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Medical Eligibility Requirements

Attachment 1

Back to OPM Adjudication of Psychiatric/Psychological Objections

Title 5, United States Code, Sections 3312 and 3318, and 5 CFR 339, Medical Qualifications Determinations, requires that OPM approve any disqualification, non-selection, or pass over of a veterans’ preference eligible applicant for medical reasons before the position is filled. Generally, OPM’s “right of review” is limited to competitive service positions.

It should be noted that OPM regulations governing the use of medical examinations (5 CFR 339) severely restricts the use of psychiatric/psychological assessments as a means of determining medical qualifications for Federal employment. A psychiatric/psychological assessment is permissible only when it is specifically required as part of an OPM approved medical standard; or when a medical doctor or clinical psychologist otherwise authorized to conduct a medical examination believes a psychiatric assessment is indicated and/or warranted. Furthermore, all psychiatric/psychological objections to preference eligibles must be based on a clinical diagnosis made by an appropriately licensed and credentialed doctor level mental health professional. The clinical diagnosis may or may not be supported by the results of a test(s) of psychological functioning.

As stated earlier, OPM receives numerous medical objections and pass over requests regarding preference eligibles based on the results of various psychological and other assessment types. In fact, there are numerous Federal agencies that are considering or have implemented non-medical psychological test(s) or Job Compatibility Assessments (JCA’s) that are designed and used to measure personality and behavioral and other counterproductive behaviors that are incompatible with a position’s essential requirements. These types of test(s) are typically used in the stages of a selection process that come before a tentative offer of employment and can be developed without OPM approval.

Job compatibility measures are less costly to implement than other procedures typically used to detect counterproductive behaviors (e.g., interviews, polygraphs) and are beneficial for safety sensitive/critical positions and positions requiring employees to interact frequently with others or handle sensitive information or valuable materials.

There is, however, considerable confusion regarding the appropriateness of using JCA’s or other types of non-medical psychological test(s) that typically stems from whether or not such assessments are considered a medical examination under the Americans with Disabilities Act (ADA) and the Equal Employment Opportunity Commission (EEOC).

As a general rule, the decision as to whether or not a psychological test(s) constitutes a medical examination should be based largely on the kind of information the test is capable of providing. If a qualified professional can use the test(s) to draw conclusions or formulate a diagnostic impression about the presence or absence of a mental disability, the test(s) should be considered a medical examination. The involvement of a mental health professional, by itself, would not mean that any test(s) administered or reviewed by this individual are “medical”. Non-medical JCA often are based on information provided by the applicant in response to personal history questionnaires, situational judgment tests, or structured interviews focused on behavior relevant to the position requirements.

If the results of a test of psychological functioning do not provide clinical evidence that would lead to the diagnosis of a mental disorder or impairment, then they are not considered medical in nature and are not a basis for a medical disqualification. For example, psychological test(s) or JCA that are only designed and used to measure traits, such as honesty, integrity, temperament, bias, interests, attitudes or similar personal qualities, are considered non-medical and should not be submitted to the OPM Recruitment, Examining and Assessment Group (REAG) for a medical determination.

The EEOC, in its March 1997 Enforcement Guidance on the ADA and Psychiatric Disabilities, states “traits and behaviors are not, in themselves, mental impairments, although they may be linked to mental impairments.” These traits include, but are not limited to, irritability, anger management issues, chronic tardiness, poor judgment, integrity, teamwork and prejudice. The EEOC Enforcement Guidance: Preemployment Disability-Related Inquiries and Medical Examinations Under the ADA of 1990, issued October 1995, is an additional recommended resource.

It should be noted that mental health factors are considered under the ADA as ‘medical’ in nature and referred to in this guidance under the term ‘psychiatric’ to emphasize the medical nature of the factor, regardless of the discipline of the diagnosing/treating practitioner or reviewing evaluator.

Agency objections to preference eligibles that are based solely on the results of psychological screening test(s) or JCA without a clinical diagnosis will not be sustained and will not be processed as a medical objection. Any medical objection submitted to OPM that is based on mental health reasons must be consistent with the diagnostic criteria as outlined in the Diagnostic and Statistical Manual of Mental Disorders –Fourth Edition (Text Revision) DSM-IV-TR, published by the American Psychiatric Association.

Agency objections to preference eligibles based on evaluations of job-related competencies (e.g., knowledge, skills or abilities) or other non-medical measures (e.g., a job compatibility, psychological, or personality assessment, specifically designed for use with normal adult populations) should be submitted to OPM’s Division for Human Capital Leadership, as a qualification objection, not a medical objection.

Another important factor to note is that Federal agencies are prohibited from conducting medical examinations and disability-related inquiries prior to a conditional offer of employment. Medical examinations and disability-related inquiries can be conducted during the “post-offer” period, as long as all applicants for a specific job category are subject to the same examinations and/or inquiries.