"Fit to work" or "fitness to work" is a medical assessment done when an employer wishes to be sure an employee can safely do a specific job or task. The purpose is to determine if medically the employee can perform the job or task under the working conditions. Fit to work assessments are most often done to determine medical fitness after an illness or injury, but are sometimes done after employment has been offered, as requested by the employer, or as a condition of a job transfer. These assessments may also be referred to as Functional Abilities Evaluations or Functional Capacity Evaluations. 

Typically, the employee will visit a medical professional who will determine if the person is able to do that particular job. The medical professional may consider physical or mental abilities, sensory acuity, level of skill, functional limitations, etc. The medical professional will typically only report one of three conditions back to the employer:

• fit,
• unfit, or
• fit subject to work modifications.

An employer is allowed to ask for information from a medical professional to make sure the employee is able to work safely and that the employee's condition does not pose a hazard to themselves or to others. A fit to work assessment may be done for the following reasons (but are not limited to):

• There has been a significant change in the working conditions.
• An employee transfers to a position where the working conditions are significantly different.
• The job at work has been modified, and the returning worker is still going for physiotherapy, rehabilitation, or both.
• There has been a change in an employee's health (e.g., returning to work during recovery or after recovering from a serious illness or injury).
• A medical condition may limit, reduce or prevent the person from performing a new or current job effectively (e.g., musculoskeletal conditions that limit mobility).
• A medical condition is likely to make it unsafe to do the job (e.g., a person may unpredictably become unconscious in a hazardous situation).
• A medical condition is likely to make it unsafe both for themselves, co-workers or the public (e.g., driving is essential to the job but the person is subject to unpredictable and sudden unconsciousness, or a food product inspection by an inspector with deficient colour vision).
• The medical condition may be made worse by the job (e.g., excessive physical exertion by an employee with a heart or lung disorder).

From: Public Service Occupational Health Program, Health Canada. 2015

It is not appropriate for the employer to ask for specific medical findings and diagnoses from the health professional. The employer can request a fit to work assessment for appropriate reasons as long as protocols and regulations such as the Human Rights Code are followed (e.g., the assessment is not used to rule out employment due to a disability). As mentioned, the employer typically only receives one of three conditions from the health professional: fit, unfit, or fit subject to work modifications. The last two conditions may be reported as temporary or permanent.

However, it is the employer's duty to accommodate. This duty means that the employer has a responsibility to ensure that all reasonable attempts have been made to modify the job, the job requirements, or the working conditions so that employment can continue in a way that is safe for the employee and co-workers. If requested, the information provided by the medical professional can include suggestions for assisting the employee. 

For more information on accommodation, please see our OSH Answers Return to Work - Accommodation. 

Assessments are usually requested by the employer, but they may be voluntary by the employee. When requested by an employer, it may be company policy or government regulations that require the examination. The employee must consent to the process.

Typically, the employer will inform the employee in writing and give the reasons why the assessment is requested. If an occupational medical specialist is not on staff, the company should give the outside professional details about the job, the job requirements, and the working conditions so that the fit to work evaluation can be made accurately.