Is it out of line for an employer to want a liver function test and note from my physician?

By | 2022-02-14T17:48:13-05:00 March 9th, 2011|0 Comments


Dear Nancy,

Recently, I had a pre-employment physical for a seasonal job. The exam was done by employee health and included the routine drug screening and a liver profile. When I asked why blood was being drawn, I was told it was to check liver function. My LFTs came back elevated, and employee health demanded I produce a note from my doctor stating she was “aware” of it. I have had a fatty liver for years, it does not affect my job, and I was not being covered by insurance provided through this employer. How much information does employee health need to have? I felt it was none of their business and did not comply. Next time, should I just have a note from my doctor saying I’m fit for duty? I finished the assignment and never missed a day of work — it is not a problem.


Nancy Brent replies:

Dear Lyle,

Pre-employment physicals are usually required after an offer of employment and before a final offer of employment. They cannot be done before an offer of employment, however. Most often, this is to ensure the prospective employee is “fit” for the position for which he or she is applying and also to detect any illegal chemical abuse.

You did not mention what job you were applying for, but the liver function test may be due to a toxic exposure you would experience while on the job for which you applied (e.g., chemotherapeutic agents) and a base line of current liver functioning is needed. Hence, the employer request for a letter from your physician supporting his or her knowledge of this condition.

As you may know, under the Americans With Disabilities Act, employers cannot ask prospective employees about any disability. Testing for drug or alcohol blood screens is not in violation of the Act, and if positive for illegal use (e.g., no prescription or the drug showing a positive result is cocaine, for example), the employer does not have to hire the individual, and there is no violation of the Act. It appears that here, despite the high liver blood results and the request for the note from your physician (with which you did not comply), you did get the job.

Some employers have wellness programs wherein employees are screened regularly for high blood pressure, high cholesterol, diabetes and so forth so treatment can be undertaken by the employee with his or her physician. You did not mention this in your question, but it could be that you consented to having the test done under such a program. Employee participation in the program is usually voluntary, and written consent forms are used by the wellness program or employer.

If you think this test was out of line, you should consult with a nurse attorney or attorney in your state who can discuss your options under the ADA and any other applicable laws concerning this situation. It is possible the same scenario could arise again when you apply for another position.



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