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Employers are permitted to require medical exams after a job offer has been made but before the candidate begins work. This practice is primarily governed by the Americans with Disabilities Act (ADA), which stipulates that medical examinations must be conducted after a conditional job offer to ensure compliance with non-discriminatory practices. Conducting these exams post-offer allows employers to ascertain an individual's medical ability to perform job-related tasks without the risk of bias based on a candidate's health status during the selection process.

The rationale behind this approach is to ensure that hiring decisions are made based on qualifications and capabilities relevant to the job rather than on any pre-existing medical conditions, which could lead to discrimination. By waiting until after the offer, employers protect themselves from potential legal issues while still maintaining the ability to assess whether the candidate can fulfill the necessary job functions safely and effectively.