Fitness-for-Duty Evaluations After Threats of Self-Harm: What the Direct-Threat Standard Asks

Stephan M. Carlson, MD, MBA, FAPA · Employment and Fitness

When an employee voices an intent to harm themselves, an employer's instinct is to remove them from the job. But a lawful fitness-for-duty determination cannot rest on the statement alone. The forensic question is narrower than the alarm it answers: does a current psychiatric condition create a present, accommodation-resistant safety risk in this specific role? The standard that governs a self-harm exclusion A fitness-for-duty referral after a self-harm threat sits inside the Americans with Disabilities Act, not outside it. Two provisions matter most. An employer may require a current employee to undergo a medical examination only when the inquiry is job-related and consistent with business

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