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Fitness for Duty Evaluations

I offer the following FFDE's

• Military active duty with psychological symptoms before discharge

• Military applicants  with existing psychological (mental) conditions

• Security Clearance initial and reviews

• First responders, including police, firefighters, and EMT's

• Border Patrol applicants with existing mental health conditions

• Security Guard, Level 3 candidates and other weapon's-carrying positions

Frequently Asked Questions About Fitness for Duty Evaluations

Why would I need a Fitness for Duty Evaluation (FFDE)?

Some jobs require the use of weapons, sensitive duties, alertness and mental stability. Jobs such as active duty service, national guard, border patrol, security guard level 3, police, firefighters, oil rigs positions, nuclear power plant and heavy equipment operators - to name a few - have these requirements.

Employers request fitness for duty evaluations to ensure their personnel are ready to perform on day one and throughout a career. The goal of the FFDE is to determine whether an employee is suffering from a psychological or mental condition listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM V-TR) and whether that condition is affecting their ability to perform their job.

What if I have a psychiatric/mental health diagnosis? Will I be disqualified from work I'm already doing?

Not necessarily. Many individuals live with psychiatric conditions and function fine on the job and at home. 


What if I'm taking a medicine for a psychiatric or psychological condition?

I am a prescribing psychologist so my knowledge of psychiatric medications has made the difference when an employer has questions about the impact of  medicines on duty performance.  There are many circumstances for which medicines are used and many classes of medications which have little to no impact on work or duty performance. In fact, there are times when medicines will help an individual increase their performance and stability. However, some medications can be hazardous, and compromise work safety.

What should I expect during an FFDE or Return to Work evaluation?

While every evaluation is tailored to the individual, there are certain things that are always included in a Fitness for Duty or Return to Work Evaluation. 

First, information will be gathered to review the employee's history:

• employee work history

• medical and psychiatric history

• relevant collateral information from employee's supervisor, spouse or other relevant historians.

Next, a clinical interview is conducted. Questions are asked about the employee's understanding of the problem, symptoms they may be experiencing or have experienced in the past, family medical and psychiatric history, past and present substance use including alcohol, caffeine, and nicotine. social, educational, legal, developmental, academic, and work performance are all explored during the clinical interview.

After the clinical interview, there is psychological testing which can include:

• Personality Assessment

• Cognitive and Intellectual Functioning Assessment

• Measures of motivation

• Diagnostic Screening tools


Are the things I say during the FFDE kept confidential?

No. In an FFDE, you are NOT the patient. You should not and must not expect the confidentiality you would normally receive from a psychologist. In this case, your employer is the client. They are most likely the one who is paying for the exam and they are entitled to the findings of your evaluation in the form of a report.  It's hard to accept seeing a health care professional and knowing that they are not there to help you through your problem. They may offer some suggestions to your employer that can help you, but that is an added benefit and not the intent of the FFDE and RTW psychological evaluation. 

What types of questions might an employer ask as part of a FFDE or Return to Work (RTW) Evaluation?

Sometimes an employer has a question about how to work with an employee who is suffering from psychological distress. The employee may be undergoing divorce or a significant life change. Some will use alcohol or drugs to medicate a mental health condition such as depression or anxiety. All or any of these factors can have a significant impact on the employee's ability to perform his or her job. I have helped employers sift through complicated questions about employee safety and how to  help them get back to work. Sometimes employees need temporary modifications to hours, duties or enhanced supervision in order to perform their job safely and effectively.

Can you give examples of why an employee might be referred for an FFDE or RTW evaluation?

Examples of some referral questions are


• Why is this employee having repeated conflicts with coworkers?

• What can be done about inappropriate, angry behavior and is this employee dangerous?

• This employee has made suicidal comments, is he at risk for self harm?

• There have been complaints of domestic violence and a restraining order, is this employee likely to hurt co-workers?

• This employee shows paranoia about coworkers and supervisors, are we safe with him at work?

• A supervisor has heard this employee describe hallucinations, is he reliable? Dependable?

Border Patrol Candidates

Since arriving in New Mexico, Dr. Foster's services have been increasingly requested for Border Patrol candidates, mostly applicants who have served in the military and who have a potentially mentally disqualifying condition. When a Border Patrol applicant has a Pre-existing mental or psychological condition, they will be asked to undergo a psychological evaluation as a pre-condition for employment.

The links below offer some more information about requirements and your rights when applying to the Border Patrol:

What is the legal authority for the request for my medical information?

Where can I find the medical standards for the job series to which I am applying?

Does the Americans with Disabilities Act of 1990 (ADA) prohibit CBP from requesting my medical information?

Does the Health Insurance Portability and Accountability Act of 1996 (HIPPA) prohibit CBP from requesting my medical information?

Does the law prohibit CBP from requesting my medical information if I am a veteran?

Will my medical records and information be held private and confidential?

Finally, some Do's and Don'ts for the FFDE or RTW Psychological Evaluation

• Do be honest

• Do think about why you're being referred and how to make the best of it.

• Don't take your anger or fear out on the evaluator

• Don't feel intimidated

If you are an employer, make sure you:

1. Have a company policy that authorizes you to request a Fitness for Duty, Preemployment application or Return to Work Psychological Evaluation.

2. Gather documentation including supervisor and collateral information pertaining to the problem.  

3. Download the FFDE form and fill out as much information as possible.

If you are an employee:

1. Contact Dr. Elaine Foster at 575-652-3654 for guidance with your specific situation.

2. Initial guidance is free.

3. You will receive instructions regarding the documentation that will be needed to perform your evaluation and the cost for the evaluation.

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