Aipedia: Occupational health providers

AI pre-placement health questionnaires

Aipedia, by the Apex broking team · Last reviewed 2026-10-27

AI can help score pre-placement health questionnaires, but it should not issue fitness verdicts on its own and must not screen out disabled applicants. Employers rely on OH clearance to confirm a job offer, so a flawed score can lead to discrimination claims.

Part of: AI in occupational health providers

In short

Pre-placement questionnaires are usually completed after a conditional job offer, because section 60 of the Equality Act 2010 restricts health questions before an offer except in limited cases. AI tools score answers and flag who needs a clinician. A solely automated fitness verdict using health data is a significant decision under UK GDPR Articles 22A to 22D, requiring explicit consent or a contract or legal requirement plus Article 9(2)(g), and safeguards including human review. If an employer withdraws an offer on an AI verdict, the OH provider may face questions about its advice.

How AI scores questionnaires

Pre-placement screening can be high volume and low risk. OH providers use online questionnaires that score answers on conditions, medication and functional limits, then sort applicants into "fit", "fit with adjustments" or "needs assessment". Newer tools may use AI to read free text answers and suggest adjustments. Some employers may want an immediate result so the start date is not delayed, which creates pressure to let the tool decide.

The OH provider is usually acting for the employer, but it still owes professional duties to the applicant. GMC guidance on dual obligations (paras 4 and 5) applies to occupational physicians in this position. The applicant may never speak to a clinician, so the questionnaire design, the scoring rules and the wording of the outcome sent to the employer carry the whole weight of the provider's advice.

The duties that apply

Equality Act: section 60 of the Equality Act 2010 says an employer must not ask about an applicant's health before offering work, subject to exceptions such as establishing whether the applicant can carry out a function intrinsic to the work. Acting on the answer in a discriminatory way can be unlawful.
Reasonable adjustments: section 20 sets the duty to make reasonable adjustments, which applies to assessments and the job itself.
Automated decisions: UK GDPR Articles 22A to 22D govern significant decisions based solely on automated processing of special category data. Article 22C safeguards include information, representations, human intervention and the right to contest.
Professional standards: GMC para 115 requires the applicant to understand the purpose and consequences and limits disclosure to relevant information; para 7 requires a balanced opinion.

What can go wrong

Illustrative scenario: an applicant for an office role declares epilepsy, well controlled for years. The scoring tool rates the answer as high risk and issues "unfit pending assessment". The employer treats this as a fail and withdraws the offer before any clinician has reviewed it. The applicant brings a disability discrimination claim against the employer, which argues it relied on the OH provider's outcome, and the provider's process comes under scrutiny.

Other risks include tools that treat a declared condition as a fitness issue regardless of the role, adjustment suggestions that are generic, and outcomes sent to the employer with more health detail than they need. Applicants may also not realise their answers are scored by software.

How PI usually responds

If an employer or applicant alleges that the OH provider's screening advice was negligent, OH professional indemnity usually responds subject to its terms. Discrimination claims are typically brought against the employer, and the provider's exposure may be a contribution claim or a complaint. Policies may restrict cover for fines and for data protection claims, and one medical defence organisation's published position excludes autonomous systems. The OH company should be insured as an entity, as well as its clinicians. See does OH indemnity cover AI mistakes and algorithmic decisions and PI.

Practical controls

Use the tool to sort, not to decide: have a clinician review any outcome other than a clear "fit".
Score answers against the actual role requirements, not general risk.
Tell applicants how answers are processed and how to request human review.
Send employers a fitness outcome and adjustments, not health details.
Tell employers in writing that a provisional outcome is not a final decision.
Monitor outcomes for patterns that suggest disability bias.

How Apex helps

Apex arranges professional indemnity for OH providers that run pre-placement screening. A broker reviews how your cover treats automated scoring and contribution claims from employer clients; see OH professional indemnity.

Sources

Frequently asked

Can an AI tool decide an applicant is unfit?

Not on its own where the decision is significant. UK GDPR Articles 22A to 22D require explicit consent, or a contract or legal requirement plus Article 9(2)(g), and safeguards including human intervention. In practice a clinician should review any outcome other than a clear pass.

When can employers ask health questions?

Section 60 of the Equality Act 2010 says employers must not ask about health before offering work, except in limited cases such as checking whether the applicant can perform a function intrinsic to the work. Pre-placement questionnaires should therefore normally be used after a conditional offer.

Is the OH provider liable if the employer withdraws an offer?

The discrimination claim is usually against the employer, but the employer may look to the OH provider if it relied on flawed advice. OH professional indemnity usually responds to negligent advice claims, subject to its terms.

Should applicants be told their answers are scored by software?

Yes. GMC para 115(a) requires the person to understand the scope, purpose and likely consequences, and UK GDPR Article 22C safeguards include information about automated decisions and a way to make representations and contest them. Tell applicants how to ask for a clinician review.

Check your indemnity covers how you use AI

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Apex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information about how AI is used in the profession and how insurance may respond. It is not legal, regulatory or insurance advice on your circumstances, and it does not guarantee that cover will be available or on what terms.