Pre-employment Medical Examination: What It Is and When It Is Mandatory

Legislative Decree 106/09 introduced the possibility for employers to assess a candidate’s fitness for work prior to the formal establishment of an employment relationship, i.e., before the employer and employee sign a contract.

When the employee formally receives the medical judgment in writing from the occupational health doctor, they may contest it by filing an appeal under paragraph 9 of Article 41, which states:
“Appeals against the judgments of the occupational health doctor, including those issued during the pre-employment phase, can be filed within thirty days from the date the judgment is communicated. Appeals must be addressed to the territorially competent supervisory body, which, after any additional assessments, may confirm, modify, or revoke the judgment.”

As this is a medical examination aimed at providing a specific fitness judgment, it must comply with all the criteria for a pre-employment medical examination.

Health and Safety Regulations on Pre-employment Medical Examinations

Workplace health and safety regulations stipulate that, in cases of hiring, a medical examination must also be conducted to assess the employee’s fitness for the position they will be assigned. This applies when the position requires health surveillance, as defined by Legislative Decree No. 81 of 2008.

After the examination, the occupational health doctor issues a document known as the Fitness for Duty Judgment, which the employer must adhere to when assigning the role to the employee.

The regulations distinguish between two types of medical examinations:

1. Pre-employment medical examination: Conducted before the employment relationship begins.
2. Preventive medical examination: Conducted after hiring but before the employee starts work.

Pre-employment Medical Examination: What Does It Involve?

A pre-employment medical examination is conducted by the occupational health doctor at the employer’s request to verify whether the candidate is fit for the position they would be assigned upon hiring.

This examination serves as a form of protection for the employer, ensuring that only those who are genuinely fit for the role are hired.

When Is a Pre-employment Medical Examination Mandatory?

Initially, this type of examination was explicitly prohibited under Article 41 of Legislative Decree 81/08. However, this prohibition was repealed by Legislative Decree 106/2009.

Despite this change, the regulations do not mandate pre-employment medical examinations, which remain optional. However, a preventive medical examination is mandatory after the employee is hired.

The pre-employment medical examination must be strictly related to positions requiring health surveillance. Under no circumstances can it be conducted to determine the pregnancy status of a potential employee.

What Tests Are Included in the Pre-employment Medical Examination?

The tests conducted depend on the nature of the position the employee will occupy. Common medical assessments include:

1. Eye Examination: To detect vision problems, essential for roles involving screen use (e.g., video display terminal operators).
2. Spirometry: To evaluate lung capacity, useful for roles involving exposure to dust or toxic substances.
3. Audiometry: To assess hearing issues, crucial for positions with exposure to loud noises.
4. Blood Tests: To provide a general overview of the potential employee’s health.
5. Alcohol and Drug Testing: To detect substance use, necessary for roles involving vehicle operation or safety-critical tasks.

This approach ensures that businesses comply with legal requirements while safeguarding the health of their workforce and mitigating potential workplace risks.