Psychiatric Fitness for Duty Evaluations
A psychiatric fitness for duty evaluation (FFDE) is an independent assessment of whether a mental health or substance use condition affects a person's ability to do their job safely. Dr. Sanya Virani performs independent FFDEs for physicians and other health professionals, physician health programs, licensing boards, hospitals and employers of safety-sensitive staff.
Who requests a fitness for duty evaluation
- Physician health programs (PHPs) and professional assistance programs
- State medical, nursing and pharmacy boards
- Hospitals and medical staff offices after a concern or incident
- Employers of pilots, first responders and other safety-sensitive workers
- The professional and their attorney seeking an independent second opinion
Dr. Virani has served as an evaluator of health professionals for HAVEN, Connecticut's physician health program. Its medical director wrote that independent evaluations of physicians require "commitment and thoroughness."
What is evaluated
- Psychiatric diagnosis, if any, and its current severity
- Alcohol and drug use, including risk of relapse
- Insight, judgment and engagement in treatment
- Specific job functions the person can or cannot perform safely
- Recommendations: return to work, return with conditions, treatment, monitoring or further assessment
The process
- Referral and questions. The referring party states the specific questions to be answered.
- Records review. Employment, incident, medical and treatment records.
- Interview. Usually 3 to 6 hours over one or two sessions, in person or by secure video.
- Testing. Psychological testing, toxicology and collateral interviews as indicated.
- Report. A written report that answers the referral questions directly.
Why an addiction specialist matters
Most fitness for duty referrals of health professionals involve alcohol, opioids or other substances. Dr. Virani is board-certified in both addiction psychiatry and forensic psychiatry, so a single evaluator can address diagnosis, relapse risk and workplace safety.
Possible outcomes
- Fit for duty with no restrictions
- Fit with conditions, such as treatment, toxicology monitoring, a workplace monitor or limited hours
- Temporarily unfit, with a treatment plan and a timeline for re-evaluation
- Unfit, with the reasons stated clearly
Preparing for the evaluation
Bring a photo ID, a list of current medications and the names of treating clinicians. Expect questions about work history, the events that led to the referral, mental health and substance use history, and current supports. Honest, complete answers lead to the most accurate and often the most favorable recommendations. The limits of confidentiality are explained in writing before any interview begins.
About Dr. Virani
Dr. Sanya Virani, MD, MPH, FAPA, is triple board-certified by the American Board of Psychiatry and Neurology in general psychiatry, forensic psychiatry and addiction psychiatry. She completed her forensic psychiatry fellowship at the Warren Alpert Medical School of Brown University and her addiction psychiatry fellowship at Yale School of Medicine, and is Assistant Professor of Clinical Psychiatry at Indiana University School of Medicine. Full credentials.
Frequently asked questions
What is a fitness for duty evaluation for physicians?
It is an independent psychiatric assessment of whether a physician's mental health or substance use affects their ability to practice safely, usually requested by a physician health program, licensing board or hospital.
How long does a psychiatric fitness for duty evaluation take?
The interview usually takes 3 to 6 hours over one or two sessions. Including records review and testing, a written report is typically ready within a few weeks.
Is the evaluation confidential?
No. Unlike treatment, a fitness for duty evaluation is done for a third party, and the findings go to the referring organization. The limits of confidentiality are explained in writing before the evaluation begins.
Can I request my own independent evaluation?
Yes. Professionals and their attorneys can retain Dr. Virani for an independent second opinion.
Do you evaluate nurses, pharmacists and other professionals?
Yes. Evaluations are available for physicians, nurses, pharmacists, dentists, other health professionals and safety-sensitive employees.
Request an evaluation
Attorneys, courts, employers and licensing boards can call (463) 282-7235, email sv@forensicsandaddiction.com, or book a free 15-minute intro call. Expert witness time is billed at $475 per hour. Evaluations are available in person in Indianapolis and Lakewood, WA, and by secure video where the jurisdiction allows.