Question: One of our employees has been getting into heated arguments with coworkers. We think he might be having mental health issues. Can we require a fitness-for-duty exam?
Answer: Not necessarily. You need to get more facts. If the employee is just being argumentative and yelling at coworkers without justification, the appropriate response is probably discipline, not a medical exam. You don’t need to figure out what’s wrong with the employee (if anything), you just need the behavior to stop. Your investigation could also reveal that the coworkers, not the employee, are instigating the altercations. However, if the employee’s statements or actions indicate that he’s untethered from reality to the extent that he can’t effectively perform his job or is a danger to himself or others, a mental health fitness-for-duty exam may be appropriate.
When ADA Rules Apply to Fitness-for-Duty Decisions
As we previously reported, the Americans with Disabilities Act (ADA) prohibits employers from inquiring about an applicant or employee’s disability status unless it’s job-related and consistent with business necessity. Both factors must be met by objective evidence before you can lawfully seek information that may reveal disability status. You’ll need to set aside all assumptions while you gather factual information surrounding these incidents. Then consult your Vigilant Law Group employment attorney or other legal counsel to determine whether it’s appropriate to proceed with discipline or ask for a fitness-for-duty exam. For example, if an employee threatens to kill a coworker, you would typically be justified in terminating the employee or placing them on a last-chance agreement. In contrast, if an employee threatens to kill themself, it would generally be appropriate to place the employee on leave until a health care provider can verify whether they are medically fit for duty (with or without a reasonable accommodation under the ADA). In that case, the danger that the employee could harm themself at work would likely be sufficient to show that your request for a fitness-for-duty exam is job-related and consistent with business necessity.
Court Awards Damages for Unjustified Mental Health Exam
A federal court recently ruled that an employee was entitled to damages resulting from his employer’s violation of the ADA’s prohibition against unjustified medical exams and inquiries. The employee sued after he was placed on leave and required to undergo a mental health fitness-for-duty exam due to his involvement in a series of altercations at work. His doctor deemed him fit for duty, but the employee argued that he shouldn’t have been put on leave and subjected to a mental health inquiry in the first place because it wasn’t job-related and consistent with business necessity. The court agreed and ruled that the employer’s ADA violation amounted to discrimination “on the basis of disability,” which meant the employee could be awarded backpay (Nawara v. Cook County, 7th Cir., April 2025).
This is a tricky area for employers to navigate. As demonstrated by this case, individuals are protected under the ADA from unnecessary employer-required medical exams even if they don’t have an actual disability. For more information, see our Legal Guide, ADA: Post-Job-Offer Medical Exams, and Model Form, Fitness for Duty Report, and contact your Vigilant Law Group employment attorney with any specific questions.
If we’re not already partnering with your company on ADA compliance and other complex HR and employment matters, contact us to learn how becoming a Vigilant member can help you stay proactive in addressing key issues.
