A staffing firm may withdraw an offer after medical questions on only 2 stated grounds.
Key takeaways for two grounds before a staffing firm withdraws an offer after medical questions
- Before you tell a worker that an assignment offer is being withdrawn because of medical answers, write down the specific reason on your decision note.
- The guidance requires that if a staffing firm or client wants to withdraw an offer from an applicant with a disability based on medical questions or examinations, it must show one of two specific grounds.
- You need to be able to state clearly that the applicant cannot perform the essential functions of the job, even with a reasonable accommodation, or that the applicant would pose a direct threat, which is defined as a significant risk of substantial harm U.S. Equal Employment Opportunity Commission.
- These are the only two stated grounds for withdrawal based on medical information after the offer stage.
A staffing firm may ask medical questions after the offer and may withdraw that offer on two stated grounds
After an offer has been made, a staffing firm or its client may ask any disability-related questions or require any medical examinations that it chooses, as long as it does so for all applicants for the same job according to U.S. Equal Employment Opportunity Commission. This post-offer window allows the firm to gather medical information that was not permitted during the pre-offer selection phase. The rule applies to contingent workers placed by temporary agencies and other staffing firms.
If the staffing firm or client wants to withdraw the offer from an applicant with a disability based on the answers to these questions or the results of medical examinations, it has to show that the applicant either: (1) cannot perform the essential functions of the job, even with a reasonable accommodation; or (2) would pose a direct threat (a significant risk of substantial harm) according to U.S. Equal Employment Opportunity Commission. The first ground focuses on the applicant’s ability to perform the core duties of the role, even after considering possible accommodations. The second ground focuses on the risk of substantial harm.
The firm must apply the same medical questions and examinations to all applicants for the same job. This consistency requirement ensures that the post-offer process is not used to target specific individuals. If a staffing firm or its client withdraws an offer from an applicant with a disability because of medical answers or exam results, it must show one of the two grounds.
When the offer happens for a staffing-firm worker
For a staffing firm, the moment that triggers the post-offer rules is not the initial interview or the selection from the roster. According to the U.S. Equal Employment Opportunity Commission, generally, the offer occurs when the worker receives an assignment with a specific client U.S. Equal Employment Opportunity Commission. This specific assignment is the event that shifts the legal context from pre-offer screening to post-offer medical inquiry. Until that assignment is made, the firm is operating under different constraints regarding what questions can be asked. The distinction matters because the ability to ask medical questions and the ability to withdraw an offer based on those answers depend on this specific trigger point.
The coverage of these rules is not universal for every staffing agency. The Guidance applies to private and to state and local government employers with fifteen or more employees, according to the U.S. Equal Employment Opportunity Commission U.S. Equal Employment Opportunity Commission. It does not apply to every employer or every firm regardless of size. If your firm has fewer than fifteen employees, this specific federal guidance does not define the coverage for your operations. You must look to other sources for rules that apply to smaller entities. Do not assume that the rules described here protect or constrain firms below this employee count.
What the firm or the client may ask after the offer
Title I of the Americans with Disabilities Act (ADA) limits an employer's ability to make disability-related inquiries or to require medical exams at three stages of employment: pre-job offer, post-job offer, and during employment, according to Job Accommodation Network. The pre-job offer stage carries a strict prohibition. The general rule states that employers cannot ask medical questions or require medical exams at this stage, according to Job Accommodation Network. This ban frames the timing for your staffing firm. You cannot probe an applicant’s health history during the interview or before extending the assignment offer. Once the offer is made, the rules shift.
At the post-offer, preemployment stage, medical questions and examinations do not have to be job related and consistent with business necessity, according to Job Accommodation Network. This distinction is critical for small staffing teams. You do not need to justify a specific medical question as directly tied to the physical demands of the assignment to ask it after the offer. However, the general rule imposes a uniformity requirement. Employers can ask any medical questions or require any medical exams they choose as long as all entering employees in the same job category are subjected to the same questions or exams, regardless of disability, according to Job Accommodation Network.
This uniformity rule is the operational core of your post-offer process. If you are placing a worker in a logistics coordinator role, every applicant receiving an offer for that specific job category must face the same medical inquiry form. You cannot tailor questions to one applicant based on perceived risk or disability status. The medical information obtained from these post-offer inquiries must be kept confidential, according to Job Accommodation Network. This confidentiality requirement applies to the data itself, not just the physical file.
The two grounds for withdrawing the offer
Before a staffing firm or its client withdraws an offer based on medical answers or examination results, the decision must rest on one of two specific grounds. According to the U.S. Equal Employment Opportunity Commission, if the firm or client wants to withdraw the offer from an applicant with a disability based on the answers to these questions or the results of medical examinations, it has to show that the applicant either: (1) cannot perform the essential functions of the job, even with a reasonable accommodation; or (2) would pose a direct threat (a significant risk of substantial harm) U.S. Equal Employment Opportunity Commission.
Ground 1: Inability to perform essential functions The first ground requires showing that the applicant cannot perform the essential functions of the job, even with a reasonable accommodation. This is not a general assessment of health or fitness. It is a specific determination about the core duties of the role. If the applicant can perform the essential functions with a reasonable accommodation, this ground does not apply. The firm or client must be able to demonstrate that the barrier remains even after accommodation is considered.
Ground 2: Direct threat The second ground is that the applicant would pose a direct threat, which the source defines as a significant risk of substantial harm. This is a high bar. It is not a minor inconvenience or a low-level risk. It requires a significant risk of substantial harm. The firm or client must be able to show that the medical condition creates this level of risk.
Contrast with the during-assignment rule These two grounds apply specifically to withdrawing an offer after medical questions or examinations. They are distinct from the rule that applies during the work assignment. During the work assignment, a staffing firm or its client generally may ask a staffing firm worker disability-related questions or require a medical examination only where it has a reasonable belief that a medical condition will make the worker unable to do the job or will result in a direct threat U.S. Equal Employment Opportunity Commission. This during-assignment rule is triggered by a reasonable belief, not by the two withdrawal grounds. Do not use the during-assignment belief rule as permission to ask questions before the offer. The pre-offer ban and the post-offer question rules are separate.
How the medical answers must be kept
Once the post-offer medical examination or inquiry is complete, the staffing firm must handle the resulting information with specific confidentiality protocols. According to Legal Information Institute, information obtained regarding the medical condition or history of the applicant shall be collected and maintained on separate forms and in separate medical files. This requirement applies to information obtained under paragraph (b). The firm must treat these records as a confidential medical record.
The separation of files is a distinct operational step from general personnel records. You cannot mix the medical answers into the worker’s standard hiring file or assignment notes. The rule specifies that the information shall be collected and maintained on separate forms. It further requires that this data be stored in separate medical files. This creates a distinct physical or digital boundary between the medical history and the rest of the applicant’s employment documentation.
The post-offer examination rule itself allows the firm to require this medical examination or inquiry after making an offer of employment and before the applicant begins employment duties. According to Legal Information Institute, a covered entity may condition an offer of employment on the results of such examination or inquiry. This permission is valid if all entering employees in the same job category are subjected to such an examination or inquiry regardless of disability. The firm must apply this process uniformly to the job category to maintain compliance with the rule.
Store the medical file separately from the personnel file. Ensure the forms used for the post-offer inquiry are distinct from standard application documents. Treat the resulting record as confidential. Do not mix these medical answers with the worker’s assignment history or performance notes.
Illustrative example of one withdrawal note
A staffing firm with 15 employees offers one worker one assignment with one client. After the offer, it asks the same medical questions of all applicants for that job and keeps the answers in a separate medical file. It withdraws the offer only after the note names 1 of the 2 grounds: the applicant cannot perform the essential functions even with a reasonable accommodation, or would pose a direct threat, meaning a significant risk of substantial harm.
Reference table of publisher rules on post-offer medical questions
Three publishers are quoted below on a post-offer medical rule.
| Publisher | Post-offer medical rule |
|---|---|
| Job Accommodation Network | Title I of the Americans with Disabilities Act (ADA) limits an employer's ability to make disability-related inquiries or to require medical exams at three stages of employment: pre-job offer, post-job offer, and during employment. |
| U.S. Equal Employment Opportunity Commission | After an offer has been made, a staffing firm or its client may ask any disability-related questions or require any medical examinations that it chooses, as long as it does so for all applicants for the same job. However, if the staffing firm or client wants to withdraw the offer from an applicant with a disability based on the answers to these questions or the results of medical examinations, it has to show that the applicant either: (1) cannot perform the essential functions of the job, even with a reasonable accommodation; or (2) would pose a direct threat (a significant risk of substantial harm). |
| Legal Information Institute | A covered entity may require a medical examination (and/or inquiry) after making an offer of employment to a job applicant and before the applicant begins his or her employment duties, and may condition an offer of employment on the results of such examination (and/or inquiry), if all entering employees in the same job category are subjected to such an examination (and/or inquiry) regardless of disability. |
According to Job Accommodation Network, the ADA limits disability-related inquiries at three specific stages, including post-job offer. The U.S. Equal Employment Opportunity Commission notes that its 1997 guidance addressed the liability of staffing firms and their clients for violations of federal employment discrimination laws, as stated in U.S. Equal Employment Opportunity Commission. The Legal Information Institute specifies that a covered entity may condition an offer on medical examination results if all entering employees in the same job category are subjected to the same examination, according to Legal Information Institute. Finally, ADA.gov states that Title I requires employers with 15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from employment-related opportunities, according to ADA.gov.
Today, name which of the 2 grounds supports the withdrawal and file the medical answers on a separate form.
FAQ on staffing-firm medical questions and withdrawn offers
When does a staffing-firm offer happen?
The offer generally occurs when the worker receives an assignment with a specific client, according to U.S. Equal Employment Opportunity Commission. This timing defines the point at which post-offer medical inquiries become permissible.
What medical questions are allowed after that offer?
A staffing firm or its client may ask any disability-related questions or require any medical examinations that it chooses, as long as it does so for all applicants for the same job, according to U.S. Equal Employment Opportunity Commission. These inquiries do not have to be job-related at this stage.
What two grounds does the page name for withdrawing the offer?
To withdraw an offer based on medical answers, the firm or client must show the applicant either cannot perform the essential functions of the job, even with a reasonable accommodation, or would pose a direct threat, according to U.S. Equal Employment Opportunity Commission. A direct threat is defined as a significant risk of substantial harm.
How must the medical file be kept?
Information regarding the medical condition or history of the applicant shall be collected and maintained on separate forms and in separate medical files and be treated as a confidential medical record, according to Legal Information Institute. This limit covers information obtained under paragraph (b).
What changes once the assignment has started?
During the assignment, a staffing firm or its client generally may ask disability-related questions or require a medical examination only with a reasonable belief that a medical condition will make the worker unable to do the job or will result in a direct threat.