HRM-037: Evaluating Employee Fitness for Duty
- Fitness for Duty Requirements
- Coordinating Team
- Results of the Evaluation
- Return to Work
- Acts or Threats of Violence and the Threat Assessment Team
- Confidentiality/Privacy of Fitness for Duty Evaluations
- Clinical Staff and Allied Health Professionals
The University of Virginia is committed to promoting a safe and healthy environment for its employees, students, patients and visitors. Such an environment is possible only when each employee is able to perform his or her job duties in a safe, secure, and effective manner, and remains able to do so throughout the entire time they are working. Employees who are not fit for duty may present a safety risk to themselves and to others.
This policy outlines the responsible parties and necessary actions when an employee’s fitness for duty is in question, the steps necessary to assess the employee’s physical or mental capabilities, necessary follow-up, and return to work.
Allied Health Professionals:
Optometrists, audiologists, substance abuse counselors, professional counselors, clinical social workers, nurse practitioners, physician assistants and certified registered nurse anesthetists granted clinical privileges to provide care and treatment to patients of the UVA Medical Center.
Physicians, dentists, podiatrists, Ph.D. clinical psychologists or Ph.D. clinical pathologists granted clinical privileges to provide care and treatment to patients of the UVA Medical Center.
The appropriate parties/offices (based on the specific situation) responsible for coordinating and facilitating the fitness for duty evaluation. The coordinating team typically includes individuals from University Human Resources, the Faculty and Employee Assistance Program (FEAP), the Office of the Provost, and UVA-WorkMed. If applicable, representatives from departmental human resources and the Physician Wellness Program shall be included on the team.
A person appointed through University Human Resources and paid through University payroll to perform services through the University, who performs services that are subject to the will and control of the University -- both what is done and how it is done. The University's right to control, not the exercise of that right, is a key factor. The University can allow the employee considerable discretion, so long as the University has the legal right to control both the methods and results of the services.
Faculty and Employee Assistance Program (or FEAP):
University program that provides comprehensive, confidential, onsite employee assistance services (such as short term counseling, assessment, and referral services) to University employees and their families. [For more information, see FEAP website].
Fitness for Duty (Fit for Duty, FFD):
Possessing the physical, emotional and mental capacities to safely and effectively perform the essential functions of an employee’s job, with or without reasonable Americans with Disabilities Act accommodation, in a manner that does not present a direct threat of harm to self or others. Fitness for duty includes, but is not limited to, being free of alcohol- or drug-induced (whether or not legitimately prescribed) impairment that affects job functioning.
Fitness for Duty Evaluation (FFD Evaluation, Evaluation):
A professional assessment of an employee’s physical, emotional or mental capacities, that is carried out by an independent, licensed healthcare provider with expertise to determine if an employee is or is not capable of effectively performing his/her essential job functions without posing a threat to his/her own safety or the safety of others.
Physicians Wellness Program (Physician Wellness):
A Health System program that collaborates with FEAP to identify and manage matters of individual clinician physical and mental health that is part of the peer review process and separate from clinical staff disciplinary functions. The Program aids clinicians in retaining or regaining optimal professional functioning, consistent with protection of patients and standards of appropriate and professional clinical behavior.
Threat Assessment Team (TAT):
The TAT is the team required by Virginia Code §23.1-805 to implement the University’s assessment, intervention, and action protocol.
A comprehensive occupational health and employee wellness program.
This policy covers only those situations in which an employee is (1) having observable difficulty performing his/her duties in an effective manner that is safe for the employee and/or for his or her co-workers, or (2) posing a serious safety threat to self or others. The policy prescribes the circumstances under which an employee may be referred to an independent, licensed health care evaluator for a fitness for duty evaluation should either of those situations be present.
An employee shall not be allowed to work unless he/she maintains a fitness for duty required for the safe performance of essential job functions, with or without reasonable accommodation. Each employee is required to report to work in an emotional, mental and physical condition (including free of the effects of alcohol and drugs) necessary to perform his or her job in a safe and satisfactory manner. [Refer to University policy STU-001: Use of Alcoholic Beverages and Prohibition of Other Drugs.]
This policy does not apply to employees with short term, infectious/communicable diseases (e.g., flu, colds). If an employee exhibits symptoms of an infectious/communicable disease, the supervisor may ask the employee to leave the workplace in order to have his/her symptoms evaluated by the employee’s own health care provider or by UVA-WorkMed.
University employees working at the Medical Center must comply with Medical Center policies regarding infection control and infectious disease evaluation.
A fitness for duty evaluation is designed to address behavioral changes in an employee that may pose a potential threat to self or others in the workplace. Application of this policy is not intended as a substitute for University policies or procedures related to chronic performance or behavioral problems or as a substitute for discipline. Supervisors shall continue to address performance or behavioral problems through the performance appraisal process and to implement appropriate corrective or disciplinary action.
The University is required to comply with federal disability law (primarily the Americans with Disabilities Act of 1990 [ADA]). In general, the ADA prohibits: (1) employers from requiring an employee to submit to a medical examination; and (2) employer inquiries into whether an individual has a disability. However, the protections afforded to employees by the ADA are not without limits. Federal law permits the University to require a medical examination of an employee if the requirement for the examination is job-related, consistent with business necessity, and if the University has a reasonable belief that:
(1) the employee's ability to perform essential job functions may be impaired by a medical condition; or
(2) an employee may pose a direct threat (i.e., significant risk of substantial harm to the health and safety of self or others) due to a medical condition.
Fitness for Duty Requirements:
An employee is expected to perform essential job functions in a safe and effective manner, and to discuss with his/her supervisor any circumstances that may impact his/her ability to do so. The University may require professional evaluation of an employee’s physical, emotional or mental capacities to determine his or her ability to perform essential job functions. Such evaluations are conducted by an independent, licensed health care professional and are undertaken only after review by the coordinating team. The employee’s department is responsible for paying the cost of an evaluation(s). To the extent allowed by law, the University shall protect the confidentiality of the evaluation and the results.
Employees who have the responsibility for on-call shifts must meet the fitness for duty standard during the entire on-call period.
Non-compliance with a request for a fitness for duty evaluation shall be cause for disciplinary action.
The employee’s satisfactory work performance is the basis for continued employment. Participation in a treatment or rehabilitation program does not guarantee continued employment and may not necessarily prevent disciplinary action for violation of University policies. An employee must comply with all treatment recommendations resulting from a fitness for duty evaluation to be allowed to return to work. A salaried employee referred for an evaluation will be prohibited from appearing for work pending the completion of the evaluation and approval for return to work. During this time, applicable leave policies shall apply. A wage employee (including a temporary employee) referred for an evaluation will be prohibited from working or appearing for work until an evaluation is completed and the employee has been approved to return to work (compensation during this time shall be discontinued).
Before initiating an evaluation, the coordinating team shall consult with the employee’s supervisor to gain a clear understanding of the behavior/circumstances that have raised questions about the employee’s fitness for duty. A member of the coordinating team shall also notify the employee of the opportunity to provide any relevant previous medical or psychological treatment information. The coordinating team shall determine the appropriateness of fitness for duty testing within a reasonable time after notification from the supervisor, usually within three business days.
Depending on the nature of the case, one or more of the following units will coordinate the evaluation requirements:
- FEAP for psychological and behavioral issues.
- UVA-WorkMed for physical and infectious disease issues.
- Physician Wellness for impairment, mental and physical issues of clinical staff and other healthcare providers covered by the Clinical Staff Bylaws, as relates to patient care (not employment) status.
While the employee is prohibited from appearing for work until completion of the FFD evaluation and approval to return to work is provided, the coordinating team shall use its discretion to determine whether to allow the employee to work off-site or to represent the University in any work-related capacity.
Results of the Evaluation:
The results of FFD evaluations performed by qualified, licensed health care professionals shall be presumed to be valid. Results of the evaluation will be received by FEAP, UVA-WorkMed or Physician Wellness, as appropriate. The employee shall be notified of the results of the FFD by the evaluator and/or FEAP, UVA-WorkMed or Physician Wellness. Only necessary information shall be shared with the coordinating team. A member of the coordinating team will communicate whether the employee may return to work to the employee’s supervisor and the respective dean or vice president. [Refer to Section 6 for Confidentiality.]
After an evaluation, information given to the employee’s supervisor and respective dean or vice president shall be limited to whether the employee may:
- return to full duty;
- not return to full duty, in which case the employee will be referred to Human Resources for a benefits discussion; or
- return to full duty with reasonable accommodations to meet the evaluator’s recommendations.
Return to Work:
In conjunction with the employee’s supervisor, the coordinating team shall discuss whether any reasonable and necessary accommodations need to be made. Continued employment shall be contingent upon compliance with recommendations provided by the evaluator, such as periodic testing, participation in professional counseling and treatment programs. During this time, applicable leave policies and health plan benefits shall apply. In consultation with the coordinating team, the supervisor and employee should engage in an interactive process to determine if any reasonable accommodations (e.g., re-assignment of duties for a specific period of time, a flexible work schedule) should be implemented. Failure to comply with the recommendations or agreed upon accommodations may result in disciplinary action up to and including possible termination from employment.
Acts or Threats of Violence and the Threat Assessment Team:
Virginia law (§23-9.2:10.C-D) and University policy HRM-028: Preventing and Addressing Threats or Acts of Violence require the establishment of a threat assessment team (“TAT”) having responsibilities for implementing the University’s assessment, intervention and action protocol in cases suggesting a potential risk of violence. All acts of violence, threats of violence or other seriously disruptive behaviors must be reported immediately to University Police and/or to the TAT. [Refer to University policy HRM-028: Preventing and Addressing Threats or Acts of Violence.]
Confidentiality/Privacy of Fitness for Duty Evaluations:
Under the Health Insurance Portability and Accountability Act (HIPAA), any document containing medical information about an employee is considered a medical record and is regarded as confidential. Records of fitness for duty evaluations shall be treated as confidential medical records and maintained by FEAP, UVA-WorkMed or Physician Wellness, as appropriate. This information may be shared only on a “need to know” basis. Employees may obtain a copy of the medical report from FEAP, UVA-WorkMed or Physician Wellness upon written request.
Clinical Staff and Allied Health Professionals:
FFD for clinical staff and Allied Health Professionals are governed by both this policy and the Clinical Staff Bylaws and shall be managed through the processes specified in those bylaws. Following a consultation with the Physician Wellness Program, an evaluation may be required. If a member of the clinical staff or an Allied Health Professional is referred for possible impairment (including physical, mental and/or substance abuse disorders), the non-disciplinary process outlined in the Clinical Staff Bylaws shall first be applied. If the practitioner refuses an evaluation or refuses to comply with treatment recommendations, the process may move to a disciplinary phase. A practitioner’s clinical privileges may be suspended immediately either for refusal to: undergo an evaluation, stop practice after a recommendation has been made for treatment, or non-compliance with required monitoring.
An employee is responsible for:
- Performing his/her job responsibilities in a safe and effective manner, with or without reasonable accommodations during the entire time at work;
- Notifying the supervisor when not fit for duty;
- Notifying the supervisor when a coworker is observed acting in a manner that indicates the coworker may not be fit for duty;
- Informing the upper level manager or calling the University Human Resources Service Center (982-0123) for further guidance, if the supervisor’s behavior is the focus of concern. (Threats or acts of violence should be reported immediately to the University Police Department by calling 911.);
- Providing relevant medical and psychological information when given the opportunity to do so; and
- Complying with this policy and any authorized request to submit to an evaluation.
A supervisor is responsible for:
- Observing the attendance, performance, and behavior of the employees under his/her supervision;
- Notifying University Human Resources (982-0123) or their local HR between the hours of 8 a.m. and 5:00 p.m. or FEAP (243-2643) after 5:00 p.m. when an employee is exhibiting behavior that suggests he/she may not be fit for duty;
- Following this policy’s procedures for completing an Initial Observation Report form when presented with circumstances or knowledge that indicate that an employee may not be fit for duty;
- Removing and escorting an employee deemed not fit for duty from the worksite unless he/she poses an immediate safety threat in which case the supervisor should call 911;
- Arranging transportation for the employee from the work site if necessary;
- Maintaining the confidentiality of an employee’s medical information; and
- Implementing any reasonable accommodation deemed necessary.
The Coordinating Team, or a member of, is responsible for:
- Soliciting information from the supervisor regarding employee behaviors or performance, and from the employee regarding any relevant previous medical or psychological treatment information;
- Identifying who will conduct the fitness for duty evaluation;
- Receiving the results of the fitness for duty evaluation;
- Communicating the results to the employee if not done so by the evaluator;
- Maintaining confidentiality except as detailed in the Confidentiality/ Privacy section above;
- Coordinating payment by the employee’s department for the fitness for dutyevaluation;
- Implementing any recommendations proposed by the FFD evaluation;
- Discussing recommendations and subsequent accommodations with the supervisor; and
- Communicating with the employee as to their rights, responsibilities and employment status.
The employee’s department is responsible for:
- Paying the costs associated with a recommended fitness for duty evaluation.