Can You Be Required to Pay for an MRI to Get a Job?

No, according to a recent federal court. BNSF Railway required Russell Holt to pay for an MRI on his back. Holt had been offered a job but suffered two ruptured discs in his back five years before. He rehabilitated successfully.

Under the Americans with Disabilities Act (ADA), employers may lawfully require people who are offered a job to take a pre-placement medical exam. They can withdraw or modify the offer for “business necessity.”

Holt’s physician told BNSF that Holt had no recurring back issues for five years. Not good enough, said BNSF. He needs to pass an MRI. Holt was told he’d have to pay for it. He was in bankruptcy and could not afford it.

Also, Holt’s physician would not approve the MRI— there was no medical necessity for the test.

BNSF rescinded its offer.

In a recent court ruling, the Ninth Circuit Courts of Appeals ruled that BNSF violated the ADA by requiring Holt and others in his position to pay for their MRIs. The court said:

Where, however, an employer requests an MRI at the applicant’s cost only from persons with a perceived or actual impairment or disability, the employer is imposing an additional financial burden on a person with a disability because of that person’s disability. In the case of an expensive test like an MRI, making an applicant bear the cost will effectively preclude many applicants, which is at odds with the ADA’s aim to increase opportunities for persons with disabilities.

In short, requiring an applicant to pay for follow-up testing is distinct from merely requiring an additional exam for a person with a disability if an additional exam is necessary to complete the medical examination contemplated in § 12112(d)(3). But it is not at all necessary that a person with an impairment pay for an exam for a thorough exam to be completed. To construe the statute otherwise would be to constrain and limit the general protections of the ADA beyond the necessary implications of the medical testing provision.

Further, elsewhere the ADA puts the financial burden on employers. The ADA requires employers to pay for reasonable accommodations unless it is an undue hardship—it does not require employees to procure reasonable accommodations at their own expense. 42 U.S.C. § 12112(a), (b)(5)(A); see also 29 C.F.R. § 1630.2(o)(4).10