What is a Fit for Work Assessment?
A Fit for Work Assessment is an evaluation ranging from daily self-declaration to comprehensive medical examination that determines whether a worker possesses the physical, mental, and cognitive capacity to perform their role safely. These assessments are critical risk management controls designed to prevent incidents that could harm workers, colleagues, or the public.
Why Fitness for Work Matters
The stakes are significant. In 2023, 200 workers died in Australian workplaces, with machinery operators and drivers accounting for 37% of these fatalities. Serious workers' compensation claims reached 139,000, with mental health conditions representing over 12% of cases and requiring recovery times five times longer than physical injuries.
Fitness for work assessments are not bureaucratic hurdles—they are the fundamental checkpoint ensuring workforce safety. An unfit worker behind the controls poses unacceptable risks to themselves, their team, and operations. No production target justifies this risk.
Legal Framework
Fit for work requirements sit at the intersection of multiple legal frameworks that create both obligations and protections.
WHS Act Duties
Section 19 places a primary duty on PCBUs to ensure worker health and safety so far as reasonably practicable. This includes monitoring worker health and providing safe systems of work. If a PCBU suspects unfitness and fails to act, they face liability if an incident occurs.
Section 28 establishes worker duties to take reasonable care for their own safety and cooperate with reasonable policies. This creates an obligation to disclose conditions affecting safety—such as medications causing drowsiness in machinery operators.
Fair Work Act Provisions
Employers can direct workers to attend medical assessments only when there are objective grounds for concern about capacity to perform duties safely. Valid triggers include prolonged absence, conflicting medical certificates, or observed behavioural changes in safety-critical roles.
The landmark case Grant v BHP Coal confirmed that where safety is concerned, an employer's right to verify fitness overrides privacy concerns, provided the direction is lawful and reasonable.
WorkSafeKit enables automated fit-for-work declarations with geo-verified check-ins and supervisor alerts for high-risk workers.
Factors Affecting Fitness
Multiple factors can impair a worker's capacity to perform safely. Research shows that being awake for 17 hours produces impairment equivalent to a blood alcohol concentration of 0.05%.
| Factor | Impact on Safety |
|---|---|
| Fatigue | Degraded reaction time, reduced vigilance, impaired decision-making. Shift workers face chronic sleep debt from circadian disruption. |
| Substances | Alcohol, illicit drugs, and prescription medications (opioids, benzodiazepines, antihistamines) can impair coordination and cognition. |
| Medical conditions | Acute illness, chronic disease, cardiovascular issues, or musculoskeletal injuries limit physical capacity. |
| Mental health | Depression and anxiety impair executive function—the ability to plan, focus, and multitask in safety-critical roles. |
| Environmental | Heat stress, dehydration, cold exposure compromise physiological performance. |
Assessment Types
Different operational phases require different assessment approaches. The spectrum ranges from low-level daily checks to forensic medical investigations.
| Assessment Type | When Used | Provider |
|---|---|---|
| Self-declaration | Start of every shift | Worker confirms fitness via app or form |
| Supervisor assessment | Daily visual checks | Trained supervisor observes for impairment signs |
| Functional screening | Pre-employment, periodic | Allied health professionals test physical capacity |
| Medical assessment | Pre-employment, return to work | GP or occupational health physician |
| Independent Medical Examination (IME) | Complex disputes, long-term prognosis | Specialist Occupational and Environmental Physician |
Drug and Alcohol Testing
Substance testing is a controversial but necessary component of fitness programs. Two main methodologies exist under Australian standards.
Urine testing (AS/NZS 4308) detects use over days or weeks, making it useful for lifestyle screening. However, it can identify weekend use no longer causing impairment, raising privacy concerns.
Oral fluid testing (AS/NZS 4760) has a shorter detection window of hours, correlating better with acute impairment. It's less invasive and focuses on recent use rather than private behaviour.
All non-negative results must be sent to NATA-accredited laboratories for confirmation using gas or liquid chromatography-mass spectrometry. A Medical Review Officer (MRO) should review positive results to determine if legitimate medical explanations exist, protecting workers from false accusations.
Testing types include random (deterrent), for-cause (triggered by observed behaviour), and post-incident (ruling out impairment as a causal factor). Programs must be documented, consistently applied, and compliant with privacy laws.
Shared Responsibilities
Employer Obligations
PCBUs must establish clear fitness policies developed through consultation with workers. Supervisors require training in recognising impairment signs and conducting supportive fitness conversations. Organisations must provide safe disclosure processes, maintain health information confidentiality, and facilitate return-to-work programs.
Worker Duties
Workers must present fit for duty and honestly self-assess their capacity. This includes disclosing conditions or medications affecting safety—not necessarily the specific diagnosis, but functional side effects like drowsiness. Workers should report vague concerns; feeling "off" is enough to warrant caution in high-risk environments.
Track fit-for-work declarations, manage fatigue risks, and support workers in reporting concerns before incidents occur.
Managing Disclosure
Best practice policies encourage non-punitive self-reporting. A worker admitting "I'm too tired to drive" should receive support—alternate duties or rest breaks—not discipline. This builds a safety culture where disclosure is rewarded rather than penalised.
When workers disclose fitness concerns, supervisors should thank them for the responsible behaviour, assess whether they can safely perform their role, consider modifications, document decisions, and plan return to normal duties. The goal is safe inclusion, not exclusion.
Frequently Asked Questions
Can I be stood down for being unfit for work?
Yes. If an employer has reasonable belief you cannot perform duties safely, they have a duty of care to remove you from the hazard. This is a safety control, not punishment. If the stand-down is precautionary and you're willing to work, you generally remain on full pay. If medically confirmed unfit, you typically move to sick leave.
Do I have to disclose my medications?
Yes, if they affect safety. You don't need to disclose the specific condition (e.g., "I have anxiety"), but must disclose functional side effects (e.g., "I'm taking medication that may cause drowsiness"). Failure to disclose sedating medication while operating machinery is a serious breach that can lead to termination.
What if I don't feel right but can't pinpoint why?
Trust your instincts and report it. Fatigue, viral onset, or mental distress often present as a general feeling of being "off." In high-risk industries, this is enough to cause an accident. Report to your supervisor—good employers appreciate proactive safety behaviour and may assign low-risk duties or allow leave.
Can I refuse to see the company doctor?
You can refuse, but it may risk your employment. If the employer has lawful and reasonable grounds (safety concerns, long absence), they can direct you to attend. Refusing a lawful and reasonable direction is serious misconduct. The Fair Work Commission consistently upholds dismissals where safety drives the requirement, as established in Grant v BHP Coal.
Who pays for the assessment?
The employer covers all costs if they initiate the request for an Independent Medical Examination or for-cause drug test. You should generally be paid for time spent attending if it occurs during normal working hours.
What's the difference between a GP medical and occupational health assessment?
GPs focus on diagnosis and treatment, acting as your advocate. Occupational physicians focus on functional capacity and the match between your health and job requirements. They provide independent expert opinions on what work you can safely perform, including restrictions like "no lifting over 5kg" or "sedentary work only."
References
- Work Health and Safety Act 2011 (Cth)
- Fair Work Act 2009 (Cth)
- Safe Work Australia – Model Work Health and Safety Regulations
- WorkSafe Victoria – Fitness for Work Guidelines
- Austroads – Assessing Fitness to Drive for Commercial and Private Vehicle Drivers
- Standards Australia – AS/NZS 4308:2008 (Urine testing), AS/NZS 4760:2019 (Oral fluid testing)
- Grant v BHP Coal Pty Ltd [2014] FCAFC 69