What Is Included in a Pre-Employment Medical in Australia?
A complete guide for employers and HR managers on what a pre-employment medical assessment covers, why it matters, and how to set one up for your workforce.
What a Pre-Employment Medical Typically Includes
A pre-employment medical is a health assessment conducted before a candidate begins work in a new role. The purpose is to determine whether the candidate can safely perform the physical demands of the position they are being hired for. The scope of the assessment varies depending on the role, the industry, and the employer's requirements, but most pre-employment medicals in Australia include the following components.
Medical History Questionnaire
The candidate completes a detailed questionnaire covering their medical history, current medications, previous injuries or surgeries, and any existing health conditions. This provides context for the clinician conducting the assessment and helps identify any areas that may require closer examination during the physical assessment.
Physical Examination
A standard physical examination includes measurement of blood pressure, heart rate, body mass index, vision screening, and hearing screening. These baseline measurements help assess the candidate's general health status and identify any conditions that may be relevant to the role they are being assessed for.
Musculoskeletal Assessment
The clinician assesses the candidate's range of motion, strength, and flexibility across key joints and muscle groups. This is particularly important for physically demanding roles where the candidate will be required to lift, carry, push, pull, or perform repetitive movements. The assessment identifies any musculoskeletal limitations that could affect job performance or increase injury risk.
Drug and Alcohol Screening
Many employers require drug and alcohol screening as part of the pre-employment process. Testing is typically conducted via urine or saliva sample, with on-the-spot results available during the same session. This is standard practice for safety-critical roles in construction, mining, transport, and warehousing.
Functional Assessment
A functional assessment involves job-specific physical tasks that replicate the demands of the role the candidate is being hired for. This may include lifting, carrying, pushing, pulling, climbing, and sustained postures. The tasks are determined by the role requirements and, where available, a job task analysis provided by the employer.
Additional Tests as Required
Depending on the role and industry, additional testing may be included. Audiometry provides a baseline hearing assessment for noise-exposed roles and is mandatory in NSW for workers who frequently use hearing protection. Spirometry measures baseline lung function for roles involving exposure to dust, fumes, or chemicals. Colour vision testing may be required for electrical, transport, or signal-dependent roles. Manual handling assessments evaluate the candidate's lifting technique and capacity against specific load requirements.
Why Pre-Employment Medicals Matter for Employers
Pre-employment medicals serve a critical role in workforce risk management. They are not about screening people out - they are about making sure people are placed into roles they can safely perform. For employers, the benefits extend across safety, compliance, and operational efficiency.
Ensure candidates can safely perform the role
The primary purpose of a pre-employment medical is to assess whether the candidate has the physical capacity to perform the demands of the specific role. This protects both the candidate and the employer from placing someone into a position that exceeds their physical capability.
Reduce workplace injury risk and workers compensation claims
Pre-employment screening helps identify candidates who may be at higher risk of injury in a given role. By matching physical capacity to role demands before employment begins, employers can reduce the incidence of workplace injuries and the associated workers compensation costs.
Meet WHS duty of care obligations
Under the Work Health and Safety Act 2011, employers have a duty to ensure, so far as is reasonably practicable, the health and safety of workers. Pre-employment medicals form part of this duty by assessing fitness for work before a candidate is exposed to workplace hazards.
Establish a baseline health record
A pre-employment medical creates a documented baseline of the candidate's health status at the time of hiring. This baseline is valuable for future comparison if a workplace injury or health issue arises during employment, as it helps determine whether the condition was pre-existing or work-related.
Identify pre-existing conditions relevant to the role
The assessment may identify pre-existing conditions that could affect the candidate's ability to perform specific job tasks. These are assessed against the specific demands of the role, not as a blanket exclusion. A candidate with a pre-existing back condition may be fully capable of performing an office role but may be at higher risk in a role requiring heavy manual handling.
Anti-discrimination note: Pre-employment medicals must comply with anti-discrimination legislation. Assessments must be job-relevant and assess the candidate's capacity to perform the inherent requirements of the specific role. Health information collected during the assessment must be handled in accordance with privacy legislation and cannot be used to discriminate against candidates on the basis of disability or health status unrelated to the role.
Types of Pre-Employment Medical Assessments
Not all pre-employment medicals are the same. The type and scope of the assessment should be matched to the risk profile and physical demands of the role. Here are the most common types of pre-employment medical assessments used across Australian workplaces.
Standard Medical
Includes medical history review, physical examination, and a basic functional screen. Suitable for office-based, administrative, and low-physical-demand roles where the primary concern is general fitness for work.
Functional Capacity Assessment
Physical demands testing matched to a job task analysis. The candidate performs simulated work tasks that replicate the demands of the role. Suitable for manual and physically demanding roles such as warehousing, manufacturing, and trades. Learn more about FCEs.
Drug and Alcohol Screening
Urine and/or saliva testing conducted in compliance with AS/NZS 4308. Commonly required for safety-critical roles in construction, mining, transport, and any workplace where impairment poses a risk to the candidate or others. Learn more about D&A testing.
Audiometric Testing
A baseline hearing assessment for workers in noise-exposed roles. In NSW, audiometric testing is mandatory for workers who frequently use hearing protection as part of their role. The baseline test allows future monitoring of hearing thresholds over time.
Spirometry
Measures baseline lung function for workers in roles involving exposure to dust, fumes, chemicals, or other respiratory hazards. The baseline spirometry result is used for future comparison to detect any work-related decline in lung function over the course of employment.
Full Pre-Employment Screening
A comprehensive assessment combining all of the above components. Suitable for high-risk roles in construction, mining, transport, and heavy industry where the physical demands and hazard exposure justify a thorough screening. View our pre-employment services.
How the Assessment Process Works
A well-run pre-employment medical process is straightforward for both the employer and the candidate. Here is what the process typically looks like from the employer's perspective.
Employer provides role requirements and physical demands
The employer provides the screening provider with the role requirements, including physical demands, hazard exposure, and any specific testing requirements. If a job task analysis is available, this forms the basis for the assessment criteria. If one does not exist, the provider can develop one based on a workplace visit and role observation.
Assessment is tailored to the specific role
The assessment is designed around the actual demands of the role, not a generic medical template. A warehouse picker has different physical demands to a truck driver or a construction labourer, and the screening criteria should reflect that. This role-specific approach produces more accurate and defensible results.
Candidate is assessed on-site or at a suitable location
The assessment can be conducted on-site at the employer's workplace, at the candidate's location, or at any suitable facility. On-site delivery across Sydney means there is no need to send candidates to a clinic, reducing downtime and simplifying the logistics for employers managing multiple candidates.
Report delivered within 24-48 hours
The employer receives a detailed report with a clear fitness-for-duty recommendation: fit, fit with restrictions, or unfit for the specific role. The report includes the clinical findings supporting the recommendation. Same-day turnaround is available for urgent requirements.
Understanding the Results
Pre-employment medical results are not a simple pass or fail. The outcome is a fitness-for-duty assessment that evaluates the candidate's capacity against the specific demands of the role they are being hired for. Understanding what each outcome means helps employers make informed hiring decisions.
Fit
The candidate can safely perform all the physical demands of the role without restriction. No modifications are required, and the candidate is cleared to commence work in the position they were assessed for.
Fit with Restrictions
The candidate can perform the role with specific modifications or limitations. The report will detail the restrictions and any recommended workplace adjustments. The employer then decides whether the role can accommodate those restrictions. For example, a candidate may be cleared for the role but with a temporary lifting restriction following a recent injury.
Unfit
The candidate cannot safely perform the physical demands of the role at the time of the assessment. This does not mean the candidate is unfit for all work - it means they are unable to meet the specific requirements of the role they were assessed for. The report will outline the clinical basis for the determination.
Employers receive a summary report containing the fitness-for-duty recommendation and the key clinical findings that support it. Detailed clinical information remains confidential between the clinician and the candidate, in accordance with privacy requirements. The results are assessed against the specific demands of the role, not the candidate's general health. A candidate deemed unfit for a physically demanding construction role may be fully fit for an administrative position.
Frequently Asked Questions
How long does a pre-employment medical take?
A standard pre-employment medical typically takes 30-45 minutes. If the assessment includes drug and alcohol testing, functional capacity testing, or additional screenings like audiometry or spirometry, it may take up to 60-90 minutes.
Can a candidate fail a pre-employment medical?
A pre-employment medical does not produce a pass or fail result. The outcome is a fitness-for-duty assessment: fit, fit with restrictions, or unfit for the specific role. The assessment evaluates whether the candidate can safely perform the physical demands of the role they are being hired for.
Who pays for a pre-employment medical in Australia?
In most cases, the employer pays for the pre-employment medical. There is no legal requirement specifying who must pay, but it is standard practice for the employer or hiring agency to cover the cost as part of the recruitment process.
Key Benefits for Employers
- Reduce workplace injury risk
- Meet WHS duty of care obligations
- Lower workers compensation costs
- Establish baseline health records
- Role-specific fitness assessment
- On-site delivery across Sydney
- Reports within 24-48 hours
- AHPRA registered physiotherapist
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Content reviewed by Jovi Villanueva, AHPRA Registered Physiotherapist, SIRA Approved Provider, Principal Physiotherapist at Wellworx Workplace Solutions.
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