Key Takeaways

  • A pre-employment physical, often called a Human Performance Evaluation (HPE test), assesses whether candidates are medically and physically fit for the demands of a job.
  • Pre-employment examinations focus on general health, while HPE tests evaluate job-specific functional abilities such as lifting, pushing, pulling, or endurance.
  • Employers must provide reasonable accommodations under the ADA and avoid using test results for discriminatory purposes.
  • Tests may include vital signs, drug screening, stamina and strength assessments, and psychological evaluations.
  • Employers often use HPE tests to reduce workplace injuries, improve job placement, and ensure compliance with safety standards.
  • Preparing for the HPE test involves reviewing job requirements, bringing medical documentation, and practicing safe movement techniques.

What Is a Pre-Employment Physical?

A pre-employment physical is part of the onboarding process for most companies. It involves the potential employee getting a medical exam to ensure that he or she is physically and mentally fit for the job. Usually, companies follow the guidelines provided by the Occupational Safety and Health Administration or the local Department of Health for pre-employment testing.

Companies also review the prospective employee's overall work and medical history. Overall, the pre-employment test ensures that the employee's health complies with his or her future job-related duties, especially if they are physically demanding. Depending on the nature of the job, the pre-employment physical can be a long or short process. 

Also known as a pre-placement test or a Human Performance Evaluation (HPE), a pre-employment physical helps companies get an overview of the prospective employee’s overall health status as well as make better choices when it comes to selecting new hires. The physical can also be used for record-keeping based on established metrics. This helps the company track any changes in the employee's health over time.

Purpose of the HPE Test

The Human Performance Evaluation (HPE test) is designed to measure whether an individual can safely perform the essential functions of a specific job. Unlike a standard medical exam that checks overall wellness, the HPE test evaluates functional abilities tied directly to workplace duties. For example, candidates may be asked to lift a certain amount of weight, climb stairs, or perform repetitive bending. These tests help employers match workers with positions that fit their physical capabilities, reducing risks of injury and improving productivity.

Pre-employment Examinations vs. Human Performance Evaluations

There are some similarities and differences with the pre-employment exam and the HPE. In most cases, the physical exam often occurs at a health care facility such as an urgent care center and conducted by a medical practitioner; whereas the HPE is usually conducted by a licensed therapist. And, whoever conducts either exam must understand the job expectations of a particular company to determine whether the prospective employee shows capability of performing the tasks.

While the pre-employment physical evaluates the prospective employee's overall health, the HPE focuses more on specific job responsibilities and skills that the person will likely use on a daily basis. HPEs also help employers potentially improve working conditions by looking at and eliminating ergonomic risk factors that could cause on-the-job injuries.

Key Components of an HPE Test

An HPE test usually involves:

  • Functional Movement Screening – tasks such as squatting, lifting, carrying, pushing, and pulling.
  • Endurance Testing – activities like step tests or timed walks to assess cardiovascular health.
  • Range of Motion & Flexibility Checks – identifying limitations that could impact job performance.
  • Grip and Strength Assessments – ensuring the employee can handle physical equipment safely.
  • Postural Analysis – evaluating safe lifting techniques and ergonomic risk factors.

The evaluation is generally administered by a physical therapist or occupational health professional who tailors the test to the employer’s job description.

Reasonable Accommodations to Consider

Pre-employment physical results often help employers evaluate a future employee's skills and capabilities, but such results must always be kept confidential and should not be used to discriminate against that employee. With that being said, companies must implement what is called "reasonable accommodation" for employees with disabilities.

Reasonable accommodations must be considered because in some cases, work-related physical exams have often been the subject of legal battles. There have been instances where the elderly, women, and minorities have been subjected to unfair or inequitable testing.

Additionally, the Americans with Disabilities Act cites health problems as reasonable accommodations, which should not be used to discriminate in the pre-employment process. These include conditions such as asthma, heart problems, and high blood pressure to name a few.

Legal Protections During HPE Testing

Employers must balance workplace safety with employee rights. Under the ADA, applicants cannot be disqualified solely for having a medical condition unless it prevents them from performing essential job functions, even with reasonable accommodations. Test administrators must also ensure results remain confidential and are not used to discriminate based on age, gender, or disability. Employers that fail to accommodate may face legal claims of discrimination.

Types of Pre-employment Tests

General pre-employment physical tests include checking the employee's vital signs. A nurse or other qualified health care professional checks the employee's weight, temperature, pulse, and blood pressure. In addition to the standard physical checks, the nurse or doctor will examine the employee's vision, hearing, cardiovascular and respiratory health, along with reflexes and range of motion.

In addition, the doctor will note anything such as bruises and swelling, and ask questions about how they happened, if known. More questions may follow the physical exam, such as medications taken, behavioral or mood changes, or the employee's ability to handle stress.

Industries That Commonly Require HPE Tests

HPE tests are particularly common in physically demanding industries, such as:

  • Construction and Skilled Trades – to confirm workers can lift heavy loads and operate equipment.
  • Warehousing and Logistics – to test repetitive lifting, carrying, and stamina.
  • Healthcare – ensuring nurses and aides can move patients safely.
  • Public Safety and Transportation – police, firefighters, and drivers may need HPE tests to verify they can meet safety-critical physical standards.

Employers in these fields use HPE tests to ensure safety, comply with insurance requirements, and reduce workers’ compensation claims.

Drug Screening Tests

Broken down into categories, types of pre-employment physical exams can include:

  • Hair drug and alcohol screening
  • Sweat drug screening
  • Saliva drug screening
  • Urine drug screening

Before starting at a new workplace, potential employees might be asked to take one of the alcohol and drug tests to ensure competency for the job.

Jobs that are considered high-risk are likely to require drug and alcohol tests, specifically in situations where employees must lift heavy equipment and handle dangerous chemicals. Being intoxicated on the job raises the risk of injury to the employee or coworkers. Drug and alcohol tests vary depending on how quickly the employer needs the results.

Most employers from larger companies require its employees to remain drug- and alcohol-free while on the job during the workweek, and these pre-employment drug tests ensure that the potential employee is not addicted. Also, to keep its employees on their toes, so to speak, some companies may administer random drug and alcohol testing to ensure that the workplace remains drug-free.

Also for job seekers in the labor industry, it's best to avoid any drugs or nutritional supplements that cause side effects such as nausea or drowsiness, as operating heavy machinery under the influence can also put everyone in danger in the workplace.

Stamina and Physical Ability Tests

Pre-employment physicals that test energy and stamina are more relevant for jobs involving frequent lifting or other heavy labor. Besides evaluating for energy and stamina, these types of tests also look at strength and flexibility of the potential employee. A physical ability test ensures that a potential employee will be able to withstand the manual labor and other demands of the job. It helps employers to also choose people who are less likely to get hurt while on the job.

Hoping to decrease the chances of injury on the job, companies may request that job seekers be able to lift a certain amount of weight, especially if it's relevant to the job. The premise of a physical ability test is to review for the following:

  • Cardiovascular health
  • Muscular tension
  • Power
  • Balance
  • Flexibility
  • Overall attitude under physical constraints

Moreover, pre-employment exams test a worker on functional tasks such as pushing and pulling, lifting, and carrying heavy loads. For this specific test, an employer may send the worker to a physical therapist, who then creates the test based around the physical demands of the job. The doctor or therapist may also ask questions about family history, lifestyle, diet and exercise to give the employer an overall profile of the employee's health status.

Psychological Tests

Another part of the pre-employment exam involves testing the new employee's mental health. In these tests, a doctor will ask questions and administer several tests to determine psychological well-being and ensure that the employee deals well with handling stress on the job.

Not only are some jobs physically demanding, but they can also be psychologically demanding, so the doctor may conduct other tests or ask questions of the employee ranging from any history of depression or other mood symptoms, to his or her coping techniques for handling pressure. For example, negative habits such as smoking may be seen as unfit for the job, while healthy habits such as taking a walking break may be perceived as a positive fit.

Next Steps After the Pre-Employment Physical

After the new employee completes his or her pre-employment physical per job requirements, the doctor issues a report that provides the details of the employee's overall health status. The medical professional may also recommend specific vaccinations, prescriptions, or additional tests, depending on the results.

The primary goal is to comply with the employer's request so a potential employee can start his or her job as soon as possible. Communication is key, and it is important that the employer and employee are both aware of any health conditions to ensure that workplace conditions are safe and accommodating.

Preparing for an HPE Test

Applicants can prepare for the HPE test by:

  • Reviewing the physical requirements outlined in the job description.
  • Wearing appropriate clothing and footwear for physical activity.
  • Bringing documentation of prior medical conditions or treatments.
  • Staying hydrated and avoiding strenuous activity immediately before the test.
  • Practicing proper lifting and posture techniques to reduce injury risk.

Being prepared helps candidates feel more confident and improves the accuracy of the evaluation.

Frequently Asked Questions

  1. What is the difference between a pre-employment physical and an HPE test?
    A pre-employment physical evaluates general health, while the HPE test measures whether a candidate can perform essential job functions safely.
  2. Who typically administers an HPE test?
    Most HPE tests are conducted by physical therapists, occupational therapists, or occupational health specialists familiar with job requirements.
  3. Can I fail an HPE test?
    Yes, if you are unable to perform essential job tasks safely. However, employers must consider whether reasonable accommodations would allow you to perform the job.
  4. What jobs require an HPE test?
    HPE tests are common in construction, warehousing, healthcare, law enforcement, firefighting, and transportation roles where physical demands are high.
  5. How should I prepare for an HPE test?
    Wear comfortable clothes, bring medical records if relevant, and be ready to demonstrate lifting, carrying, and movement tasks that reflect job duties.

If you need more information on pre-employment physicals, you can post your legal need on UpCounsel’s marketplace. UpCounsel accepts only the top 5 percent of lawyers to its site. Lawyers on UpCounsel come from law schools such as Harvard Law and Yale Law and average 14 years of legal experience, including work with or on behalf of companies like Google, Menlo Ventures, and Airbnb.