Fitness for Duty Evaluation After Self-Harm Threats

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

Short answer: a fitness for duty evaluation after a threat of self-harm asks whether a current psychiatric condition impairs essential job functions or meets the direct threat standard. The statement alone does not answer the employment question. 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-

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