Title I of the Americans with Disabilities Act (ADA) limits an employer's ability to make disability-related inquiries or require medical examinations.  The rules concerning disability-related inquiries and medical examinations differ, depending upon whether the inquiry is made at the pre-offer stage, the post-offer stage, or during employment.
On July 27, 2000, the Equal Employment Opportunity Commission (EEOC) issued a Guidance explaining when employers may and may not obtain medical information about their employees.  The Guidance responds to some of the most frequently asked questions the Commission has received from EEOC investigators, attorneys, employers and employees. 

As a general rule, the ADA permits employers to make disability-related inquiries and require medical examinations of existing employees only if they are job related and consistent with business necessity.  The Guidance provides that a medical inquiry may be "job related and consistent with business necessity" when an employer "has a reasonable belief, based on objective evidence, that (1) an employee's ability to perform essential job functions will be impaired by a medical condition; or (2) an employee will pose a direct threat due to a medical condition."  Disability-related inquiries and medical examinations that follow up on a request for reasonable accommodation, when the disability or need for accommodation is not known or obvious, also may be job related and consistent with business necessity.  According to the EEOC, under limited and specific circumstances, periodic medical examinations and other monitoring also may be job related and consistent with business necessity.

Although other provisions of Title I of the ADA are limited to "qualified individuals with disabilities," the EEOC has concluded that the restrictions on medical inquiries apply to all employees, not just those with disabilities.  Therefore, according to the EEOC, any employee has a right to challenge a disability-related inquiry or medical examination that is not job related and consistent with business necessity.  This is a view that has not been shared by all those courts that have addressed the issue.

The following summarizes certain of the EEOC's expressed views on frequently asked questions regarding disability-related inquiries as set forth in its most recent Guidance. 
„h An employer must treat an employee who is applying for a new job as an applicant for the new job, rather than an existing employee for purposes of determining whether and what disability-related questions are appropriate.  If a current supervisor has medical information regarding an employee who is applying for a new job, he/she may not disclose that information to the person interviewing the employee for the new job or to the supervisor of that job.  An individual is not an applicant where he or she is non-competitively entitled to another position with the same employer (e.g., because of seniority or satisfactory performance in his/her current position).

„h The requirement that an inquiry or examination be "job-related and consistent with business necessity," may be met when an employer knows about a particular employee's medical condition, has observed performance problems, and can reasonably attribute the problems to the medical condition.  It is also met if the employer observes symptoms indicating that an employee may have a medical condition that will impair his or her ability to perform essential job functions, or will pose a direct threat.
„h An employer may make disability related inquiries of an employee based, in whole or in part, on information learned from another person, if the information learned is reliable and would give rise to a reasonable belief that the employee's ability to perform essential job functions will be impaired by a medical condition or that he/she will pose a direct threat due to a medical condition. Factors that an employer might consider in assessing whether the information learned is reliable include how well the person providing the information knows the individual, the seriousness of the medical condition at issue, and how the person learned the information.

„h Generally speaking, employers may not ask employees what prescription medications they are taking.  However, in limited circumstances, it may be appropriate to ask an employee in a position affecting public safety about his/her use of medication that may affect his/her ability to perform essential functions and thereby result in a direct threat.
„h If an employer believes that an employee is having performance problems because of a medical condition, but the employee refuses to answer any questions or submit to a medical examination that is job related and consistent with business necessity, the employer may discipline the employee for performance problems in accordance with a uniformly applied policy.  Similarly, if an employee asks for an accommodation, but fails to respond to the employer's job related questions regarding the need for the accommodation, the employer can refuse to provide the accommodation requested.

„h If an employer requests documentation to support an employee's request for a reasonable accommodation, and the employee provides insufficient documentation in response to this request, the employer should explain why the documentation is insufficient and allow the employee to provide the missing information in a timely manner. Employers should consider consulting with the employee's doctor (with the employee's consent) before requiring the employee to go to a health care professional of the employer's choice.  However, an employer is not prohibited from requiring an employee to go to an appropriate healthcare professional of the employer's choice if the employee provides insufficient documentation.  Documentation is insufficient if it does not specify the existence of an ADA disability and explain the need for reasonable accommodation; if the healthcare professional does not have the expertise to give an opinion about the employee's medical condition; if the information does not specify the functional limitations due to the disability; or if other factors indicate that that information is not credible or is fraudulent.

„h An employee may have an employee who the employer reasonably believes will pose a direct threat examined by the employer's own healthcare provider.   However, the healthcare professional that the employer chooses should have expertise in the employee's specific condition, as well as medical information that will allow the employer to determine the affects of the condition on the employee's ability to perform his/her job.  The employer must pay all costs associated with the employee's visits to its healthcare professional.

„h Physical agility and physical fitness tests generally are not considered medical examinations. Employers may require employees to provide medical certification that they can safely perform such tests.  However, the employer is only entitled to a note stating that the employee can safely perform the test, or an explanation of the reasons why the employee cannot perform the test.

Although the EEOC's Guidance does not have the effect of law, courts often refer to and rely upon the views of the EEOC as set forth in such materials in analyzing ADA disputes.