Pre-Employment Medicals: A Lifesaving Control, Not a Paperwork Exercise

Jul 28

3 min read

In workplace safety, it’s often said that “you don’t know the value of a control until it fails.” Few things make that truth clearer than a workplace fatality—especially one that could have been prevented.

Last year, while acting in my capacity as a WHS investigator, I was called to assist with the investigation of a fatal truck crash in Western Queensland. A seasoned truck driver had lost control of his vehicle and died almost instantly. The route was familiar to him. The road was straight. The vehicle was one he had driven many times before. But this time, something went catastrophically wrong.

Three weeks into the investigation—working alongside WHS Queensland and Queensland Police—post-mortem findings confirmed the cause: a seizure occurred while the worker was behind the wheel. There was no time to react. A slight bend in the road became fatal.

This was not simply a tragic accident. It was a failure of a critical risk control: the pre-employment medical.

When I reviewed the worker’s pre-employment paperwork, something immediately stood out. He had declared a history of epilepsy and seizures. That’s not unusual in itself—but what happened next was inexcusable.

Despite that disclosure, the medical provider conducting the pre-employment assessment declared the worker “fit to drive heavy vehicles,” without any referral to a neurologist or further investigation. The practitioner was not a neurologist and had no documented consultation with one.

To be clear, the employer did nothing wrong. They relied in good faith on the outcome of a professional medical assessment conducted by a third-party provider. They had a worker with the right skills, experience, and history of safe driving—and they had a piece of paper from a doctor stating he was medically fit for the role.

But that medical provider failed to follow well-established procedures. According to Assessing Fitness to Drive (Austroads, 2022), any individual with a history of epilepsy must be assessed by a neurologist before being cleared to drive commercially. That requirement was ignored.

Why does this matter?

Because pre-employment medicals are only as strong as the process behind them. When a provider cuts corners or ignores risk triggers, the consequences aren’t theoretical—they are fatal.

This incident should be a wake-up call to every employer who uses third-party medicals:

Do not assume that every provider follows proper protocols. Ask specific questions: Was a specialist review required? Was it done? What evidence supports the clearance?
Ensure your pre-employment medicals are job-specific. A generic “fit/unfit” determination is meaningless without reference to the actual demands of the role—especially in high-risk work like heavy vehicle operation.
Retain documentation. If a regulator or coroner comes knocking, your ability to demonstrate diligence—not just in hiring, but in verifying your providers—will be critical.
Don’t ignore red flags. If a worker discloses a condition like epilepsy, diabetes, or cardiac disease, don’t rely solely on a general practitioner’s clearance. Verify that proper referral pathways have been followed.

In this case, a company acted in good faith and lost a worker. The provider they trusted failed to act with the same care. It’s a painful reminder that pre-employment medicals are not mere paperwork—they are a life-and-death risk control.

It’s not just about protecting workers. It’s about protecting the businesses that employ them—from tragedy, from liability, and from the devastating fallout of someone else’s negligence.