Pre-employment physical exams are a critical part of the hiring process. Contingent upon an applicant’s ability to pass the exam, pre-employment physicals help ensure that job applicants are physically capable of performing required job tasks.

How much does a pre-employment physical cost? The cost of a physical exam for work depends on the employer’s required exam type and specialty. Using national pricing as a guideline, exam costs could range between $100 and $700.

In this blog, we explore why pre-employment physicals are important, what they screen for, and the financial costs involved.

What is a Pre-Employment Physical

Doctor examining job applicant in a medical room with job application forms in the foreground.

A pre-employment physical exam is often required by employers before an offer is extended to a job applicant. These exams help ensure that a candidate has the physical ability to perform a job safely and without risk of injury.

Components of a Pre-Employment Physical?

The components of a pre-employment physical are dictated by the industry, position, and, in some cases, government regulations.

What Does a Pre-Employment Physical Consist of?

Pre-employment physical exams include a variety of tests and evaluations:

  • Weight
  • Blood pressure
  • Temperature
  • Heart rate/pulse
  • Respiratory health
  • Cardiovascular health
  • Reflexes
  • Range of motion
  • Hearing
  • Vision

In addition, a pre-employment physical may include an assessment of:

  • Physical ability (including the ability to perform certain functions required for the position, such as lifting or aerobic activity)
  • The candidate’s medical history
  • Laboratory tests
  • Psychological and cognitive screening
  • Strength, stamina, and physical endurance
  • Drug and alcohol screening (if the position requires the operation of heavy equipment, machinery, or a commercial motor vehicle (CMV) — and any substance abuse could put the employee, other workers, and the public at risk)

What’s Included in a Full Physical Exam?

The specific tests performed during a full physical exam vary based on the position an applicant has received a conditional job offer for, the employer’s industry, and the functions the individual must perform.

For example, the U.S. Department of Transportation (DOT) requires that all applicants in safety-sensitive positions undergo a DOT physical. A DOT physical exam is used to screen CMV drivers to determine if they are healthy enough to perform their roles. DOT medical exams are mandated by the Federal Motor Carrier Safety Administration (FMCSA) and help keep the nation’s roads safe. A driver must participate in a physical to maintain a valid commercial driver’s license (CDL). The exam is valid for 24 months.

Other industries that require a pre-employment physical include construction, manufacturing, law enforcement, firefighters, healthcare, and more. These physical exams focus on the candidate’s strength, stamina, and drug and alcohol use and are essentially a medical clearance for work.

What’s the difference between a pre-employment physical and a regular physical? A pre-employment physical is designed to assess a candidate’s ability to perform specific job functions and record baseline health. While a typical annual physical is performed by an individual’s primary care physician and is more in-depth and comprehensive.

Understanding the Cost of Pre-Employment Physicals

Calculato and dollars on a table, representing the cost of pre-employment physicals.

How much does a pre-employment physical examination cost?

Factors Influencing the Cost of Pre-Employment Physicals

The cost of a pre-employment physical exam depends on several factors including the type of position the employee is being hired for and the complexity of tests involved.

Physical Exam Cost Without Insurance

The typical cost for a pre-employment physical examination is dependent on the employer’s compliance or regulatory requirements and is priced anywhere between $100 and $700. These costs vary depending on the medical examiner, state, and the employer’s screening requirements.

Who Foots the Bill

Employer and job applicant sitting across a table with a bill for a pre-employment physical exam.

Both employers and future hires understandably have questions about who pays for pre-employment physicals and how that rate varies. Let’s address some of these questions.

Who Pays for Pre-Employment Physical Exams?

The cost of a pre-employment physical exam is typically the responsibility of a prospective employer – not the individual being evaluated. In fact, in most cases, insurance companies will not cover the cost of a pre-employment physical for employers or potential employees.

There are benefits to employers in covering these costs. For instance, physical exams help employers gain valuable insight into the health of their workforce and save money by reducing workplace accidents and absences. They also help ensure compliance with occupational health and safety regulations.

Pre-employment physicals are especially important in detecting chronic conditions that can impede an individual’s ability to perform work-related tasks. They also provide a medical baseline that is used to track an employee’s health or injuries over time.

Physicals also provide recruitment and retention advantages. By offering health and wellness screening, organizations demonstrate how much they value their employees.

Low-Cost Work Physicals and How to Find Them

To keep costs low, employers should look for a network of pre-employment physical providers who have screening sites near them. Alternatively, on-site examination options can bring the process nearer to, or scheduled at the workplace, increasing convenience for job applicants and reducing screening cost and time.

In the rare event that an employer does not cover the cost of a pre-employment physical, job applicants who are expected to undergo a physical exam for work should consult their insurance provider to see if any portion of the exam is covered. Alternatively, occupational health services providers or outpatient medical facilities offer affordable pre-employment physical exams. A search for “urgent care physical exam” or “free physical exam near me” will suggest options.

Special Cases in Pre-Employment Physicals

A lineup of workers from different industries being examined by medical professionals.

In addition to DOT-regulated industries, other sectors, such as healthcare, have special requirements for pre-employment physicals.

Physical Exam for Healthcare Workers

Because of the high-risk nature of their occupation, healthcare workers are subject to unique requirements and tests as a condition of employment.

Many nurses and providers are required to lift and move patients and must have the stamina to perform these tasks – and be free of health conditions that could be exacerbated by heavy lifting, such as cardiovascular disease, high blood pressure, vertigo, or a recent surgery or injury.

Healthcare workers must also undergo screening to ensure they are free of communicable diseases, such as air-borne and blood-borne pathogens (Hepatitis A, B, and C and HIV).

Potential Roadblocks: Reasons for Failing a Pre-Employment Physical

There are various reasons why job candidates might not pass a pre-employment physical. For instance, if they don’t meet the requirements for strength or stamina and cannot perform their job without modifications, they might be disqualified from roles like firefighting or operating heavy equipment.

Can high blood pressure cause you to fail a pre-employment physical? The answer depends on the industry and role an individual is applying to. DOT regulations state that candidates with blood pressure that is too high or uncontrolled cannot be cleared for employment. However, other industries may pass a candidate or require them to undergo a treatment plan to lower their blood pressure and retake the exam at a later date.

If a job candidate fails a pre-placement physical exam an employer is legally permitted to withdraw the contingent or conditional job offer. However, the exam results may not be used to discriminate against the candidate/employee. Their medical records and history become confidential and are protected as Protected Health Information (PHI) and Personal Identifying Information (PII).

Other reasons why a job applicant may fail a pre-employment physical include:

  • A failed drug or alcohol test
  • Inability to stand or sit for a protracted period of time
  • A vision impairment that can’t be corrected to 20/40 in each eye
  • A chronic condition such as insulin-treated diabetes mellitus (ITDM) or heart disease
  • Certain mental health conditions, including dementia, PTSD, ADHD, bipolar mood disorder, and more

Note: The U.S. Equal Employment Opportunity Commission and Americans with Disabilities Act (ADA) prohibit employers from failing a candidate based on any disability.

FAQs on Pre-Employment Physical Costs and Procedures

What is a pre-employment physical?

A pre-employment physical exam is often required by employers before an offer is extended to a job applicant. These exams help ensure that a candidate has the physical ability to perform a job safely and without risk of injury.

Who pays for a pre-employment physical?

The cost of a pre-employment physical exam is typically the responsibility of a prospective employer.

What does a complete physical include?

Pre-employment physical exams include a variety of tests and evaluations:

• Weight
• Blood pressure
• Temperature
• Heart rate/pulse
• Respiratory health
• Cardiovascular health
• Reflexes
• Range of motion
• Hearing
• Vision

In addition, a pre-employment physical may include an assessment of:

• Physical ability (including the ability to perform certain functions required for the position, such as lifting or aerobic activity)
• The candidate’s medical history
Laboratory tests
• Psychological and cognitive screening
• Strength, stamina, and physical endurance
• Drug and alcohol screening

What reasons would you fail a pre-employment physical?

Job applicants may fail a pre-employment physical for several reasons, including:

• A failed strength or stamina test
• High blood pressure
• A failed drug or alcohol test
• Inability to stand or sit for a protracted period of time
• A vision impairment that can’t be corrected to 20/40 in each eye
• A chronic condition such as insulin-treated diabetes mellitus (ITDM) or heart disease
• Certain mental health conditions, including dementia, PTSD, ADHD, bipolar mood disorder, and more

What happens if a job applicant fails a pre-employment physical exam?

If a job candidate fails a pre-employment physical exam an employer is legally permitted to withdraw the contingent or conditional job offer. However, the exam results may not be used to discriminate against the candidate/employee. Their medical records and history become confidential and are protected as Protected Health Information (PHI) and Personal Identifying Information (PII).

However, exceptions can be made. For example, if a medical examiner finds that a candidate for a firefighter position cannot perform their essential job tasks due to a specific condition, the physician can recommend restricting that individual from performing tasks that cannot be safely performed given their medical condition.

What types of drugs can be detected in a pre-employment physical exam?

A five-panel drug test is a common pre-employment drug screening exam for job candidates. The test is used to determine the presence of cocaine, marijuana, amphetamines, opioids, and phencyclidine (PCP). Workplace drug testing may also check for alcohol.

Understanding Performance Evaluations

Job candidate lifting a box during a performance evaluation with charts and graphs in the background.

Like physical exams, human performance evaluations (HPEs) are a form of pre-employment screening.

What is a Human Performance Evaluation?

A human performance evaluation is a pre-employment screening measure that compares a job applicant’s physical abilities to those required for a position. The exam assesses whether the individual can complete tasks safely and without risk of injury.

Types of Performance Evaluation

What are the two types of performance evaluations?

Employers can use two types of evaluations to assess a potential hire’s physical readiness for a position: a human performance evaluation or a pre-employment physical.

These screening methods are frequently mistaken for being identical. Nevertheless, there exist significant distinctions:

  • A pre-employment physical is performed by a licensed medical examiner or practitioner in a medical setting and focuses on assessing a candidate’s overall health.
  • A HPE focuses more on the tasks the candidate must perform daily. The evaluation is often completed by a licensed occupational therapist.

Key Components of a Performance Evaluation

What are the three components of a performance evaluation? A human performance evaluation includes:

  • A review of the candidate’s medical and occupational history
  • A medical examination
  • Evaluation of functional tasks such as heavy lifting, pushing, pulling, and carrying

Human performance evaluations must be performed in compliance with ADA guidelines and can only test for medical or physical issues that would prevent a potential hire from safely performing their duties. They must also be given to every candidate offered a job and cannot be limited to specific individuals.

A see-saw in a park-like setting with a doctor and employer in balance, symbolizing the cost and necessity of pre-employment physicals.

Regardless of cost, pre-employment physicals are an important part of maintaining occupational health and workplace safety. A physical exam for work also helps job applicants ensure they are the right fit for a role and not at risk of injury.

More importantly, a pre-employment physical exam helps employers make informed, objective decisions about hiring based on an applicant’s physical and behavioral health and monitor employee health over time.

If you have questions or are looking to start or optimize your pre-employment physical program, contact us to learn more about how Acuity can help. We combine our pre-employment physical exam services with advanced technology and a widespread provider network to give organizations 24/7 access to scheduling, exam status notifications, case management reporting, and more.

Learn more about Acuity Medical Exam Services.