Employers referring employees for fitness for duty examinations outside of job-related reasons may now be on the hook for higher damages. Remedies for inappropriate referrals to medical examinations, such as fitness for duty, now include back pay awards regardless of disability status. Under a new ruling by the 7th Circuit, non-disabled employees who are sent for medical evaluations for non-job related reasons or reasons that are not consistent with business necessity are still eligible for back pay.

In the case of Nawara v. Cook Couty et al., 132 F.4th 1031 (7th Circ. 2025), the employer placed Nawara on leave following a series of altercations with other employees and asked for a fitness for duty evaluation before he could return to work. As part of the fitness for duty evaluation, they requested that Nawara sign two medical information releases. Nawara alleged the examination requirement and inquiry into his mental health was a violation of the Americans with Disabilities Act (“ADA”) under a section that prohibits medical examinations that are not job-related or consistent with business necessity. 42 U.S. Code § 12112.

The jury found in favor of Nawara but awarded no back pay. Upon the employee’s post-trial motion for backpay, pension benefits, and restoration of seniority, the trial court granted the restoration of seniority but denied back pay and pension benefits. Upon appeal, the 7^th Circuit reversed the decision on backpay, stating that the jury’s finding of the ADA violation constituted discrimination, thus entitling Nawara to back pay.

This is an important reminder for employers to take care when referring employees to fitness for duty evaluations. The requirement must be job-related and consistent with business necessity, regardless of the employee’s disability status.

For more information about this article, please contact Tressler attorney Katie Ngo at kngo@tresslerllp.com.

About the Author

Katie is senior counsel in Tressler’s Local Government Practice Group. She concentrates her practice in all aspects of school law. She works directly with superintendents and administrators to ensure compliance with the Illinois School Code, the Individuals with Disabilities in Education Act (IDEA), the Open Meetings Act (OMA), the Illinois Freedom of Information Act (FOIA) and various other state and federal laws and regulations. Click here to read Katie’s full attorney bio.