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LCR 2018-2 - Medical Examination Policy of the Library of Congress

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LCR 2018-2 Medical Examination Policy of the Library of Congress

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Section 1: Medical Examination Policy Section 2: Medical Examination Procedures Section 3: Definitions Notes

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Section 1: Medical Examination Policy A. Physical Examinations 1. A routine validated pre-placement examination is appropriate for any position which has specific medical standards/ physical requirements listed on the position description, or is covered by an established Health Services Office medical evaluation program. Such examinations will be conducted by the Library's Health Services Officer or designee, including nurse practitioners or physician assistants. 2. The Library may require an individual who has applied for and who has received a bona fide offer of a position, or who occupies a position which has specific medical standards/physical requirements listed in the position description, or is covered by an established Health Services Office medical evaluation program, to report for a medical examination: a. Prior to placement but after a bona fide job offer (including reemployment on the basis of full or partial recovery from a medical condition except that the return-to-work provisions of the Family Medical Leave Act shall supersede the provisions of this regulation); b. On a regularly recurring, periodic basis after appointment; or c. Whenever there is a direct question about an employee's continued capacity to meet the physical or medical requirements of his/her position as listed in the position description. 3. When an employee is placed in a position that has specific medical standards or physical requirements which are different from those of his/her current position by administrative actions (such as reduction-in-force, detail, or reassignment), the Library may require that the employee undergo a relevant medical examination. B. Psychiatric Examinations 1. The Library's Health Services Officer or a qualified practitioner designated by her/him, may order a psychiatric examination (including a psychological assessment) only when:

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LCR 2018-2 - Medical Examination Policy of the Library of Congress


a. The result of a current general medical examination which the Library has the authority to order under section A. above indicates no physical explanation for behavior or actions which may affect the safe and efficient performance of the employee or other individuals. b. A psychiatric examination is specifically called for in a position having medical standards or a position which is subject to an established medical evaluation program. 2. Library ordered psychiatric examinations or psychological assessments must be conducted in accordance with accepted professional standards, by a licensed practitioner or physician authorized to conduct such examinations, and may only be used to make legitimate inquiry into a person's mental fitness to successfully perform the duties of his or her position without undue hazard to the individual or others. C. Offered Medical Examinations The Library may, at its option, offer a medical examination (including a psychiatric examination) in any situation where the Library needs additional medical documentation to make an informed management decision. This may include situations where an employee requests for medical reasons a change in duty status, assignment, working conditions, or any other benefit or special treatment (including reasonable accommodation or reemployment on the basis of full or partial recovery from a medical condition subject to the conditions of the Family Medical Leave Act and the Americans With Disabilities Act Library of Congress regulations), or where the employee has a performance or conduct problem which may require agency action. Reasons for offering an examination must be documented in writing and in accordance with the pre-employment prohibitions of the Americans with Disabilities Act. The offer shall be made in writing and shall include: 1. Reasons for the examination. 2. Instructions on how to participate in the selection of a medical examiner. (See Section D below). 3. Notification that the staff member has the right to name a representative to act on his/her behalf in matters related to the examination and any subsequent related transactions, but that in so naming a representative, the staff member must bear any expenses involved in obtaining that representative's services. D. Selection of Examiners When an examination is directed, or offered and the employee elects to be examined, the Library shall provide a written notice to the employee setting forth the following options: 1. The employee may submit to the Library's Health Services Office, a list, including names, addresses, and telephone numbers of up to three medical examiners that he/she is willing to have examine him/her. From these names, one shall be selected by the Library's Health Services Officer. These examiners must be fully qualified and board-certified in the specialty appropriate to the condition of the employee that is under question and be willing to submit a report of the examination directly to the Library's Health Services Officer. The employee must provide the list of prospective examiners to the Library's Health Services Office within 15 work days of receipt of the Library's notice. If a list is not received within that 15 workday period, the Library's Health Services Officer may select an examiner who shall conduct the examination. The Library shall notify the employee of the name, address, and telephone number of the examiner selected. The Library shall either notify the employee of the date, place, and time of the appointment, or allow the employee to schedule the appointment. When the Library does not schedule the appointment, the employee shall promptly contact the selected examiner to schedule an appointment. However, if an employee can demonstrate that exigent circumstances prevented him/her from compiling and submitting a list of examiners within that 15 day period, he/she may request a reasonable extension of time to submit a list of names. The Library shall not unreasonably deny such request where supported by evidence of exigent circumstances, or: 2. The employee may elect to be examined by a medical examiner selected by the Library's Health Services Officer or designee. E. Qualifications of Examiners All physicians and practitioners selected by the Library to

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LCR 2018-2 - Medical Examination Policy of the Library of Congress


perform examinations must be fully qualified and board-certified in the field of specialization indicated. F. Report of Examination 1. Upon receipt of medical reports from examining physicians, the Library's medical staff shall evaluate them and make appropriate recommendations to the Director of Personnel. All such reports are confidential and are strictly between the Health Services Office and the employee. 2. Upon written request to the examining health care provider by the staff member concerned, copies of medical reports shall be provided to the employee, the designated representative and/or the employee's physician by the examining health care provider. G. Voluntary Medical Examinations Periodic voluntary health maintenance examinations will be provided to employees by Health Services Office personnel to the extent resources permit. H. Payment for Medical Examinations 1. The Library will pay for all medical examinations which are ordered or offered under this section, whether conducted by Health Services Office personnel, a Library contracted physician (or practitioner) or the employee's (or applicant's) private physician (or practitioner), subject to the selection procedures in Section 1.D. 2. Employees (and applicants) must pay for any medical examination conducted by a private physician (or practitioner) where the purpose of the examination is to secure a benefit sought by the employee (or applicant). This does not apply to examinations conducted under the Family Medical Leave Act and the Americans With Disabilities Act when so stated in the appropriate regulation. Section 2: Medical Examination Procedures A. When the Library orders or offers a medical examination under Section 1, it must inform the applicant or employee in writing of its specific reasons for doing so and the consequences of failure to cooperate.(A single notification is sufficient to cover a series of regularly recurring or periodic examinations ordered under this regulation.) B. Subject to the provisions of Section 1.D., the Library must offer the individual in writing that he/she has the opportunity to submit additional medical documentation from his or her personal physician or practitioner at his/her own expense. The Library must review and consider all such documentation supplied by the individual's personal physician or practitioner. Any rejection of the medical documentation submitted by the individual's personal physician or practitioner must be in writing and given to the employee. Section 3: Definitions Medical condition means health impairment which results from injury or disease, including psychiatric disease. Medical documentation or documentation of a medical condition means a statement from a licensed physician or other appropriate practitioner which provides information the agency considers necessary to enable it to make an employment decision. To be acceptable, the diagnosis or clinical impression must be justified according to established diagnostic criteria and the conclusions and recommendations must not be inconsistent with generally accepted professional standards. The determination that the diagnosis meets these criteria is made by or in coordination with a physician or, if appropriate, a practitioner of the same discipline as the one who issued the statement. An acceptable diagnosis must include the following information, or parts identified by the agency as necessary and relevant: A. The history of the medical conditions, including references to findings from previous examinations, treatment, and responses to treatment; B. Clinical findings from the most recent medical evaluation, including any of the following which have been obtained: findings of physical examination; results of laboratory tests; X-rays; EKG's and other special evaluations or diagnostic procedures; and in the case of psychiatric evaluation of psychological assessment, the findings of a mental status

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LCR 2018-2 - Medical Examination Policy of the Library of Congress


examination and the results of psychological tests, if appropriate; C. Diagnosis, including the current clinical status; D. Prognosis, including plans for future treatment and an estimate of the expected date of full or partial recovery; E. An explanation of the impact of the medical condition on overall health and activities, including the basis for any conclusion that restrictions or accommodations are or are not warranted, and where they are warranted, an explanation of their therapeutic or risk avoiding value; F. An explanation of the medical basis for any conclusion which indicates the likelihood that the individual is or is not expected to suffer sudden or subtle incapacitation by carrying out, with or without accommodation, the tasks or duties of a specific position; G. Narrative explanation of the medical basis for any conclusion that the medical condition has or has not become static or well established and the likelihood that the individual may experience sudden or subtle incapacitation as a result of the medical condition. In this context, static or well-stabilized medical condition means a medical condition which is not likely to change as a consequence of the natural progression of the condition, specifically as a result of the normal aging process, or in response to the work environment or the work itself. Subtle incapacitation means gradual, initially imperceptible impairment of physical or mental function whether reversible or not which is likely to result in performance or conduct deficiencies. Sudden incapacitation means abrupt onset of loss of control of physical or mental function. Medical evaluation program means a program of recurring medical examinations or tests established by written agency policy or directive, to safeguard the health of employees whose work may subject them or others to significant health or safety risks due to occupational or environmental exposures or demands. Medical standard is a written description of the medical requirements for a particular occupation based on a determination that a certain level of fitness of health status is required for successful performance. Physical requirement is a written description of job-related physical abilities which are normally considered essential for successful performance in a specific position . Physician means a licensed Doctor of Medicine or Doctor of Osteopathy, or physician who is serving on active duty in the uniformed services and is designated by the uniformed service to conduct examinations under this part. Practitioner means a person providing health services who is not a medical doctor, but who is certified by a national organization and licensed by a State to provide the service in question.

Notes Series: 2018 Health and Welfare of Library Staff Responsible Office: Health Services Office Statutory Authority: 2 U.S.C. 136 ; 5 U.S.C. 7901 ; 42 U.S.C. 1201, et seq. Last Revised: March 12, 1998 Top

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Last Updated: 03/25/2011

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