Overview.
Methodologies & Types.
It is important to understand that there are different methodologies and different formats for testing.
Starting with the methodologies in the diagram below, you can simulate the actual task specifics of a job to confirm whether a candidate is capable or incapable of performing the job. This is the most direct method of testing – it actually tests if the applicant can perform the job. Functional testing/physical ability testing is an example of a direct method of testing.
Other less direct methods essentially extrapolate from measurements (isokinetic, electrodiagnostic, etc.) to predict if the candidate can capably perform a task. With these methods, a significant amount of computation is required to ensure the extrapolation is truly reflective of performing the job.
While it is true that there are valid tests on the market for both types of methodologies (direct and indirect), the act of having someone perform the job task in a clinic eliminates the burden – and with it the risk – that arises with an indirect method that requires a conversion of a nonfunctional measurement into an accurate prediction of someone’s ability to do the job.
Testing Methodologies.
Isokinetic
Testing
Physical Fitness
Testing
Electrodiagnostic Functional
Assessment Testing1
Functional Testing /
Physical Ability Testing
- Quick to perform
- Can be performed by PTs/OTs, athletic trainers, techs, etc.
- Works well for public safety-sensitive positions such as law enforcement, emergency medical, firefighters
- Includes job-specific tasks to ascertain the applicant’s ability to do the job.
- Job-specific
- Includes different types of testing formats for post-offer comprehensive tests, agility tests, and Fit For Duty testing.
- Provides baseline info for the body parts recorded in the event of injury using surface EMG.
- Can be performed by a trained tech
- Requires expensive isokinetic equipment making it difficult and costly to scale
- Does not allow for job-specific movements such as lifting/carrying, reaching at various levels, stair climbing, and ladder climbing.
- Requires criterion-related validity, which only occurs by collecting data from a large population of the work force to establish “cut scores”. This requires substantial human resources and costs to complete, and most employers/job analysts skip this step – resulting in cut scores that are not job-specific thus leading to disparate impact as noted in several recent cases.
- Studies have shown isokinetic trunk testing was of no value in employee selection – isokinetic measures of trunk muscles were not found to predict future cases of occupational low back pain (https://pubmed.ncbi.nlm.nih.gov/8138847/)
- The test tasks correlate to the job tasks, but do not simulate the job tasks
- Requires criterion-related validity, which only occurs by collecting data from a large population of the work force to establish “cut scores”. This requires substantial human resources and costs to complete, and most employers/job analysts skip this step – resulting in cut scores that are not job-specific thus leading to disparate impact as noted in several recent cases.
- Not job-specific
- Expensive (over $2000 for test results was noted)
- Requires a second test to be performed (post-injury claim) to compare to baseline test to determine age/extent of injury (at least one case ruled the EFA to be invalid)
- Relies on 1st and 2nd test having the exact same electrode setup/placement to record comparative results
These tests were not job-specific and were deemed to be discriminatory by the EEOC.
- Only court cases lost were due to a lack of scientific rigor of physical demands/job analysis and/or test was not actually job-specific.
- With proper physical demands analysis, legal compliance is assured.
- Not all physical demands analysis are created equal
In this case, the court ruled the orthopedic surgeon was correct in asserting the EFA was not valid and didn’t correspond/correlate to his physical exam and medical history findings. The employer lost the case and had to compensate the injured employee.
1 - Baseline Testing once hired or already employed
Isokinetic Testing
Pros:
- Quick to perform
- Can be performed by PTs/OTs, athletic trainers, techs, etc.
Cons:
- Requires expensive isokinetic equipment making it difficult and costly to scale
- Does not allow for job-specific movements such as lifting/carrying, reaching at various levels, stair climbing, and ladder climbing.
- Requires criterion-related validity, which only occurs by collecting data from a large population of the work force to establish “cut scores”. This requires substantial human resources and costs to complete, and most employers/job analysts skip this step – resulting in cut scores that are not job-specific thus leading to disparate impact as noted in several recent cases.
- Studies have shown isokinetic trunk testing was of no value in employee selection – isokinetic measures of trunk muscles were not found to predict future cases of occupational low back pain (https://pubmed.ncbi.nlm.nih.gov/8138847/)
Court Cases:
Physical Fitness Testing
Pros:
- Works well for public safety-sensitive positions such as law enforcement, emergency medical, firefighters
Cons:
- The test tasks correlate to the job tasks, but do not simulate the job tasks
- Requires criterion-related validity, which only occurs by collecting data from a large population of the work force to establish “cut scores”. This requires substantial human resources and costs to complete, and most employers/job analysts skip this step – resulting in cut scores that are not job-specific thus leading to disparate impact as noted in several recent cases.
Court Cases:
These tests were not job-specific and were deemed to be discriminatory by the EEOC.
Electrodiagnostic Functional Assessment Testing1
Pros:
- Provides baseline info for the body parts recorded in the event of injury using surface EMG.
- Can be performed by a trained tech
Cons:
- Provides baseline info for the body parts recorded in the event of injury using surface EMG.
- Can be performed by a trained tech
Court Cases:
In this case, the court ruled the orthopedic surgeon was correct in asserting the EFA was not valid and didn’t correspond/correlate to his physical exam and medical history findings. The employer lost the case and had to compensate the injured employee.
Functional Testing / Physical Ability Testing
Pros:
- Includes job-specific tasks to ascertain the applicant’s ability to do the job.
- With proper physical demands analysis, legal compliance is assured.
- Not all physical demands analysis are created equal
Cons:
- Job-specific
- Includes different types of testing formats for post-offer comprehensive tests, agility tests, and Fit For Duty testing.
Court Cases:
- Only court cases lost were due to a lack of scientific rigor of physical demands/job analysis and/or test was not actually job-specific.
1 - Baseline Testing once hired or already employed
Types of Functional/Physical Abilities Tests.
Independent of methodologies, there are different test formats that can be used, depending on the goals and business requirements of your organization for testing the functions of a job.
Post-Offer Comprehensive Test
Benefits:
- Medical history questionnaire - increased level of safety for candidate and employer to ensure a medical threat isn’t imminent
- Musculoskeletal exam - allows employer to document current limitation in the event someone
is hired but injured later in employment - Dynamic lifting - safety measure for candidate during testing Job-Specific Tasks - actually measures the actual job tasks
Limitations:
- More expensive than a Physical Agility Test (PAT)
- Has a higher “not capable” rate than PAT due to medical measures
- Takes longer to administer than a PAT.
- Requires a therapist (PT/OT) to perform due to musculoskeletal exam.
- Requires more room than PAT due to need for exam table(s)
Notes:
- Gold standard of physical ability/functional testing
- Must have a scientifically rigorous physical demands/job analysis performed to ensure job-specificity
Physical Agility Test (Post Offer)
Benefits:
- Dynamic lifting
- Job-Specific Tasks
- A strategic consideration for tight labor markets
- Less expensive than Comprehensive Exam (CE)
- Can be performed by ATs
- Quicker to perform than CE
- Does not require as much room as CE due to no need for exam table(s).
Limitations:
- No medical measures/musculoskeletal exam shifts risks to employee during tests and to employer in post injury scenario
- Only determines if person can perform material handling duties and body positions associated with job tasks
Notes:
- Must have a scientifically rigorous physical demands/job analysis performed to ensure job-specificity
Fit For Duty Testing (Post Employment)
Benefits:
- Determines if a person returning from illness/injury (work-related or not) is able to safely perform the physical demands of the job.
- Same job-specific test as CE or PAT
Limitations:
- Unable to perform comprehensive medical history/musculoskeletal exam – can only look at the involved body part.
- Must be performed by a PT/OT.
Notes:
- Not as popular or as well-received by clients compared to testing job candidates for initial hire (CE and PAT)
Employee Testing Legalities and Case Law
Employment testing has grown in popularity over the last three decades, as employers strive to hire and promote the most qualified job candidates and employees. With many employers moving to online job applications and interviews, they’re seeking more efficient ways to screen larger numbers of job applicants in a non-biased way. When appropriate employment screening practices are put into place to protect all job applicants, and processes are reviewed regularly, an employment testing program can be very successful!
There are many different types of tests and employee selection procedures, including cognitive tests, personality tests, medical examinations, comprehensive medical/musculoskeletal and physical agility testing, as well as background screenings and drug testing. The use of such tests can be a very effective tool for means of determining which applicants or employees are most qualified for a particular job; however, there are legal considerations that employers and testing providers should be aware of prior to implementation of an employment testing program:
- Testing must be fully compliant with ADA/EEOC federal guidelines and current case law.
- Testing must be job-related and consistent with business necessity.
- Testing information – medical and/or functional criteria – must be collected appropriately according to the stage of employment, i.e. pre-offer, post-offer, or post- employment.
- Testing programs should be reviewed regularly (more on how frequently below) for disparate impact to avoid unintended consequences of discrimination against any group of workers such as older workers or females. The recommended frequency for reviewing testing programs should be annually or after significant changes have been made to the job – whichever occurs first. Significant changes to the job may include workstation design, tools and equipment, changes to how the work is performed, changes to the actual product(s) being produced/handled, etc.
Through implementation of the above practices and guidelines, and a strong partnership between the employer and the testing provider, hiring discrimination will be minimized, with the outcome being a healthy, safe, and productive workforce.
Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act of 1990 (ADA), and the Age Discrimination Act of 1967 forbid the use of employment selection practices that are discriminatory in nature.
Title VII prohibits employers from using neutral tests or selection procedures that have the effect of disproportionately excluding persons based on race, color, religion, sex, or national origin, where the tests or selection procedures are not “job-related and consistent with business necessity.” This is called “disparate impact” discrimination. Most commonly, disparate impact affects females and older workers.
The Americans with Disabilities Act of 1990 (ADA) is a civil rights law, which makes it unlawful to discriminate in employment against a qualified individual with a disability. Simply stated, the purpose of this law is to make sure people with disabilities have the same rights and opportunities as everyone else.
The Equal Employment Opportunity Commission (EEOC) is a federal entity that is responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex (including pregnancy and related conditions, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information. Simply stated for employment testing purposes, the EEOC investigates and enforces violations involving the Americans with Disabilities Act of 1990, as well as the Americans with Disabilities Act Amendments Act (ADAAA) of 2008 - enacted January 1, 2009.
A valid employment testing methodology will be ADA-compliant; i.e. non-discriminatory.
For a physical ability test to be valid, the test must be job-related. To ensure the test is job-related, a scientifically rigorous job analysis must be conducted. This job analysis will include measures such as material handling duties (lifting, carrying, pushing, pulling, etc.), positional tolerances (standing, sitting, reaching, fine motor movements, etc.), as well as potential personal protective equipment (PPE) and environmental considerations that may impact the physical requirements of the essential functions of the job.
Not only is a job analysis necessary to begin physical ability testing, but it is also necessary to update the job analysis as part of an ongoing process due to changes in the job, job process, tools & equipment utilized. These changes may increase or decrease the physical requirements of the essential functions of the job. A job analysis and test that have not been updated as part of an ongoing process may potentially cause discrimination/disparate impact by testing job candidates at physical requirements that exceed the actual physical requirements of the job. For example, the initial job analysis revealed employees lifting a 50 lb. box from the floor to an overhead level rack. After engineering changes were made, the employees now only lift a 20 lb. item from a waist level counter to a waist level rack. If the job analysis and test were not updated to reflect those changes, job candidates would still be required to lift a 50 lb. item from floor to overhead level – thus reducing the number of candidates able to physically perform that task, as well as now having a test that is not based on scientific rigor/job relatedness – which increases the likelihood of discrimination/disparate impact. There are convenient and cost-effective services to keep your job analyses up-to-date.
Often, employers seek recommendations on how and where to begin implementation of an employment testing program, particularly large employers with thousands of employees across multiple locations. It is recommended employers identify those job position(s) with the largest number of work-related injuries and implement testing with those position(s) first. Additional positions to be tested can be prioritized by the employer and implemented at a future date based on need and the employer’s budget. In other words, you don't need to test every position or even plan to test every position to be compliant.
In accordance with EEOC/ADA guidelines, the employer must be consistent with administration of employee selection criteria with all job applicants applying for job position(s) identified for testing. This ensures a fair and unbiased hiring process for all job applicants! It is always recommended the employer implement the same employee selection criteria with all job applicants in similar job positions at other locations. Employers with multiple locations may choose to begin testing at a “pilot” location with the goal of testing expansion to additional locations at a future date.
A Post Offer Employment Test or POET allows an employer to ensure that a newly hired worker can perform the physical requirements of the essential functions of the job they were hired for before their first day on the job. This type of test is for job candidates who have been hired by the employer contingent to being capable of performing the physical requirements of the job they were hired for.
A Fit For Duty test or FFD is a test that allows an employer to ensure an existing employee is capable of performing the physical requirements of the essential functions of the job after experiencing an injury, illness, surgery, or extended absence from work. Based on the results of the Fit For Duty test, the employee may return to their job, return to a different job temporarily, and/or undergo additional treatment, rehabilitation, etc.
Different but Similar Acronyms:
- POET = Post-Offer Employment Test
- POPE = Post-Offer Pre-Employment Test OR /Post-Offer Pre-Placement Exam
POET and POPE testing are terms used interchangeably when referring to pre-employment tests that are administered AFTER a job application has been received, an interview has been conducted, and a conditional offer of employment has been made to a job applicant.
At the post-offer stage of employment, the employer can legally collect medical measures and require the applicant to demonstrate the ability to perform job-related essential functions.
Use of pre-employment post-offer testing as part of the hiring process can provide many benefits to an employer! Benefits such as a reduction in work-related injuries, improved employee retention, reduction in lost time injuries, and lower health care costs on the personal medical side!
Pre-employment testing is most beneficial when used in these scenarios:
- Jobs with heavy physical demands such as heavy lifting, carrying, pushing/pulling, high repetitions, and/or repetitive upper extremity intensive work.
- Jobs with high numbers of musculoskeletal injuries, especially with new employees.
- Jobs with high turnover which may indicate the employer is hiring workers who are not physically capable of doing the job.
The job analysis is not a protected name or methodology. However, to complete an accurate, objective, and quantifiable job analysis (for ADA/EEOC compliance and legal defensibility), the practitioner should be properly trained in data collection methodologies, quantitative analysis, job task analysis, anatomy & physiology, and biomechanics. In addition to the training necessary to collect info for testing/performing a job analysis, specialized tools & equipment, such as a dynamometer for determining push/pull forces, are required.
Although not a requirement, it is a recommended best practice to use an independent, third-party practitioner with experience in conducting job analyses to ensure any potential employer biases are reduced/eliminated. Biases may skew the results of the job analysis, which may result in a non-valid test – ultimately leading to discrimination/disparate impact.
Physical and Occupational therapists and Athletic Trainers are uniquely qualified to administer functional, job-specific employment testing programs due to their strong backgrounds in musculoskeletal health and wellness, evaluation of postures, body mechanics and movement patterns.
While physical and occupational therapists are widely utilized to administer comprehensive medical and musculoskeletal testing measures in conjunction with functional, job-specific testing; athletic trainers are ideally suited to oversee physical agility testing programs that are more focused on functional, job-specific testing.
Therapists and athletic trainers working in industrial settings often have a strong knowledge of the physical demands of the job positions they support as well as knowledge of risk factors for injury, and unique safety concerns specific to those jobs. Therapists and athletic trainers with additional training in ergonomics can also participate in data collection and PDA development of job positions to be tested, and development of job-specific testing criteria. These highly trained testing providers can also offer invaluable expertise in the annual review of PDAs and testing criteria to ensure ongoing validity, reliability, and predictability of testing protocols.
Implementing Testing.
To best implement an Employee Testing program at your organization, ensure you engage with a knowledgeable partner who can provide guidance and solutions tailored to your needs.
- An implementation roadmap considerate of your Human Resources and Legal stakeholders and works within the parameters of your current structure.
- Coordination of near-site and on-site options to provide flexibility when and where it is needed for your Employee Testing program.
- Quick turnaround time – including the ability to remove the burden of scheduling and report gathering – to get your candidates through the process promptly.
- Experience in Job Analysis and Validation processes to construct ADA/EEOC-compliant, legally defensible tests – getting you compliant and keeping you there.
In essence, partner with an employee testing authority who will be by your side to create and continually optimize a program that is easy for you to manage, provides a good experience for your candidates, keeps you in compliance, and enhances your business practices.
Foundation of Employee Testing.
Legal Compliance.
Business Case.
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