Fitness for Duty Case Examples

  • Fitness for Duty Evaluations (FFDEs) are designed to determine whether an employee is psychologically capable of safely and effectively performing the essential functions of their current position. This section outlines FMRT's approach to FFDE determinations, report writing, treatment recommendations, referral for medical evaluation, and the distinction between clinical recommendations and employment decisions. The primary consideration is the employee's current functional capacity and occupational risk.

  • Fitness for Duty (FFDE) evaluations should focus on the employee's current psychological ability to safely and effectively perform the essential functions of the position.

    The evaluation should consider:

    • Current psychological functioning

    • Emotional regulation

    • Judgment and decision-making

    • Ability to safely perform essential job duties

    • Risk to self or others

    • Ability to function under occupational stress

    • Treatment compliance

    • Current symptom severity

    • Behavioral observations

    • Objective testing

    • Relevant collateral information

    The determination should be based on the employee's current functional capacity, not solely on diagnosis or past history.

  • Yes.

    An employee may be found Fit for Duty while still receiving recommendations intended to reduce future risk or support continued success.

    Examples include:

    • Continued mental health treatment

    • Employee Assistance Program (EAP) participation

    • Medication follow-up

    • Stress management

    • Coaching or supervision

    • Periodic monitoring

    These recommendations are advisory and do not constitute required accommodations unless specifically directed by the employer.

    A finding of Fit means the evaluator believes the employee is currently capable of performing the essential functions of the position.

  • Psychologists should remain within the scope of psychological practice.

    Referral to an appropriate medical provider should be considered when symptoms suggest a possible medical etiology rather than a primary psychological condition.

    Examples include:

    • Sudden cognitive decline

    • New attentional deficits

    • Unexplained mood changes

    • Hallucinations without clear psychiatric history

    • Medication-related cognitive changes

    • Neurological symptoms

    • Endocrine or metabolic concerns

    The purpose of the referral is to ensure a comprehensive evaluation—not to delay or avoid rendering a psychological opinion.

  • FFDE reports should remain:

    • Objective

    • Behaviorally focused

    • Clinically supported

    • Limited to the psychologist's scope of practice

    Reports should:

    • Focus on observed functioning.

    • Describe behavioral risk rather than speculate about medical diagnoses.

    • Clearly address suicidality when clinically relevant.

    • Use broad medical terminology rather than unnecessary medication details.

    • Distinguish psychological findings from employment decisions.

    Recommendations should remain clinically focused and avoid advising the employer on disciplinary or personnel actions.

  • A personality disorder diagnosis alone does not determine fitness for duty.

    The evaluation should focus on:

    • Current functioning

    • Emotional regulation

    • Behavioral stability

    • Occupational performance

    • Risk to self or others

    • Treatment participation

    • Ability to safely perform job duties

    Employees may be found Fit if they are currently functioning adequately, while recommendations for ongoing treatment or monitoring may still be appropriate.

  • A Not Fit determination should be reserved for situations in which the employee's current psychological functioning significantly interferes with their ability to safely perform one or more essential job functions.

    Examples may include:

    • Active psychological symptoms causing functional impairment

    • Significant emotional dysregulation

    • Impaired judgment affecting safety

    • Uncontrolled behavioral risk

    • Acute suicidality or homicidality

    • Untreated psychiatric conditions that compromise occupational functioning

    The determination should always be supported by objective clinical findings and a clear explanation of how the symptoms affect job performance.

    • FFDEs evaluate current functional capacity, not simply diagnosis.

    • The central question is whether the employee can safely perform the essential functions of the position.

    • Fit determinations may include recommendations but do not require accommodations.

    • Remain within the scope of psychological practice.

    • Refer for medical evaluation when symptoms suggest a possible medical rather than psychological cause.

    • FFDE reports should focus on observable behavior, functional impairment, and occupational risk.

    • Avoid making employment or disciplinary recommendations; those decisions remain with the employer.