What Are the Parameters for An Employer’s Requests for Medical Records Under the ADA?


The Americans with Disabilities Act governs employers’ ability to make medical inquiries of employees, including requests for medical records. And where the ADA permits employers to make such inquiries, it also requires employees to comply with those requests, as the U.S. Court of Appeals for the Fourth Circuit recently affirmed in a case that also provided a useful summary of the scope of such inquiries.

Case Background. In Coffey v. Norfolk Southern Railway Co., following a work-related accident, a railroad engineer was required to undergo periodic drug testing. At some point, he tested positive for amphetamines and codeine, for which he claimed to have prescriptions. The employer then requested information from the employee’s doctor regarding his diagnoses, significant symptoms, medication regimen and compliance with that regimen, medication side effects, awareness of other medications prescribed by other doctors, ability to safely perform essential job functions, and recommended work restrictions or accommodations. Although some records were eventually provided, the employer notified the employee that they were not sufficient. A disciplinary hearing was subsequently held, and the employee provided over 400 pages of medical records – but they still did not address fully the employer’s requests. He was terminated and, of course, sued his employer. Although he conceded that the employer was entitled to some information, he challenged the scope of the employer’s request for medical records and his termination for failing to provide the requested records.

The Fourth Circuit’s Opinion. Under the ADA, employers may make medical inquiries where such inquiries are “job related and consistent with business necessity.” As the Fourth Circuit noted, that standard is met if the employer reasonably believes that an employee’s medical condition impairs their “ability to perform the essential functions of the job” or “the employee poses a direct threat to himself or others.” Moreover, the employer must “show that the asserted `business necessity’ is vital to the business” and that “the request is no broader or more intrusive than necessary.”

In this case, the Fourth Circuit found that the employer’s inquiries into the employee’s use of amphetamines and codeine were “plainly” job-related and consistent with business necessity. The employer had an “objective basis” to believe the employee’s use of these medications could impact his ability to operate a train. The Fourth Circuit stated that each of the employer’s inquiries, as listed above, was related to the employee’s job, and was “unquestionably consistent” with the necessity of ensuring the safe operation of the trains. The fact that the inquiry required the employee to provide extensive records did not change this conclusion – especially given the public safety aspect of this matter, the employer “was more than justified in requesting enough information to permit an informed decision about whether it was safe for its locomotive engineer to operate a train.” And furthermore, the employer was required by federal railroad regulations to obtain that information. Thus, the employee’s failure to provide the required information justified his termination.

Of additional interest, the Fourth Circuit rejected the employee’s contention that the employer acted unreasonably because it could have spoken directly to the doctor itself, rather than requiring the employee to obtain the information. Although the Fourth Circuit acknowledged this might have been a matter of “common courtesy,” the fact that there might have been a better way to get the information did not impact the employer’s business necessity defense. As the Fourth Circuit stated, “The employer need not show that the examination or inquiry is the only way of achieving a business necessity, but the examination or inquiry must be a reasonably effective method of achieving it.”

Lessons for Employers. Although in this case the court found that the employer was entitled to extensive medical records, employers should still be thoughtful about ensuring that they are requesting only as much information as is necessary to establish that the employee has a disability, the extent of their limitations, possible accommodations to enable them to perform the essential functions of their job, and, if applicable, whether they pose a direct threat to the safety of themselves or others. The information requested must be relevant to the job and necessary to the business. And assuming that these conditions are met, the employer can hold the employee accountable for providing the requested information. Moreover, the employer need not contact the doctor directly for the information, although it may choose to do so – with an appropriate written release/authorization from the employee.