Occupational Health Screening for Employers

Bchex coordinates pre-employment physical exams, DOT physicals, fit-for-duty evaluations, audiometric (hearing) tests, vision screenings, respirator fit testing, pulmonary function testing, TB testing, workplace immunizations, and functional capacity evaluations. All exams are ordered through the bchex platform and conducted at partner clinics in our nationwide network. Results are delivered to the same dashboard where your background check and drug testing results appear — one platform, one view.

A DOT physical is a medical examination required by the Federal Motor Carrier Safety Administration (FMCSA) for anyone who operates a commercial motor vehicle (CMV). The exam evaluates vision, hearing, blood pressure, cardiovascular health, and other factors that affect safe driving. It must be performed by a medical examiner listed on the FMCSA National Registry. DOT physicals are valid for up to 24 months, though shorter certification periods may apply based on the driver’s health conditions.

The outcome depends on the exam type. For a DOT physical, a failed exam means the driver cannot be medically certified to operate a commercial vehicle until the disqualifying condition is resolved. The examiner may issue a temporary certificate, refer the driver for further evaluation, or recommend treatment before retesting. For a non-DOT pre-employment physical, the employer must evaluate whether the condition actually prevents the candidate from performing the essential functions of the job — with or without reasonable accommodation — under ADA guidelines. A failed physical does not automatically disqualify a candidate from employment.

In most cases, the employer pays. When a physical exam is required as a condition of employment, the employer is generally responsible for the cost. FMCSA does not mandate who pays for DOT physicals, but most employers cover the expense as part of their compliance program. OSHA-mandated exams — audiometric testing, respirator fit testing, pulmonary function testing — must be provided at no cost to the employee under OSHA regulations. The same applies to required immunizations and TB testing in states that mandate them for certain roles.

No. Under the Americans with Disabilities Act (ADA), employers cannot require medical examinations or make disability-related inquiries before extending a conditional job offer. After a conditional offer has been made, the employer may require a physical exam as long as it applies to all entering employees in the same job category and the exam is job-related and consistent with business necessity. All medical information must be kept confidential and stored separately from general personnel files.

A pre-employment physical is a general medical evaluation tailored to a specific job’s physical demands — the employer defines what the exam covers based on the role. A DOT physical is a federally standardized exam with specific criteria set by FMCSA, required only for commercial motor vehicle drivers. DOT physicals must be performed by National Registry-certified medical examiners using standardized forms (MCSA-5875 and MCSA-5876). A non-DOT physical has no standardized format and does not require a certified examiner.

DOT physicals are required every 24 months, though drivers with certain health conditions may receive shorter certification periods. OSHA audiometric exams are required annually for employees in hearing conservation programs (29 CFR 1910.95). Respirator fit testing is required at least annually under 29 CFR 1910.134, and whenever an employee changes respirator type, model, or size. Pulmonary function tests follow the same schedule as respirator medical clearance. TB testing frequency varies by state and employer policy. Pre-employment physicals are typically a one-time requirement at the point of hire.

A fit-for-duty evaluation determines whether a current employee can safely perform the essential functions of their job. Employers can request one after an injury, extended medical leave, a workplace incident, or when a supervisor has reasonable, documented concern about an employee’s ability to work safely. The evaluation must be job-specific — the clinician assesses the employee against the physical demands of their actual role, not a generic standard. Under the ADA, the employer must have an objective, factual basis for requiring the exam.

OSHA requires employers to retain audiometric test records for the duration of the affected employee’s employment (29 CFR 1910.95). Respirator fit test records must be kept until the next fit test is administered. Pulmonary function test records fall under the medical surveillance requirements of the specific substance standard (e.g., silica, asbestos). DOT Medical Examiner’s Certificates must be maintained in the driver qualification file for the duration of the driver’s employment. All occupational health records must be stored separately from general personnel files and treated as confidential medical information under the ADA.

Yes. OSHA’s Respiratory Protection Standard (29 CFR 1910.134) requires fit testing before initial use of a tight-fitting respirator and at least annually thereafter. Additional fit testing is required whenever an employee is assigned a different respirator type, model, or size, or when physical changes — significant weight gain or loss, dental work, facial scarring — could affect the respirator seal. There are two methods: qualitative (pass/fail using taste or smell agents) and quantitative (measured with instruments that detect leakage).

Yes. Bchex allows employers to order occupational health exams, background checks, and drug tests through a single platform. When you initiate a screening order, you can add any occupational health service — physicals, DOT exams, audiometric testing, respirator fit testing — to the same order. The candidate or employee is directed to a nearby clinic in our nationwide partner network, and results are returned to the same dashboard where your background check and drug testing results appear.

A physical exam evaluates general health, vital signs, and medical fitness for a specific role. A functional capacity evaluation (FCE) is a more intensive, multi-hour assessment that objectively measures a person’s ability to perform specific physical tasks — lifting, carrying, pushing, pulling, standing, walking, and climbing — at the levels the job actually requires. FCEs are typically used for return-to-work clearance, workers’ compensation disputes, and roles with very specific physical demands. A physical exam tells you if someone is medically fit. An FCE tells you if they can do the work.