Can We Send an Employee for a Mental Health Exam?

By Kelly A. Hayden, JD, Chief Legal Counsel
Published January 9, 2018

mental health exams for employeesHave you ever considered sending an employee for a mental health exam and wondered about the legality of this action? Under what circumstances is it appropriate to require such an exam? Recently, the United States Court of Appeals for the Seventh Circuit considered these issues in Painter v. Illinois Department of Transportation (Case No. 16-3187, Seventh Circuit, December 6, 2017).

Painter was the office administrator for IDOT’s Division of Traffic Safety. After receiving several complaints from other employees about her behavior, she was placed on administrative leave and required to submit to a fitness-for-duty exam. The first exam revealed that she was fit to perform the essential functions of her job, but “displayed some hypomania” and “could be bipolar.” The doctor recommended she be reevaluated in 45 days. At the next exam, the doctor recommended that she see a mental health specialist.

During this period, Painter was working, but continuing to have problems with coworkers. At one point, it was determined that Painter was keeping a log of coworkers’ conversations and other actions. Upon IDOT receiving a complaint regarding this log, she was again placed on administrative leave.

Painter ultimately saw a psychiatrist, who supported the determination that she could perform essential functions, but suggested that she might have a “personality disorder.” Upon returning to work for the third time, Painter was still unable to get along with coworkers. After investigation, it was determined that Painter was very “argumentative” with others and spoke in an “unprofessional tone.” Painter was placed on another leave and asked to see the doctor once again. However, before she could be examined, she contacted her union representative in a “threatening manner” that resulted in intervention by the Illinois State Police. After her next examination, she was finally declared unfit to return to work due to “her paranoid thinking and the highly disruptive behavior which results from her paranoia.” Painter filed a lawsuit, alleging violations of the American with Disabilities Act (ADA) based on the medical examinations she was “forced” to attend.

At the United States Court of Appeals for the Seventh Circuit, Painter’s focus was on the last two examinations (the one that determined she had personality disorder but could work and the second that declared her unfit for duty.) The Court noted that when an employee challenges a medical exam, the burden is on the employer to prove that the exam was performed for a business necessity. Guidance from the EEOC states that a business necessity is met where “the employer has a reasonable belief based on objective evidence that a medical condition will impair an employee’s ability to perform essential job junctions or that the employee will pose a threat due to a medical condition.” The Court recognized that simply annoying coworkers or behaving in an inefficient manner is not enough to justify a medical exam under the ADA.

Nevertheless, the Court found in favor of IDOT, emphasizing that there were over 160 pages of documentation indicating that the exam was job-related and consistent with business necessity. This documentation included supervisor notes, formal discipline, and email communications from coworkers related to Painter’s behavior.

What can employers learn from this case? First, understand the guidelines for sending an employee for a medical exam and, when in doubt, consult with legal counsel concerning the efficacy of such an exam. Further, the importance of documentation by supervisors cannot be stressed enough. Without those 160 pages of notes, discipline, and other communications, it is unclear if the exams would have been upheld. While “160 pages” is not the standard, a court or the EEOC will want to see substantial documentation supporting this type of action by employers.

Want to discuss sending an employee for a medical exam? Management Association members should contact our Employment Law Services Department at 800-448-4584 and speak with one of our attorneys to review your specific situation, or email us at



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