Pre-Employment Medical Exam Laws in Indiana

The Americans with Disabilities Act (ADA), 42 U.S.C. § 12112, establishes the federal framework for employment medical examinations. Under the ADA, employers covered by Title I (generally 15 or more employees) cannot require medical exams or ask disability-related questions before making a conditional job offer. Once a conditional offer is extended, employers may require a medical exam and ask medical questions, but only if they do so for all applicants in the same job category without exception.

The exam must be job-related and consistent with business necessity. Employers cannot use the exam results to withdraw job offers based on disability unless the withdrawal is job-related and based on legitimate medical reasons. Medical information must be kept strictly confidential in separate medical files, with access limited to occupational health and safety personnel, first aid and safety personnel, and management on a need-to-know basis. The Equal Employment Opportunity Commission (EEOC) enforces these rules. Violations can result in damages for lost wages, emotional distress, and attorney fees.

Indiana law governing pre-employment medical exams mirrors federal ADA standards through the Indiana Civil Rights Act (Indiana Code § 22-9-2-1 et seq.) and Indiana's incorporation of federal disability protections. Indiana employers are covered under the ADA if they have 15 or more employees; there is no separate lower state threshold. Indiana does not create a parallel state medical exam standard—instead, the state requires compliance with the ADA as the controlling legal framework.

Under Indiana law, disability discrimination in hiring is prohibited under Indiana Code § 22-9-2-1, which makes it illegal for employers to discriminate against individuals with disabilities. This prohibition encompasses refusal to hire based on disability or medical examination results that reveal a disability. Indiana courts have consistently applied federal ADA standards when evaluating medical exam disputes.

Indiana does not provide stronger protections than the ADA for pre-employment medical exams—the state adheres to federal timelines and standards. Employers with fewer than 15 employees in Indiana are not covered by the ADA but may still be subject to Indiana's broader public accommodations laws if applicable. The key distinction from federal law is that Indiana enforces its civil rights protections through the Indiana Civil Rights Commission and state court litigation in addition to EEOC procedures.

Indiana has not enacted separate legislation regulating medical exam confidentiality beyond federal HIPAA and ADA requirements. Remedies under Indiana law include damages for lost wages, emotional distress, and punitive damages in cases of intentional discrimination. An employee or job applicant in Indiana can file a charge with both the EEOC and the Indiana Civil Rights Commission simultaneously.

The primary exception to the post-offer requirement applies to alcohol and drug testing, which may be conducted at any stage if the employer complies with Indiana law and the ADA. Employers are not required to hire or retain any individual who is not qualified to perform essential job functions even with reasonable accommodation, provided the determination is made based on legitimate medical reasons, not disability status alone.

Medical exams may be required pre-offer in very limited circumstances: (1) for bona fide occupational qualifications in safety-sensitive positions where a disability poses a direct threat to health or safety (e.g., commercial driver positions), but only if a medical assessment is truly necessary to determine qualification; (2) in response to an employee's voluntary disclosure of a medical condition that may affect job performance; and (3) for post-employment medical exams when an employee requests accommodation or when the employer has observed performance decline.

Small employers with fewer than 15 employees are not covered by the ADA and are not bound by its pre-offer exam restrictions, though they remain subject to Indiana's general disability discrimination statute (Indiana Code § 22-9-2-1) if their conduct amounts to intentional discrimination based on disability. At-will employment in Indiana is the default rule, but it does not override statutory protections against medical discrimination. Union-represented employees may have additional protections negotiated in collective bargaining agreements, but the agreement cannot reduce ADA protections. Applicants cannot waive their rights under the ADA or Indiana Civil Rights Act in exchange for employment.

Step 1 — Document Everything: Keep copies of all pre-offer communications from the employer, including job postings, application forms, interview notes, and emails. If you were asked medical questions, disability-related questions, or required to take a medical exam before receiving a conditional job offer, document the date, time, person's name, and exact questions asked. Write down the timeline: when you applied, when the interview occurred, when the exam was requested, and when the job offer (if any) was made. Save all written materials, including application forms that asked medical questions or HR communications mentioning medical requirements before an offer.

Step 2 — Understand the Internal Complaint Process and Why It Matters: Before filing an external charge, review your employee handbook or HR policies to identify any internal complaint procedures. Many Indiana employers have an HR department or an anti-discrimination policy requiring complaints be filed internally first. Filing an internal complaint establishes a record within the company and often triggers an internal investigation, which can be valuable evidence later. Document your internal complaint in writing (email is acceptable) to HR or the person identified in the handbook. Keep a copy and note the date sent. Internal complaints do not delay your legal deadlines and may support a retaliation claim if the employer responds negatively after you file.

Step 3 — File an EEOC Charge or Dual State-Federal Charge: Indiana is a non-deferral state, meaning you can file directly with the EEOC without waiting for a state agency to process your complaint first. However, many complainants file dual charges with both the EEOC and the Indiana Civil Rights Commission. The EEOC accepts charges online at www.eeoc.gov/charges or by mail to the Indianapolis District Office. You have 180 days from the discriminatory act (the date you were asked a pre-offer medical question or required to take a pre-offer exam) to file. Include in your charge: (1) the employer's name, address, and phone number; (2) the date of hire or application; (3) a clear description of what happened ("Employer required medical exam before extending conditional job offer in violation of ADA"); (4) the protected category involved (disability); (5) names of witnesses if any; and (6) damages sought if known. The EEOC will issue a Right to Sue letter after investigation, which you need before filing a federal court lawsuit.

Step 4 — The Investigation Process: Expect the EEOC to contact the employer within 30 days of your charge filing and request a written response. The EEOC investigator will review the job posting, application process, the exam itself, and communications. You may be interviewed by phone or in person. The employer will submit its position and may provide evidence that the exam was post-offer or that other candidates were treated the same way. The investigation typically takes 60 to 120 days, though complex cases take longer. You will receive updates by mail; stay responsive if the EEOC contacts you for additional information. After investigation, the EEOC will issue a determination: either "cause" (likely violation found) or "no cause" (insufficient evidence). Even a "no cause" determination allows you to request a Right to Sue letter and proceed to federal court.

Step 5 — When to Consult an Attorney: Consult an employment law attorney immediately if: (1) the EEOC issues a "cause" determination and the employer does not settle; (2) you received a Right to Sue letter and wish to file in federal court; (3) you face retaliation after filing your charge; or (4) you wish to negotiate a settlement. An ADA/disability discrimination attorney in Indiana can represent you before the EEOC, negotiate with the employer, and file a lawsuit in U.S. District Court for the Southern or Northern District of Indiana. Many employment attorneys work on contingency (you pay nothing unless you win or settle). Initial consultations are often free. Ask about the attorney's experience with ADA medical exam cases and whether they have settled similar claims in your jurisdiction.