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Published on January 29, 2021

Strategies for Effective and Efficient Pre-Employment Screenings

Pre-employment health screenings can have a dramatic, positive impact on the amount of money your company spends on healthcare. They can also increase your employee retention rate and significantly affect the overall health and fitness of your workforce. However, pre-employment physicals and substance abuse screenings can be a very complex area for HR departments to navigate.

Laws vary by state. National regulations and compliance with the Americans with Disabilities Act (ADA), the Federal Motor Carrier Safety Administration (FMCSA), the Genetic Information Nondiscrimination Act (GINA), and more are tedious and consequential. Asking the wrong question — or the right question at the wrong time — can create a serious liability for your company.

The complexities and consequences are the main reasons that many organizations elect to let experts with continually current compliance and best practices organize and carry out their pre-employment health screenings. For many years, Cone Employee Health & Wellness has been a trusted healthcare partner in pre-employment examinations and screenings for organizations in Greensboro and the Piedmont Triad of North Carolina. Read our tips for making this part of your hiring process efficient and effective, and then get in touch with our team to learn about the value and savings we generate for our clients.

Types of Pre-Employment Physicals

You might be surprised to see some of the items on the list below — there are a growing number of pre-employment exams that have been developed in recent years. Though they test for different capabilities, they all have the same essential purpose: to help employers understand if an applicant can adequately perform the essential duties of a position. These screenings could include:

  • Strength tests to measure how much someone can lift, carry, or move.
  • Physical capacity profiles are tests that provide employers with objective medical information regarding an employee’s physical abilities.
  • Drug & Alcohol tests to ensure applicants are not suffering from a substance abuse addiction or dependency.
  • Heart Health tests to measure blood pressure, pulse rate, and other metrics of this core indicator for overall health.
  • Hearing & Vision tests to ensure workers can safely carry out essential duties in their work station or area.
  • General Physical tests to screen for undetected chronic conditions, examine prior injuries, range of movement, and more.

Some jobs will require a specific combination of tests. For example, DOT physicals are not only a common pre-employment screening, but also something that drivers need to get on a regular basis. Those physicals will measure vision, hearing, heart functions, urinalysis, and a broad physical examination of an applicant’s overall health.

How Your HR Team Can Optimize Pre-Employment Health Screenings

Whether you are going to handle all of the pre-employment health screening details in-house or partner with a trusted healthcare provider, these are essential guidelines you can take to make things efficient and effective.

Maintain Thorough Updated Job Descriptions

Keep your job descriptions and the list of physical requirements for each position in your company updated regularly. You should be able to clearly tie any screening or physical to specific job duties. These descriptions and screening requirements should be reviewed and adjusted at least yearly or anytime a new job description is created or revised. Not only will this help ensure that your pre-employment health screenings are testing for the right capabilities, but it will also minimize your company’s liability for conducting unnecessary screenings or ones that no longer fit an outdated position description.

When you create and review your job descriptions, it’s also important to make a distinction between essential and non-essential functions for each position. The U.S. Equal Opportunity Commission (EEOC) has defined an essential function as: "the basic job duties that an employee must be able to perform, with or without reasonable accommodation.” Here are some good questions to ask when considering whether a function is essential or not:

  • Does the position exist for the purpose of performing this function?
  • How many other employees are able to perform this function?
  • Can the performance of this function be redistributed among other employees?
  • How much skill or expertise is required to perform this function?

The EEOC has outlined more specific information that you’ll find helpful in navigating the process of creating ADA-compliant job descriptions. Review their resources about your responsibilities as an employer here and see their Glossary for Small Businesses for even more helpful information.

Ensure Applicants Have Everything They Need

This is one of the most important things your company can do to make your pre-employment health screenings be as helpful, efficient, and effective as possible. After you’ve determined that a job candidate is a potential fit for a given position and decide to order a physical or drug screening, provide them with a clear and thorough checklist of things they will need to bring to their physical examinations. That could include:

  • Directions to the doctor’s office or testing facility
  • Contact details and information about scheduling their appointment(s)
  • Instructions about what to expect and how to prepare for their screening(s)
  • Lab orders, which physical(s) they need, and other information for doctors and clinicians
  • Proper identification
  • Hearing aids
  • Glasses or contacts
  • A current, accurate list of medications they take
  • General medical history information (allergies, past surgeries, chronic health conditions)

Your goal here is to give your applicants everything they will need to prepare for and complete their pre-employment physical or screening in one easy-to-reference document or packet of materials.

What Can Your Company Save with Pre-Employment Health Screenings?

The answer will depend on many factors, but the bottom line is that effective screening before you hire new employees will likely reduce injuries and accidents in the workplace, detect and help treat chronic conditions earlier, increase productivity, and lower both the number of workers' compensation claims at your organization and also the average cost of those claims. A 2019 study found that the University of Illinois at Chicago saved an estimated $18 dollars for every $1 dollar spent on their pre-employment screening program.

Physicals and screenings are just one component of the occupational health services we provide to local businesses and organizations at Cone Employee Health & Wellness. Explore the benefits for your company and contact Jacqueline Heyward at or 336-832-7315 to learn more.

Strategies for Effective and Efficient Pre-Employment Screenings