According to the National Academy of Social Insurance, in the United States, workers’ compensation covered approximately 129.6 million workers in 2013, with $63.6 billion being paid in workers’ compensation benefits. Additionally, for that same year, employers’ cost for workers’ compensation was $88.5 billion, an increase of 19.8 percent since 2009. To this end, no employer wants to inherit a pre-existing injury. Unfortunately, if a company has no pre-employment medical testing in place, then this may very well be the case. (Learn more in "How to Set Up a Fit-for-Work Testing Program".) Failure to determine an employee's pre-existing injuries can result in the employer being held liable for paying all medicals bills for treatment that strictly relate to injuries and illnesses that have nothing to do with their business or the injured employee's job role and tasks. Thus, this makes it important for employers to determine whether or not a potential new hire has pre-existing injuries.

The Importance of Fitness-to-Work Testing

A fit-to-work evaluation is a series of tests conducted on an individual in order to determine if that individual’s medical, musculoskeletal, and critical strength and mobility capabilities matches his/her abilities to perform the essential tasks of the job competently and safely. Therefore, a fit-to-work evaluation (in conjunction with a good physical demands analysis of the job in question) will also be able to tell the prospective employer if their potential new hire has any pre-existing injuries or medical conditions. (Learn more in "Physical Demands Analysis 101".) Additionally, one or more experience medical practitioners who understand the job requirements conduct this pre-employment medical. Furthermore, depending on the employer’s specifications, the tests may include:


Top 3 Ways Employers can Minimize their Liability

Workers are not entitled to compensation if they aggravate an existing injury. However, if an employer is unaware of a worker’s prior existing injuries and the worker reports the issue as a new injury, then that employer could be liable for the high cost of compensation claims relating to an injury, which did not actually occur on their job site or as a result of the nature of their job tasks. Furthermore, if the worker is now unable to continue working due to aggravating this pre-existing (but previously unreported or hidden in an attempt to defraud) injury, the employer would also have to pay time loss compensation benefits to the worker as there would be no proof the injury was not the current employer's fault. Therefore, to minimize their liability for pre-existing injuries and illnesses carried by their workers, employers must: (1) acquire a baseline reading of the health of new employees; (2) have new employees complete the appropriate documentations; and (3) perform relevant background checks on any potential new hire.

1. Base-line the health of new employees

Base-lining the health of new a worker can help an employer to accurately assess the new worker’s health because it provides the employer with guideline for comparing the new worker’s health in relation to any pre-existing injuries or medical conditions. This is useful because in the event that the new worker becomes injured or ill on the job, the employer knows what was prior to employment and what was unrelated to the current job. To successful obtain baseline data regarding a new worker’s health status employers should:

  • Have the new worker complete pre-employment screening medical testing
  • Brief medical practitioners and health professionals on the scope of their business, as well as what the new worker job role and duties entail—this assists the medical practitioner in understanding the likely risks that the work presents to the new employee so they can accurately access the impact of new work-related injuries and illnesses
  • Create policies regarding obtaining and using medical information
  • Pay special attention to workers with pre-existing injuries and illnesses, that is, if the worker needs to be examined by a specialist then one should be sought, especially if it is the case that the new job could potentially exacerbate the injury or illness
  • Keep records and make them easily accessible to their insurer

2. Ensure that employees complete the appropriate documentation


Employers should request that new workers complete questionnaires with candor, in order to obtain information regarding the health of the new worker. To develop the most effective questionnaire, employers should carry out risk assessments to determine what are the occupational health and safety risks that the new worker may be potentially exposed to. Using this information to formulate the pre-employment health questionnaire, employers will be able to assess the consequences of hiring new workers with pre-existing injuries and illnesses. That is, the main aim of the questionnaire will be to provide employers with an insight as to whether or not the risks associated with the job task would exacerbate a new worker’s pre-existing medical conditions.

3. Do background checks

Employers should make any reasonable and legal inquires in an effort to determine if the new worker:

  • Has any injury or medical condition that may be exacerbated due to the nature of the job
  • Have ever lodge any workers’ compensation claims
  • Have previously lodged any workers' compensation claims in relation to injuries or illnesses that may be exacerbated by the nature of the proposed new work

What you don’t know CAN hurt


In addition to the costs associated with workers’ compensation claims, lack of information can be costly in other ways as well:


  • Safety – The new worker should be free from medical conditions and injuries that may potentially lead to sudden incapacitation, which may result in an accident. This can negatively impact on the safety of the entire workplace. (Learn more in "When To Use A Functional Capacity Evaluation".)
  • Health – Determining pre-existing injuries allows for baseline health data to be established, which can be used in the future as it relates to comparing the health status of the new worker.
  • Productivity and Efficiency – Hiring a new worker that is medically fit for the job increases the company’s productivity and efficiency.


It is crucial for employers to take all the necessary steps to ensure that they hire the right person for the job. One such step is determining a new worker’s pre-existing injuries, which can be achieved through the implementation of pre-employment screening health/medical programs.