What Medical Information Is An Employer Entitled To?

Employers Can Only Ask About Health Information In Limited, Relevant Circumstances

Often, one of the first questions we hear from employees after obtaining health insurance through their Colorado employer is, “What medical information is an employer entitled to?” The good news is that federal law provides robust privacy protections and places many limitations on when and what employers can ask regarding an employee’s medical history and conditions.

However, companies can inquire and request personal health information in limited circumstances, usually when such information is directly related to the employee’s ability to do their job.

What Medical Information Is An Employer Entitled To Under the Americans With Disabilities Act?

The Americans With Disabilities Act (ADA) is a comprehensive federal law that addresses discrimination based on disabilities or health conditions and includes discrimination in the workplace. To prevent employers from making hiring and employment decisions based on a candidate’s or employee’s perceived disability, the ADA prohibits them from asking about health and disabilities.

That said, there are three circumstances in which an employer can request or require health information from an employee.

Condition That Poses Safety Risk or Impacts Ability To Do Job

The Equal Employment Opportunity Commission (EEOC) is the governmental agency that enforces employment provisions in the ADA. According to their guidance, an employer may make a disability or health-related inquiry or request that an employee undergoes a medical examination if the request is “job-related and consistent with business necessity.” According to the EEOC, these circumstances exist when an employer “has a reasonable belief, based on objective evidence,” that:

• an employee’s medical condition will impair their ability to perform essential job functions; or
• an employee may pose a direct threat to themselves or others because of a medical condition.

Examples of what medical information an employer is entitled to are when an employer:

• knows about an employee’s medical condition;
• observes performance problems reasonably connected to the employee’s medical condition;
• receives information or documentation from a credible third party that an employee has a medical condition; or
• observes symptoms or other indications that an employee may have a medical condition.

Request for Reasonable Accommodation

Under the ADA, businesses employing 15 or more full-time employees must provide “reasonable accommodation” for qualified applicants and employees with disabilities. Reasonable accommodations can include alterations to the work environment or how a job is typically performed to enable a disabled individual to apply for a position, perform the job, or have equal access to the benefits and privileges of the job. An employer is not required to provide a requested or proposed accommodation if it would cause significant difficulty or expense. Thus the quantifier “reasonable.”

Additionally, if the disability or need for accommodation is not known or obvious, an employer may ask health and disability-related questions and request information about the employee’s condition, and capabilities after an employee requests reasonable accommodation.

What Medical Information Is An Employer Entitled To When an Employee Requests Medical Leave?

The Family and Medical Leave Act (FMLA) requires covered employers to provide employees with protected, unpaid leave for qualified medical and family reasons. When an employee requests leave based on a claimed medical condition, the medical information an employer is entitled to include confirmation and evidence to support the employee’s health-based request.

Therefore, an employer has the legal right to ask the employee to provide a certification from their physician or health care provider explaining the reasons behind the need for leave and the expected duration of the condition/leave. At the anticipated end of the requested leave period, the employer may again ask for a physician’s certification that the employee is ready and able to return to work.

The employer has the legal right to reject the request if the employee does not provide a requested certification when asking for leave. An employee must provide the requested medical certification within 15 days after the employer’s request (unless that time frame is not feasible or the employer agrees to give the employee more time). If the employee doesn’t return the certification on time, the employer can deny the FMLA leave request until the employee provides a complete and sufficient certification.

Preferred Insurance: Guiding Employees Through Their Group Health Insurance Benefits

Do you have more questions about what benefits come with your employer-provided group health insurance policy? At Preferred Insurance, we work with employers to obtain the best group health insurance for their company. Then we shift our focus to individual employees to ensure they get the most from their policy. This is one of the many free benefits of buying health insurance through a broker.

Speak with one of our independent health insurance brokers today.