Suzanne Watson MD, MDiv, MEd

Del Mar Psychiatry


In-Person Appointments & Telemedicine Available, 317 14th Street, Suite D
 Del Mar, CA 92014

Fitness-for-Duty Evaluations

When an employee's job performance has been called into question, a Fitness-for-Duty (FFD) evaluation may be ordered by the employer. An FFD evaluation determines whether there are physical and/or psychological issues that are affecting the employee's job performance. An FFD evaluation may also be requested in advance of hiring someone in order to determine the likelihood of success on the job. FFD evaluations are performed for government agencies, the military, police departments and some private companies.

Reasons for Fitness-for-Duty Evaluations

There are two basic situations that require an FFD evaluation. Either of them may be considered detrimental to the efficiency or general atmosphere of the workplace, or deemed dangerous to the well-being of staff or clients.

Problematic Behavioral Condition

A problematic behavioral condition is any physical or behavioral problem, such as substance abuse, that interferes with job performance. It may include peculiar or dangerous behavior, or "immoral" or illegal conduct.

Serious Medical Condition

A serious medical condition is one that interferes with work, or that requires clearance for an employee to return to work following a medical leave of absence. Evaluations of medical conditions must be made by healthcare providers.

Qualifications for Fitness-for-Duty Evaluations

In order to perform a behavioral FFD evaluation, the examiner should be:

  • A licensed psychologist or psychiatrist
  • Familiar with the laws surrounding such inquiries

Methods of Fitness-for-Duty Evaluations

It is important that FFD evaluations be done as carefully, completely and specifically as possible, and that all subjects are treated with respect.

Usage of Specific Information

It is always necessary for an evaluator to cite specific incidents. For example, an individual should not be psychologically assessed as "generally depressed" or "overly emotional." Rather, it might be noted that the person has shown up late to work 5 times during a 2-week period, has prompted 7 customer complaints, or has broken a piece of equipment during a tirade. Similarly, in terms of medical fitness for duty, an individual should not be called "too tired," but rather might be observed as becoming breathless and having to rest after lifting a ream of paper. Records must be kept to ensure that any incident cited can be independently corroborated.

Attempts at Remediation

In most situations, it is incumbent on an employer to make certain accommodations for a disability or medical condition. It is also necessary to direct an individual to get further medical treatment or counseling if either is deemed necessary. This is especially true when there is contract employment or union stipulations involved. When it can be substantiated that counseling or other treatment has failed, the employee may be relieved of duties.

Fitness-for-Duty Report

It is necessary that an FFD report be thorough, and provide convincing evidence as to whether an employee should be dismissed. There are several parts to a FFD evaluation, which include:

  • Identifying data
  • Reasons for evaluation
  • Background information pertinent to employment
  • Clinical interview and observations
  • Psychological test evaluations
  • Review of records
  • Conclusion and recommendations

The FFD final report indicates the integrated findings of the psychiatrist or psychologist. The facts are presented in a condensed, readable fashion, with emphasis on the results pertinent to the particular job involved. Usually, the result is one of those listed below.

Unfit for Duty

A finding of "unfit for duty" means that the person has a physical, mental or emotional problem that will interfere with work performance for the foreseeable future. The recommendation is termination of employment.

Unfit but Treatable

A finding of "unfit but treatable" means that the person is, at present, unfit to work, but is willing to participate in a treatment program that will likely have good results.

No Psychological Diagnosis

"No psychological diagnosis" means that no evidence has been found of psychological disturbance that would interfere with employment. The recommendation may be that the person receive on-the-job training, education or coaching, but it is also possible that disciplinary action will be recommended.

Invalid Results

An "invalid results" conclusion is reached when there is a major discrepancy between the way the person presents at an interview or answers test questions, and the person's behavioral history. Someone might, for example, fake an engaging personality or give clearly false answers to questions, thereby invalidating the results.

Additional Resources

Del Mar Psychiatry