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Topic: ESTABLISHING MEDICAL STANDARDS Date Issued: April 18, 1991

Section: CLASSIFICATION Date Revised:

Number: III.6.

PURPOSE:

To define the job analysis methodology used by the County in establishing

the medical standards for job classes in the classification plan.

CROSS REFERENCE:

Section VI.1. Physical Job Requirements/Physical Screening and Examination

LEGAL BASIS:

County Code Section 4.15.020 - Appointments, require that all persons se-

lected for employment with the County have a physical examination or

screening by the time of employment, except for elected officials. Pursu-

ant to Board policy, extra-help appointments are subject to this provision.

Government Code Section 1031 requires that peace officers must be given

physical and mental examinations prior to employment. (Peace Officers

Standards and Training - POST standards also require that information from

the background investigation regarding the candidate's medical condition be

provided to the physician performing the pre-employment examination.) As

of this date, peace officers for the County are: Deputy Sheriff Trainee;

Deputy Sheriff; Sheriff's Sergeant; Sheriff's Lieutenant; Sheriff's Chief

Deputy; District Attorney (DA) Inspector I and II; Chief DA Inspector;

Deputy Probation Officer I, II and III; Probation Division Director; Chief

Probation Officer; Welfare Fraud Investigator I and II; and Chief Welfare

Fraud Investigator.

POST further requires that, when a peace officer moves to a different de-

partment (e.g. a Deputy Sheriff promotes to DA Inspector I), a medical

examination be given for the appointment in the new department.

Department of Fair Employment and Housing (DFEH) regulations require that a

pre-employment medical examination may only be given following an offer of

employment. DFEH guidelines on selection interviews permit the employer to

tell candidates that any offer of employment is contingent upon the candi-

date passing the physical examination. These guidelines also permit an

employer to ask if the candidate has any physical condition or handicap

which may limit the ability to perform the job applied for, for purposes of

determining what might be done to accommodate the candidate's limita-

III.6.

Page 2 of 27 ESTABLISHING MEDICAL STANDARDS

tion(s). These guidelines PROHIBIT questions regarding the candidate's

general medical condition, state of health or illness, or questions regard-

ing receipt of workers' compensation, or questions such as "Do you have any

physical disabilities or handicaps?"

Government Code Section 12940 makes it an unlawful employment practice

(unless based upon a bona fide occupational qualification or except where

based upon applicable security regulations established by the United States

or State of California) to refuse to employ or hire a person based on phys-

ical handicap or medical condition. This statute also provides that an

employer is not prohibited from refusing to hire or dismissing a physically

handicapped person or because of a medical condition, when the person with

the condition cannot perform the duties in a manner that would not endanger

his/her health or safety, the health or safety of others, or where the

employee is unable to perform his/her duties. (Additional requirements

regarding disabled candidates will apply based upon the American's with

Disabilities Act of 1990). Also see federal Vocational Rehabilitation Act

of 1973, Sections 501, 503 and 504.

Government Code Section 855.6 provides that pre-employment medical exams

are not for the purposes of diagnosis or treatment, and excludes a public

entity (and the employee administering the exam in the scope of his/her

employment) from any liability regarding failure to give the exam or to

make an adequate examination.

REFERENCE:

San Bernardino County Medical Standards Methodology

POLICY:

I. Basis for Job Analysis

To help assure that the pre-employment medical examination adminis-

tered by the County Occupational Health physician evaluates the candi-

date's ability to perform the tasks of the job without endangering the

candidate or others, the County uses a validated method of job analy-

sis to establish the medical standards of the job class and create a

profile of the demands of the job for the class.

II. Job Analysis to Establish Medical Standards

Personnel Services Division staff determine specific physical ability

requirements and working conditions of job classes using the San Ber-

nardino County Medical Standards methodology where the following Phys-

ical Abilities and Working Conditions are evaluated. For job classes

having physical abilities or working conditions requirements, a Medi-

cal Standards Profile is developed for the class to provide the Occu-

pational Health physician with a profile of the class for the two

categories.

III.6.

ESTABLISHING MEDICAL STANDARDS Page 3 of 27

Individual positions in broad classes MAY be identified for a pre-

employment medical examination when the particular position has physi-

cal demands, even though the class may not require a medical examina-

tion. For example, if a department has a Clerk II position that re-

quires incumbents to lift and carry 60 pound boxes, they should attach

a note to the Personnel action form for appointment of the candidate,

requesting a medical examination and identifying the specific physical

requirements or working conditions of the position. The request will

be reviewed by Personnel Services Division staff and, if appropriate,

the candidate will be scheduled for the applicable medical examination

in conjunction with HSA staff.

A. Physical Abilities

1. Static Strength

2. Explosive Strength

3. Dynamic Strength

4. Trunk Strength

5. Stamina

6. Effort

7. Extent Flexibility

8. Dynamic Flexibility

9. Mobility

10. Speed of Limb Movement

11. Gross Body Coordination

12. Gross Body Equilibrium

13. Arm-Hand Steadiness

14. Manual Dexterity

15. Finger Dexterity

16. Near Vision

17. Far Vision

18. Visual Color Discrimination

19. Hearing-Quiet

20. Hearing-Noisy

21. Hearing-Location

22. Hearing-Discriminate

B. Working Conditions

1. Inside

2. Outside

3. High Elevations

4. Low Temperature

5. High Temperature

6. Cramped Body Positions

7. Sudden Temperature Changes

8. High Humidity

9. Low Humidity

10. Wetness

11. Air Pressure

12. Noise

III.6.

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B. Working Conditions (continued)

13. Vibrations

14. Oily

15. Odors

16. Body Injuries

17. Burns

18. Electrical Hazards

19. Explosives

20. Slippery Surfaces

21. Ionizing Radiation

22. Non-Ionizing Radiation

23. Dust

24. Silica Dust

25. Toxic Conditions

26. Infections

27. Moving Objects

28. Chemical Irritant

29. Allergenic

30. Working With Others

31. Responsibility

32. Job Complexity

33. Role Ambiguity

34. Irregular Work Hours

PROCEDURE:

I. Analysts review the job class and using the class specification, work

with incumbents and supervisors (subject matter experts - SME's) de-

termines the tasks of the class that require physical abilities to

perform for each of the areas above.

II. The incumbent(s), supervisor(s) and analyst complete a Medical Stan-

dards Questionnaire (Attachment A - Sample) that rates the tasks of

the physical ability to a anchored scale. Also included in the ques-

tionnaire is a rating of the working conditions that apply and a bio-

graphical data sheet of the rater to establish the background and

relationship to the job class.

III. Ratings of participants are tabulated to create a profile specific to

the job class (Attachment B) that is forwarded to the Occupational

Health physician for use in the pre-employment medical examination.

IV. The Occupational Health physician and Personnel representatives review

the profile and determine the appropriate method of evaluating the

physical ability requirements of the job (See Section VI.1. Physical

Job Requirements/Physical Screening and Examination).

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