Fitness for Duty Examinations

  • Michael Chafetz
Part of the Clinical Handbooks in Neuropsychology book series (CHNEURO)


Fitness-for-duty (FFD) examinations are requested of psychologists when an employer has concerns about an employee’s psychological or neuropsychological functioning. In a psychological FFD examination, the employer wants to understand the impact and risks of the psychological or emotional instability and whether this instability poses any risk of harm in the workplace. In a neuropsychological FFD examination, the questions focus on the impact of the employee’s neuropathology (e.g., seizure disorder, stroke) in the workplace. Boundaries, rules, ethics, and informed consent for FFD examinations are discussed. The validity of the examination must be addressed, but in FFD testing, validity is more about a lack of findings being the product of underreporting of emotional or psychological distress. Case examples are provided to show different types of FFD and related examinations.



The author wishes to thank Dr. David Fisher, who provided helpful comments and suggestions, and Paige Haley, for her work on the final manuscript.


  1. 1.
    Schappel, C. (2014). When do fitness-for-duty inquiries go too far? EEOC weighs in. (September 19, 2014). Downloaded from (
  2. 2.
    Anfang SA, Wall BW. Psychiatric fitness-for-duty evaluations. Psychiatr Clin N Am. 2006;29:675–93.CrossRefGoogle Scholar
  3. 3.
    Morel KR. Test security in medicolegal cases: proposed guidelines for attorneys utilizing neuropsychology practice. Arch Clin Neuropsychol. 2009;24:635–46.CrossRefGoogle Scholar
  4. 4.
    Axelrod B, Barth J, Faust D, Fisher J, Heilbronner R, Larrabee G, Pliskin N, Silver C. Presence of third-party observers during neuropsychological testing: official statement of the National Academy of neuropsychology. Arch Clin Neuropsychol. 2000;15:379–80.CrossRefGoogle Scholar
  5. 5.
    Otto RK, Douglas KS. Handbook of violence risk assessment. New York: Routledge; 2010.Google Scholar
  6. 6.
    Heilbrun K, Yashuhara K, Shah S. Violence risk assessment tools. In: Otto RK, Douglas KS, editors. Handbook of violence risk assessment. New York: Routledge; 2010.p. 1–17.Google Scholar
  7. 7.
    Chafetz MD, Prentkowski E, Rao A. To work or not to work: motivation (not low IQ) determines symptom validity test findings. Arch Clin Neuropsychol. 2011;26(4):306–13.CrossRefGoogle Scholar
  8. 8.
    Morey LC. Personality assessment inventory. Odessa: Psychological Assessment Resources; 1991.Google Scholar
  9. 9.
    Ben-Porath YS, Tellegen A. Minnesota multiphasic personality Inventory-2-restructured form (MMPI-2-RF): manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press; 2008.Google Scholar
  10. 10.
    Rosen GM, Baldwin SA, Smith RE. Reassessing the “traditional background hypothesis” for elevated MMPI and MMPI-2 lie-scale scores. Psychol Assess. 2016;28(10):1336–43.CrossRefGoogle Scholar
  11. 11.
    Paulhus DL. Paulhus deception scales. North Tonawanda: Multi-Health Systems; 1998.Google Scholar
  12. 12.
    Kay, G. & Atkins, K. (2016). Which norms should I be using? Presentation at the 4th annual aerospace psychology seminar, Denver, CO, September 18, 2016.Google Scholar
  13. 13.
    Kennedy CH, Kay GG. Aeromedical psychology. Boca Raton: Taylor & Francis, CRC Press; 2013.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Michael Chafetz
    • 1
  1. 1.Algiers Neurobehavioral Resource, LLCNew OrleansUSA

Personalised recommendations