Pre-Employment Medical Exam Laws in Pennsylvania

The Americans with Disabilities Act (ADA), 42 U.S.C. § 12111, strictly regulates when employers can conduct medical exams. Before extending a job offer, employers covered by the ADA cannot require medical exams or ask disability-related questions—even if other applicants have had pre-employment physical examinations. After a conditional job offer is made, an employer may require a medical exam, but only if all applicants for the same job category must undergo the same exam and the results are kept confidential in separate files.

The exam must be job-related and necessary for the employer's business. The ADA applies to employers with 15 or more employees. The Equal Employment Opportunity Commission (EEOC) enforces these rules. If an applicant is rejected based on exam results, the rejection must be justified by legitimate job-related medical findings. An applicant can refuse a post-offer medical exam, though the employer may rescind the offer if the exam is a condition of employment. Remedies include back pay, front pay, attorney fees, and compensatory damages.

Pennsylvania does not have a state statute that is stronger or more protective than federal ADA law regarding pre-employment medical exams. The Pennsylvania Human Relations Act (43 P.S. § 951 et seq.) prohibits disability discrimination in hiring but defers to federal ADA standards for the timing and scope of medical examinations. Employers in Pennsylvania with 15 or more employees are covered by both the ADA and the Pennsylvania Human Relations Act; smaller employers are not covered by either federal or state law but may be subject to other state regulations.

Pennsylvania law incorporates the same pre-offer prohibition found in the ADA: no medical exams or disability-related questions before a job offer. However, Pennsylvania has not expanded protections beyond federal requirements. The state does not provide a separate private cause of action for pre-employment medical exam violations independent of the ADA; instead, remedies flow through the ADA framework.

One important distinction is that Pennsylvania employers must comply with state workers' compensation laws (Pennsylvania Consolidated Statutes Title 77) when conducting post-offer medical exams. If an exam reveals a condition that would qualify for workers' compensation, the employer cannot use that finding to withdraw an offer unless the condition genuinely prevents the applicant from performing essential job functions. Additionally, Pennsylvania recognizes implied contracts in employment, which may limit at-will employment in certain contexts, but this does not affect pre-employment exam rules.

For enforcement in Pennsylvania, applicants can file charges with the U.S. Equal Employment Opportunity Commission (EEOC) or the Pennsylvania Human Relations Commission (PHRC), which operate under a worksharing agreement. Both agencies follow identical ADA standards for pre-employment medical exam violations.

The ADA exception permitting post-offer medical exams applies only when the exam is job-related and required for all applicants in the same position. Employers may conduct exams to determine if an applicant can safely perform essential job functions, such as a construction worker passing a fitness exam or a driver passing a vision test. However, the exam cannot be used as a pretext to screen out people with disabilities.

Small employers with fewer than 15 employees are not covered by the ADA and have greater discretion to require medical exams, though they may still face liability under other laws such as state tort law or disability discrimination statutes that apply to smaller employers in some contexts. Independent contractors are not covered by the ADA, so an employer may require medical information from a contractor without triggering ADA restrictions.

The confidentiality requirement has an exception: an employer may disclose exam results to supervisors and managers if they need to know about job accommodations or restrictions. Similarly, first aid and safety personnel may access information necessary to provide emergency care. An employer may also disclose results when legally required, such as in response to a government investigation.

Another exception exists for certain safety-sensitive positions. Federal law allows the Department of Transportation (DOT) and other federal agencies to mandate medical exams for commercial drivers and certain occupations. These exams are lawful even if not job-related in the traditional sense, because they serve a compelling public safety interest. However, Pennsylvania employers cannot create their own safety exception—the exception applies only to federally mandated exams.

Step 1: Document everything immediately. If an employer requested a medical exam or disability-related questions before extending a job offer, save all emails, job applications, interview notes, and any written communications. Keep records of the date, time, and specific questions asked. Document the names and titles of anyone who participated in the process. Take screenshots of online applications that ask health or disability questions.

Step 2: Attempt internal resolution if possible. Contact the employer's HR department in writing (email is acceptable) and explain that pre-offer medical exams violate the ADA. Request clarification of the employer's hiring process and whether the exam was truly a pre-offer requirement. This step is not required to file a charge, but it creates a paper trail and may prompt the employer to correct the practice. Keep a copy of all correspondence.

Step 3: File a charge with the EEOC or Pennsylvania Human Relations Commission (PHRC). In Pennsylvania, you have 300 days to file from the date of the violation. You can file with either agency; they operate under a worksharing agreement. To file with the EEOC, visit www.eeoc.gov or call 1-800-669-4000 to schedule an in-person interview at the Philadelphia or Pittsburgh office. To file with the PHRC, visit www.phrc.pa.gov or call 717-787-9780. Include your name, contact information, the employer's name and address, the date the illegal exam or question was requested, and a detailed description of what happened. Provide names of witnesses if possible.

Step 4: Understand the investigation process. The EEOC or PHRC will investigate your charge within 120 days. The agency will notify the employer of your charge and request a response. You may be asked to provide additional documentation or participate in interviews. The investigator will review company hiring records, policies, and testimony from other applicants and managers. Most charges settle during investigation; if not, the agency will issue a determination of whether there is probable cause to believe a violation occurred. If the agency finds probable cause, you may enter conciliation or move toward litigation.

Step 5: Know when to consult an attorney. If you did not get the job and believe it was due to the illegal medical exam, consult an employment lawyer experienced in ADA cases. An attorney can evaluate whether you have a discrimination claim beyond the medical exam violation. Attorneys in this area typically work on contingency (no upfront cost) if they believe the case is strong. Contact the Pennsylvania Bar Association's Lawyer Referral Service at 1-800-932-0777 or visit www.pabar.org.