the background check results before it received its medical department’s "does not meet AA guidelines" disposition.

The court in Leonel v. American Airlines, Inc. stated "The statutes regulate the sequence in which employers collect information, not the order in which they evaluate it."

The ADA requires that employers conducting pre-employment medical exams do so as a "separate, second step of the selection process, after the individual has met all other job qualifications." The two-step structure protects applicants who wish to keep their personal medical information private until the last stage of the hiring process. Furthermore, when the medical exam is the last step and "all non-medical components” of the hiring process are completed, applicants are able to “know when they have been denied employment on medical grounds."

For additional questions concerning this decision, we recommend that you speak with your employment attorney.

Download Leonel v. American Airlines, Inc.

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