Pre-employment health assessment is legitimate where it addresses genuine job requirements. It becomes a problem when it is used as a general filter, because it then engages human rights and privacy obligations without producing useful information.
The legitimate purpose
The health and safety duty requires you to ensure workers are not exposed to risks so far as reasonably practicable. Where a role has specific physical or health demands, assessing fitness for those demands is a reasonable step.
Examples with a genuine basis: hearing baseline for work in high-noise environments, respiratory baseline where there is dust or fume exposure, vision requirements for certain machinery, and fitness assessment for physically demanding roles.
Note that several of these are baseline monitoring rather than screening — establishing a starting point so that later deterioration can be attributed and managed. That is a different and often more useful purpose than deciding whether to hire.
The discrimination boundary
The Human Rights Act prohibits discrimination on grounds including disability. Refusing employment because of a health condition is unlawful unless the person cannot perform the duties of the position even with reasonable accommodation, or would require unreasonable disruption or risk.
Two implications:
- Assess against the actual requirements of the role, not against general health. A condition that does not affect the person’s ability to do the job is not a lawful basis for declining them.
- Consider accommodation. The question is whether they can do the job with reasonable adjustment, not whether they can do it exactly as everyone else does.
Blanket questionnaires asking about every condition, unrelated to the role, invite exactly the wrong analysis and create a record that is difficult to defend.
Privacy obligations
Health information is personal information and among the most sensitive categories.
- Collect only what is necessary for the stated purpose. If the role does not involve heavy lifting, you do not need a back history.
- Tell the person what you are collecting, why, who will see it and how long it will be held.
- Get informed consent, genuinely. Consent obtained under the implicit threat of losing the offer is weak.
- Restrict access. Health information should not sit in a general personnel file readable by any manager. The hiring manager generally needs to know fitness for the role, not the underlying condition.
- Hold securely and dispose when no longer needed, particularly for unsuccessful candidates.
Where an occupational health provider conducts the assessment, the appropriate output to the employer is a fitness statement — fit, fit with accommodations, or not fit for specified duties — rather than clinical detail.
Drug and alcohol testing at recruitment
Pre-employment testing as a condition of an offer is generally accepted for safety-sensitive roles. It is much harder to justify for roles where impairment creates no meaningful safety risk.
Requirements: a policy setting out which roles are covered and why, use of an accredited provider following recognised standards, confirmatory laboratory testing of any non-negative screen, and a process that allows the person to explain a result including prescribed medication.
Be clear about what a positive result means. Urine testing detects metabolites that can remain well after any impairing effect, so presence is not evidence of impairment at work. If your standard is presence, say so and be prepared to justify why that standard is reasonable for the role.
Timing
Health assessment should generally come after a conditional offer, not during shortlisting. Collecting health information from every applicant creates a large volume of sensitive data about people you will not employ, and invites the inference that health influenced selection.
What to do with an adverse finding
Do not simply withdraw the offer. The sequence that holds up:
- Identify precisely which duties are affected.
- Consider what accommodation would allow the person to perform them.
- Discuss it with the person — they frequently know what works.
- Assess whether the accommodation is reasonable in your circumstances.
- Document the reasoning.
WorkSafe publishes health monitoring guidance, the Human Rights Commission publishes material on employment discrimination, and the Office of the Privacy Commissioner publishes guidance on health information. All free.
General information only, not legal advice. Take advice before declining a candidate on health grounds.
