When is it appropriate to require an employee to complete a medical examination? This question presents a common challenge for employers. A federal court of appeals recently issued a decision that helps clarify an employer’s rights to seek a medical opinion when it is concerned about workplace safety. In Owusu-Ansah v. Coca-Cola Company, the Eleventh Circuit found that an employee’s threatening comments and behavior during a meeting with a supervisor were legitimate reasons to mandate that the employee pass a fitness-for-duty examination before returning to work. 


Franklin Owusu-Ansah was a quality assurance specialist for Coca-Cola at its customer call center. During a routine meeting with his supervisor, Owusu complained that certain co-workers had been harassing him for the past nine years because of his Ghanaian national origin. The supervisor observed Owusu becoming physically agitated, banging his hand on the table where they were sitting, and proclaiming that someone was “going to pay for this.” Concerned that Owusu might harm other employees, the supervisor reported the conversation to human resources and security.

The company retained a consulting psychologist to assess the situation, and Owusu agreed to speak with him. After the meeting, the psychologist expressed concern to the company about Owusu’s emotional and psychological stability and suggested that Owusu may be delusional. The company placed Owusu on paid leave pending further evaluation. Owusu continued to meet with the psychologist by phone and email, and also agreed to a psychiatric evaluation. However, Owusu refused to authorize the psychiatrist to share his findings with the company’s psychologist. As a result, psychologist was unable to complete his assessment. 

Based on the psychologist’s recommendation, the company informed Owusu that he must complete a fitness-for-duty evaluation in order to return to work. Afraid of losing his job, Owusu agreed to another psychiatric evaluation, including a personality test. The test showed that Owusu’s profile was within normal limits, and he was cleared to return.

Owusu subsequently filed a lawsuit against Coca-Cola alleging that the company’s mandatory medical examinations violated his rights under the ADA.

Court’s Ruling

At issue in the lawsuit was the ADA’s provision that employers shall not require medical examinations or otherwise inquire about an employee’s disability unless the examination or inquiry is job-related and consistent with business necessity. The district decided that Coca-Cola’s mandatory fitness-for-duty exams were lawful in Owusu’s case, and the Eleventh Circuit affirmed.

The court of appeals made two interesting rulings in this case. First, it held that employees can assert ADA claims for unlawful medical examinations whether or not they are disabled. Second, the court found Coca-Cola’s medical exam requirements were job-related because “an employee’s ability to handle reasonably necessary stress and work reasonably well with others are essential functions of any position.” It also found that the company’s concerns about safety were objectively reasonable because they were based on the unbiased observations by Owusu’s supervisor and an independent psychologist.

Insights for Employers

The Americans with Disabilities Act raises many questions about when an employer can require an employee to complete a medical examination based on the employee’s behavior in the workplace. The Eleventh Circuit took a common sense approach in the Owusu case by finding that an employer can lawfully mandate a fitness-for-duty exam if it has a reasonable and objective concern that an employee may pose a danger to himself or others. In those situations, an employer should not have to wait until a perceived threat results in injuries before seeking a medical opinion. 

The Owusu decision is encouraging, but employers should continue to exercise caution before requiring an employee to pass a fitness-for-duty examination. These decisions should be based on objective facts and/or observations by unbiased witnesses.  In the Owusu case, the supervisor’s concerns arose during a meeting where Owusu was complaining about harassment by others. Employees can be understandably become emotional and angry in those situations, and a knee-jerk reaction by the employer could be construed as retaliatory.