According to the 2008 Liberty Mutual Workplace Safety Index and the U.S. Department of Labor’s Bureau of Labor Statistics, workplace injuries, although on the decline since 2003, account for an estimated $50 billion direct annual cost.


Of the incidents of injuries, about 65 percent are directly attributable to a combination of overexertion (“defined as injuries related to lifting, pushing, pulling, holding, carrying or throwing,”) slip and falls, “bodily reaction” (“defined as injury that occurs when a worker tries to regain a loss of balance during bending, climbing, and slipping or tripping without falling”) and repetitive-motion injuries such as carpal tunnel syndrome. Moreover, experts estimate the indirect cost may be as high as five times the direct cost.


As a result, pre-employment physicals are rapidly becoming standard for most occupations and in part account for the recent decline since 2003. Employ-ment law allows employers to screen candidates to determine if they are physically capable of performing the essential job functions of the position for which they are applying.


Most physicals performed by physicians are typically limited to a physical exam to rule out impending medical risk and qualify the vast majority of candidates who go through the process as “capable.” Functional pre-employment physicals go a step further and assess the candidates’ ability to meet the physical demands of the job. Functional testing tends to disqualify a larger proportion of the candidates, averaging 10 percent nationally (according to WorkSTEPS, a national provider of functional employment testing services), but offers a more accurate measure of the candidates’ physical capabilities. In either case and depending on the position, the employer also may require a drug test among other potential screens as part of the physical.


In an economy that is struggling, this may seem like an unfair obstacle for the candidate who is ready and willing to take the assignment; however, neither party — future employee or employer — is served by not testing. In fact, according to J.P. Leigh, et al., and their study “Costs of Occupational Injuries and Illnesses” (University of Michigan Press, 2000) everyone bears the burden of these injures. The authors state, “Costs were borne by injured workers and their families, by all other workers through lower wages, by firms through lower profits, and by consumers through higher prices.”


If you are in the job market and applying for a position that is new to you, find out everything you can about the position before interviewing. Reference the U.S. Department of Labor’s Dictionary of Occupation Titles (available online at to find out what the physical demand category is for the position. This will give you a good basis from which to gauge the potential physical demand of the job.


You also can request a job description from your future employer. A thorough job description should list the essential job functions. The employer you are applying with will let you know if you will be tested. Ask your employer if the essential job functions will be tested. This way you can be better prepared, or make a determination yourself if in fact the position is even right for you.


During the testing process, be completely truthful about your past medical history, as inconsistencies can be grounds for disqualification. In fact, preparing a complete medical history and volunteering it to the clinician performing the physical in advance will help speed up the process and eliminate unintended omissions. Then, do your best.


If you qualify, assuming the test included a functional component, you can rest assured that your chances of injury are low. If on the other hand, you do not qualify, you likely avoided an injury. Either way, you win.


Pre-employment physicals are the right thing to do. They protect the candidate for employment, they protect the employer and they reduce the burden to society as a whole.


— Sevak Khodabakhshian is a doctor of chiropractic with Thousand Oaks-based Omega Rehab & Sport, where a team of physical therapists, chiropractors and athletic trainers applies an active-care approach to healthcare. He can be reached for comments, questions or suggestions by e-mail, at