Medical information

Employers, employees, trade unions, and doctors all play a role in gathering reasonable medical information in disability, injury, or illness situations.

What is medical information?

Medical information is information from a doctor about the state of a person’s health. In the workplace, employees may need to provide medical information from their own doctor about whether they are fit to work or require accommodation at work.

Employers may request medical information to:

  • confirm an employee's absence for medical reasons
  • decide whether an employee is fit to return to work after a medical absence
  • understand an employee's restrictions and limitations relating to their job duties
  • explore reasonable accommodation for an employee with a disability
  • decide whether they can accommodate an employee’s disability

Pre-employment medical evaluations

An employer can ask for a pre-employment medical evaluation only if there are no other reasonable ways to assess the candidate’s ability to do the job. The employer can also only require testing after making a conditional job offer. The testing should be limited to only providing information about the candidate’s ability to do the job, not their health generally.

For example, a psychological exam may screen out candidates with a mental disability. This testing is only acceptable if the employer can show a mental disability would prevent the candidate from performing key job duties. This might be reasonable for those working in high-stress situations such as paramedics or 911 operators.

The employer cannot refuse to hire a candidate because of a disability unless the disability would prevent the candidate from doing the job or where the employer cannot accommodate the condition because of a bona fide occupational requirement (BFOR). Candidates should provide employers with enough information about their accommodation needs based on a protected ground to allow employers to assess ways to accommodate them. Employers must also protect the privacy of all testing information and accommodation requests.

Absence for medical reasons

When an employee is absent from work for medical reasons, an employer may ask for medical information that:

  • confirms the employee’s absence is for medical reasons
  • gives an approximate return to work or reassessment date
  • only relates to the operation of the workplace and the employee’s job duties
  • is relevant to the period of absence

Employers do not have a right to full disclosure of employees’ medical situations. Some disability-related absences may not require any medical documentation. For example, short, infrequent absences will likely only require minimal medical information. Employers are not entitled to an employee’s diagnosis except in very limited circumstances.

Return to work and accommodation at work

Employers have a duty to accommodate an employee’s request for accommodation to the point of undue hardship. For more information, read the Duty to accommodate at work page. When an employee returns to work after a medical absence, the employer may ask the employee’s doctor to confirm in writing that:

  • the employee is fit to return to work, and
  • what, if any, accommodation is needed.

Employees who make an accommodation request must make the employer aware of their need for accommodation. The employee must provide enough information or documentation for their employer to understand their accommodation needs. For example, the employee may need to provide information such as:

  • whether the illness or injury is permanent or temporary
  • what restrictions and limitations they have
  • whether their treatment or medication will affect their ability to perform job duties
  • expected length of disability and absence (prognosis for recovery)
  • their fitness to return to work
  • their fitness to perform specific parts of the pre-injury job
  • their ability to perform modified work
  • likely duration of any physical or mental restrictions or limitations following their return to work

For physical and mental disabilities, employees often must provide documentation from medical professionals. However, they do not need to disclose their specific diagnosis or treatment to their employer.

The employee, the employer, and trade union (if there is one) all must cooperate in the accommodation process. An employee cannot refuse a reasonable solution just because they prefer a different kind of accommodation.

Limits with medical information

While an employer can ask an employee for medical information when they are absent for medical reasons or require accommodation at work, there are certain things the employer does not have the right to do. For example, employers do not have the right to:

  • contact the employee’s doctor by phone
  • demand an opinion that says the employee is fit to work and will not require future accommodation
  • request medical information unrelated to their employment
  • release medical information to anyone other than staff who need it for a specific purpose
  • know the employee’s diagnosis, except in limited cases

FAQs

When disability is one of the reasons for workplace discipline or potential termination, the employer must consider the employee’s medical information or documents about their disability or absence. The employer cannot simply discipline or terminate an employee based on the employee’s absence record. Employers have a duty to accommodate employees with disabilities to the point of undue hardship. For more information, refer to the Duty to accommodate at work page.

An employee who feels they are being terminated or disciplined for a disability-related absence should provide the employer with medical information to support their claim. An employee with a mental health or addiction issue that is affecting their ability to work should get help from a doctor or addictions expert. They should also provide information about their disability to their employer as soon as possible.

An employee requesting accommodation has a right to privacy. The employer also has a right to, and a need for, information that can help determine appropriate accommodation. However, there are very limited circumstances where the employee may need to disclose their diagnosis and medical treatment to their employer.

Employees generally have a right to confidentiality with their medical information in the workplace. An employer should only share confidential medical information about an employee with those who need to know for specific purposes, such as arranging modified work.

If you have questions about privacy issues, refer to the Office of the Information and Privacy Commissioner.

Conflicting medical opinions are common, such as between a family doctor and a specialist, between two specialists, or between a Workers’ Compensation Board (WCB) doctor and an independent doctor. Usually, an employer will accept the opinion of an independent specialist who practices in the area of the employee’s disability over the opinion of a family doctor. If two specialists give conflicting information, it may be necessary to choose another specialist whom the employee and employer agree on to resolve the conflict.

In complex medical situations, employers may require more detailed medical information from their employees. Employees may look into:

  • getting further information from their family doctor or specialist in writing
  • choosing a specialist that the employee and employer agree on to do an independent medical examination (IME), where there is a difference of opinion between specialists and an IME is required

If an employee does not provide any or sufficient medical information, it does not mean a disability or medical condition does not exist.

Before asking for more medical information, employers should first decide if they can use information the employee has already provided to assess the situation. If not, the employer should:

  • ask the employee to get more information from a healthcare professional, such as a doctor, specialist, mental health professional, nurse practitioner, or physical or occupational health therapist
  • let the employee know in writing that they must provide further medical information, and indicate why the information is necessary
  • specifically identify the information they are requesting
  • remind the employee that they will only share information on a need-to-know basis
  • continue to be open about concerns the employee has about providing further medical information, and try to resolve the concerns with the employee

Employees may not willingly provide necessary medical information or be aware of how their disability is affecting their work. In these situations, it’s important for employers to take extra measures by:

  • meeting with the employee, if they are still working
  • respectfully requesting the information, and
  • explaining why the information is important.

When providing medical information for a medical absence, doctors should make sure the information only:

  • relates to the operation of the workplace and the employee’s job duties, and
  • relates to the period of absence.

There are very limited circumstances when a doctor needs to disclose a diagnosis.

Doctors should only provide information that is necessary to help employers make decisions about accommodating employees, providing disability leave, or confirming the employee’s absences for medical reasons. When providing medical information for return to work or workplace accommodation, doctors may provide information such as:

  • whether an employee’s illness or injury is permanent or temporary
  • what functional restrictions and limitations the employee has, and their duration
  • whether treatment or medication the employee is taking will affect the employee’s ability to perform job duties in a satisfactory and safe way