Q: One of our employees has been exhibiting strange, erratic behavior at work. Can we require the employee to submit to a mental health examination?

A: Possibly. The ADA prohibits employers from requiring their workers to undergo medical exams unless the exam is “shown to be job-related and consistent with business necessity.”  However, an employer may require an employee to undergo a mental health examination if the employee’s behavior raises questions about the employee’s ability to perform essential job-related functions or raises a safety concern.

The Seventh Circuit (which has federal jurisdiction over the States of Illinois, Wisconsin and Indiana) recently affirmed a district court’s decision rejecting a plaintiff’s claim for disability discrimination when her employer required her to undergo several mental health examinations in response to her behavior. In Painter v. Illinois Department of Transportation, No. 16-3187 (7th Cir. Dec. 6, 2017), the company placed the plaintiff on administrative leave and required her to undergo a fitness for duty exam after she had several outbursts aimed at coworkers and habitually walked around the office talking to herself.  Many employees expressed fear that the plaintiff would become physically violent, did not want to be alone with the plaintiff in the office, and believed that the plaintiff was spying on them at work.  After two exams by a doctor and one exam by a psychologist, the plaintiff returned to work and was transferred to another division.

In her new division, the employer continued to receive reports from co-workers complaining of incidents with the plaintiff.  The plaintiff kept a detailed written log of her co-workers’ actions and conversations, purportedly in order to determine why she was put on leave.  The plaintiff also sent her supervisor numerous nonsensical emails, often during the evening and in the middle of the night.  The plaintiff was again placed on administrative leave and underwent two additional fitness for duty exams.  The doctor found that the plaintiff exhibited signs of a personality disorder, but deemed her fit to return to work.  This pattern repeated a few additional times until the plaintiff ultimately was found by a psychiatrist to be unfit for duty.  She then sued.

The Seventh Circuit noted that employers bear a high burden of establishing that compelled medical examinations are consistent with business necessity. Nonetheless, in this case, the court held that the employer had established it had a reasonable belief based on objective evidence that the plaintiff may have had a medical condition that impaired her ability to perform essential job functions, and that the medical condition could cause the plaintiff to pose a safety threat.  The court noted that, prior to each leave and exam, multiple employees raised concerns about the plaintiff’s behavior in the workplace, and a number of employees felt unsafe around the plaintiff.  Each leave and exam was based on new incidents of behavior, and in general, on more than person’s complaints.  The court therefore concluded that inquiries—even multiple inquiries—concerning a worker’s psychiatric health may be permissible if they reflect concern for the safety of other employees and the public at large.

The Seventh Circuit’s decision is consistent with EEOC guidance, which states that an employer may require an employee to undergo a medical examination if the employer has a reasonable belief, based on objective evidence, that a medical condition will impair the employee’s ability to perform essential job functions, or that the employee will pose a threat due to a medical condition.

When assessing whether to have an employee undergo a fitness for duty exam based on unusual behaviors, it is important for employers to keep in mind that there must be a genuine reason to doubt whether the employee can perform job-related functions, or there must be a genuine safety concern. Behavior that simply is annoying or inefficient does not rise to that level.