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Firefighters Failing a Medical/Physical Examination

Firefighters die from preventable diseases. Fire Departments must implement a comprehensive testing process to ensure your employees stay healthy and a program designed to return the firefighter back to work if there is the discovery of a possible disabling medical condition.

A question for you Fire Chiefs or Human Resource Directors - you have a medical/physical evaluation program and a Physical Abilities test in your department that provides bi-annual medical/physical and Physical Ability testing for your firefighters. One of your firefighters has failed these test(s) and the Chief or HR Director is asking what should they do next. I will assume for this question, the department is using NFPA 1582 as a guideline for the components of the medical/physical evaluation and has a physician or other qualified health care practitioner performing the medical/physical, knowing what firefighters do for a living. I will also assume for this question the department is using a validated physical abilities test that examines the essential functions of the job for the annual or bi-annual testing.

The answer is multifaceted but not all that difficult to sort out the next few steps in your decision tree. Let's take this question in three different phases. The first phase is related to entry level firefighters. There is no issues with a Physical Abilities test as it is generally a pass/fail proposition. Many fire departments are using the CPAT testing model with good results. If not using the CPAT, then your physical abilities test should test the essential functions of the job and not a Combat Challenge testing process. Failure of this physical abilities test automatically disqualifies the candidate.

If the candidate makes it past the preliminary testing and you provide a written offer of employment, you can then conduct a medical/physical and a psychological evaluation. Failure of these tests may disqualify the candidate and the decision to have the candidate continue in the process is now your decision. I recommend that if anyone fails the psychological, you do not hire that individual. As the employer you will not know the reasons for failure under HIPAA and the examining psychologist should provide three hiring categories - Unrestricted Hire; Qualified Hire (some problems noted) and Do Not Hire. If there are issues with the medical/physical, you may want to dig a little deeper as to the medical condition and have the potential firefighter employee seek a specialist for additional testing. Here, I have sent candidate firefighters to a cardiologist for further evaluation as there was some abnormality on the EKG or the Pulmonary Function Test. If they return from these specialists with a clearance to continue, then the candidate can proceed in the process to hopefully the ultimate hire.

The second issue is your existing candidate. I highly recommended that your department have an annual or bi-annual medical/physical examination program as a large number of our firefighters are dying from cardiac and other diseases every year. If your firefighter fails this examination, it is recommended that the firefighter seek additional evaluation to determine and possibly mitigate the cause of the failure. For example hypertension or high cholesterol. This is easily corrected with possible weight loss, better diet, exercise and medications. There is a great example of a firefighter diagnosed after a treadmill stress test with severe coronary artery disease with 97% blockage. The firefighter underwent a 4 way bypass and returned to work. If there is a failure of the physical abilities evaluation, I recommend the firefighter be placed on administrative (light) duties and the department sponsor a rehabilitation program with a trainer, nutritionist and a physician to enable your firefighter to pass a retest.

I received a call the other day where a 380 pound firefighter failed the physical ability test. The question is what to do with this firefighter. The concept here is to attempt to keep the employee healthy and a valued member of the organization. It is incumbent on the department with a medical evaluation and additional testing to see if there is the ability to have the firefighter qualify go back on the line.

The department placed this employee on administrative light duty in another section of the city to do desk work; obtain clearance from the departments physician that the firefighter can participate in a weight loss program; hired a nutritionist and trainer and purchased a gym membership for the firefighter so he can loose the weight. He will be retested in three months. If he fails this physical ability test or fails to participate in the program or fails to loose weight, he will be terminated from his job.

Finally, as an attorney I have toss in this little nugget - you may have to make reasonable accommodation's under the ADA rules and regulation for these firefighters that cannot pass the medical/physical or physical ability test. Under the law (, Title I of the ADA requires an employer to provide reasonable accommodation to qualified individuals with disabilities who are employees or applicants for employment, except when such accommodation would cause an undue hardship on the employer. As this is a complex issue, I suggest employers look at the EEOC website and discuss this issue with your HR director for guidance.

By M2 Resource Group, Inc
EMS & Fire Subject Matter Expert Witness; Litigation Support; Psychological Testing & Counseling
John K. Murphy, J.D. M.S, PA-C, EFO is a consultant focusing on the areas of fire service delivery and private industry strategic planning and creating innovative ways of delivering services efficiently and cost effectively. John has worked in the emergency services field for over 30 years providing emergency medical and fire services and as a licensed medical practitioner in a clinical setting. As an attorney, John’s legal background provides the foundation for risk avoidance in the areas of employment hiring and termination practices, worker liability, consulting and training services for private and public entities.

Copyright M2 Resource Group, Inc

Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer.For specific technical or legal advice on the information provided and related topics, please contact the author.

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