Article Figures & Data
Tables
Type of Question State Question Consistent with the Americans with Disabilities Act? None Connecticut None Y Hawaii Y Michigan Y New York Y Pennsylvania Y Rhode Island Y West Virginia Y Current fitness Arizona Have you received treatment within the last five years for use of alcohol or a controlled substance, prescription-only drug, or dangerous drug or narcotic or a physical, mental, emotional, or nervous disorder or condition that currently affects your ability to exercise the judgment and skills of a medical professional? Y Delaware Do you have a mental or physical disability that limits your ability to practice medicine in a fully competent and professional manner with safety to patients? Y Illinois Have you had or do you now have any disease or condition that interferes with your ability to perform the essential functions of your profession, including any disease or condition generally regarded as chronic by the medical community, i.e., (1) mental or emotional disease or condition; (2) alcohol or other substance abuse; (3) physical disease or condition, that presently interferes with your ability to practice your profession? Y Iowa Do you currently have a medical condition which in any way impairs or limits your ability to practice medicine with reasonable skill and safety? Y Massachusetts Do you have a medical or physical condition that currently impairs your ability to practice medicine? Y Nevada Do you currently have a medical condition which in any way impairs or limits your ability to practice medicine with reasonable skill and safety? Y New Jersey Do you have a medical condition which in any way impairs or limits your ability to practice medicine with reasonable skill and safety? Y Ohio In the past five years, have you been diagnosed as having, or been hospitalized for, a medical condition which in any way impairs or limits your ability to practice medicine with reasonable skill and safety? Y Tennessee Do you currently have a medical condition which in any way impairs or limits your ability to practice medicine with reasonable skill and safety? Y Washington Do you have a medical condition which in any way impairs or limits your ability to practice your profession with reasonable skill and safety? Y Wisconsin Do you have a medical condition which in any way impairs or limits your ability to practice medicine with reasonable skill and safety? Y Hypothetical impairment Alabama Do you currently have any mental or physical condition or impairment (including, but not limited to, substance abuse, alcohol abuse, or mental, emotional, or nervous disorder or condition) which in any way currently affects, or if untreated could affect, your ability to practice in a competent and professional manner? N Arkansas Do you currently have or have you ever had any physical or mental health condition, including alcohol or drug dependency, which, with or without accommodation, affects or is reasonably likely to affect your ability to practice medicine or to perform professional or medical staff duties appropriately? N California Have you ever been diagnosed with an emotional, mental, or behavioral disorder that may impair your ability to practice medicine safely? N Colorado In the last five years, have you been diagnosed with or treated for a condition that significantly disturbs your cognition, behavior, or motor function, and that may impair your ability to practice as a physician safely and competently including but not limited to bipolar disorder, severe major depression, schizophrenia or other major psychotic disorder, a neurological illness, or sleep disorder? N District of Columbia Do you have a medical condition or have you become aware of any medical condition that currently impairs or limits your ability to practice medicine safely or that could affect your performance or impact your ability to practice your profession? Are you currently being treated, or within the past five years have you been treated, for a physical or mental condition that, but for the treatment, could impair your ability to practice your profession? N Idaho Have you had any current or past mental or physical condition or any current or previous physical or mental illness which may impact your ability to practice medicine with reasonable skill and safety? N Indiana Do you have any condition or impairment (including a history of alcohol or substance abuse) that currently interferes, or if left untreated may interfere, with your ability to practice medicine in a competent and professional manner? N Kansas Do you presently have any physical or mental problems or disabilities which could affect your ability to competently practice your particular branch of the healing arts or your particular specialty? N Kentucky Do you currently, or have you had within the past five years, any physical, mental, or emotional condition which impaired, or might reasonably impair, your ability to practice your health care profession safely and competently? N Louisiana In the five years prior to this application have you had any physical injury or disease or mental illness or impairment which could reasonably be expected to affect your ability to practice medicine or other health profession? N Maryland Do you have any physical or mental condition that currently impairs your ability to practice medicine or that would cause reasonable questions to be raised about your physical, mental, or professional competency? N Minnesota Have you within the past five years been advised by your treating physician that you have a mental, physical, or emotional condition, which, if untreated, would be likely to impair your ability to practice medicine with reasonable skill and safety? N Montana Have you any physical or mental condition(s) which may have or has adversely affected your ability to practice this profession, including but not limited to a contagious or infectious disease involving risk to the public? N New Hampshire Have you ever had any physical, emotional, or mental illness which has impaired or would be likely to impair your ability to practice medicine? N New Mexico In the five years prior to this application, have you had any physical injury or disease, or mental illness or impairment, which you are currently under treatment for or could reasonably be expected to affect your ongoing ability to practice medicine safely and competently? N North Carolina In the past five years, have you had, or have you been told you had, a mental health or physical condition (not referenced above) which in any way limits or impairs or, if untreated, could limit or impair your ability to practice medicine in a competent or professional manner? N Oklahoma Do you currently have or have you had within the past two years any mental or physical disorder or condition which, if untreated, could affect your ability to practice competently? N South Carolina Are you currently being treated for any physical, mental or emotional condition that might interfere with your ability to competently and safely perform the essential functions of practice as a physician? Do you currently have any mental illness (e.g. bipolar disorder, schizophrenia, paranoia or any other psychotic disorder) or any physical illness or condition that might interfere with your ability to competently and safely perform the essential functions of practice? N South Dakota Do you have a physical, mental, or emotional condition which may adversely affect your practice? N Vermont Do you have a medical condition that in any way impairs or potentially impairs or limits your ability to practice medicine in your field of practice with reasonable skill and safety? N Virginia Do you have a physical disease, mental disorder, or any condition, which could affect your performance of professional duties? N Wyoming Do you have any medical condition which, in any way, impairs or limits, or might impair or limit, your ability to safely and skillfully practice medicine? N Past impairment Alaska Has your ability to practice medicine in a competent and safe manner ever been impaired or limited by any condition, behavior, impairment, or limitation of a physical, mental, or emotional nature? Since completing your postgraduate training, have you ever been physically or mentally unable to practice medicine for a period of 60 days or longer? Have you ever been diagnosed with, treated for, or do you currently have: bipolar disorder, depressive neurosis, kleptomania, hypomania, any dissociative disorder, pyromania, schizophrenia, any psychotic disorder, delirium, depression, any organic mental disorder, paranoia, seasonal affective, or any condition requiring chronic medical or behavioral treatment? N Florida During the last five years, have you been treated for or had a recurrence of a diagnosed mental disorder that has impaired your ability to practice medicine within the past five years? N Georgia During the last seven years, have you suffered from any physical, psychiatric, or substance use disorder that could impair or require limitations on your functioning as a professional or has resulted in the inability to practice medicine for more than 30 days, or required court-ordered treatment or hospitalization? N Maine Do you have a mental or physical condition that currently impairs your ability to safely and competently practice medicine? Within the last five years have you been diagnosed with or treated for any medical or mental health disorder that impaired your behavior, judgment, understanding, or ability to function in school, work or other important life activities? N Mississippi Have you ever been diagnosed as having, or have you ever been treated for, pedophilia, exhibitionism or voyeurism, bipolar disorder, sexual disorder, schizophrenia, paranoia or other psychiatric disorder? N Missouri Have you in the last ten years or since the age of 18 been treated for or hospitalized for bipolar disorder, schizophrenia, paranoia or any other psychotic disorder? N Montana Have you ever been diagnosed with a physical condition or mental health disorder involving potential health risk to the public? N Nebraska Do you currently, or have you ever had, any physical, mental, or emotional condition which impaired, or does impair your ability to practice your health care profession safely and competently? N New Hampshire Have you ever had any physical, emotional, or mental illness which has impaired or would be likely to impair your ability to practice medicine? N North Dakota Within the past five years have you had or have you been admitted to any hospital or other inpatient care facility for any physical, mental, or emotional condition which impaired or does impair your ability to practice medicine safely and competently? N Oregon Do you currently have, or have you had within the past five years, any physical, mental, or emotional condition which impaired or does impair your ability to practice your health care profession safely and competently? Within the past five years, have you been admitted to any hospital or other treatment facility for any physical, mental, or emotional condition or substance use disorder which impaired or does impair your ability to practice your health care profession safely and competently? N South Dakota Have you been treated for or do you have a diagnosis for any mental health condition? N Texas Within the past five years, have you been diagnosed with or treated for any psychotic disorder, delusional disorder, mood disorder, major depression, personality disorder, or any other mental condition which impaired or does impair your behavior, judgment, or ability to function in school or work? N Utah Have you ever been declared by any court to be incompetent by reason of mental defect or disease and not restored? N Wyoming Within the past five years have you been hospitalized for, missed work because of, or been significantly impaired by any mental or emotional condition? N Hospitalization, commitment, incompetence determination Alaska Have you ever been voluntarily or involuntarily committed or confined to any facility for mental health care? Have you ever been adjudicated, or declared incompetent, or been the subject of an incompetency proceeding? N Florida In the last five years, have you been admitted or referred to a hospital, facility or impaired practitioner program for treatment of a diagnosed mental disorder or impairment? N Georgia During the last seven years, have you suffered from any physical, psychiatric, or substance use disorder that could impair or require limitations on your functioning as a professional or has resulted in the inability to practice medicine for more than 30 days, or required court-ordered treatment or hospitalization? N Kentucky Within the past five years, have you been admitted to any hospital or other in-patient care facility for any physical, mental or emotional condition, which impaired, or might reasonably be considered to impair, your ability to practice your health care profession safely and competently? N Missouri Have you in the last ten years or since the age of 18 been treated for or hospitalized for bipolar disorder, schizophrenia, paranoia or any other psychotic disorder? N North Dakota Within the past five years have you had or have you been admitted to any hospital or other inpatient care facility for any physical, mental, or emotional condition which impaired or does impair your ability to practice medicine safely and competently? N Oregon Within the past five years, have you been admitted to any hospital or other treatment facility for any physical, mental, or emotional condition or substance use disorder which impaired or does impair your ability to practice your health care profession safely and competently? N Utah Have you ever been declared by any court to be incompetent by reason of mental defect or disease and not restored? N Wyoming Within the past five years have you been hospitalized for, missed work because of, or been significantly impaired by any mental or emotional condition? N Diagnosis Alabama Within the past two years, have you been diagnosed with or have you been treated for bipolar disorder, schizophrenia, paranoia, or any other psychotic disorder? N Alaska Have you ever been diagnosed with, treated for, or do you currently have: bipolar disorder, depressive neurosis, kleptomania, hypomania, any dissociative disorder, pyromania, schizophrenia, any psychotic disorder, delirium, depression, any organic mental disorder, paranoia, seasonal affective, any condition requiring chronic medical or behavioral treatment? N Colorado In the last five years, have you been diagnosed with or treated for a condition that significantly disturbs your cognition, behavior, or motor function, and that may impair your ability to practice as a physician safely and competently, including but not limited to bipolar disorder, severe major depression, schizophrenia or other major psychotic disorder, a neurological illness, or sleep disorder? N Mississippi Have you ever been diagnosed as having, or have you ever been treated for, pedophilia, exhibitionism or voyeurism, bipolar disorder, sexual disorder, schizophrenia, paranoia or other psychiatric disorder? N Missouri Have you in the last ten years or since the age of 18 been treated for or hospitalized for bipolar disorder, schizophrenia, paranoia or any other psychotic disorder? N Montana Have you ever been diagnosed with a physical condition or mental health disorder involving potential health risk to the public? N South Carolina Do you currently have any mental illness (e.g., bipolar disorder, schizophrenia, paranoia or any other psychotic disorder) or any physical illness or condition that might interfere with your ability to competently and safely perform the essential functions of practice? N South Dakota Have you been treated for or do you have a diagnosis for any mental health condition? N Texas Within the past five years, have you been diagnosed with or treated for any psychotic disorder, delusional disorder, mood disorder, major depression, personality disorder, or any other mental condition which impaired or does impair your behavior, judgment, or ability to function in school or work? N Notes: States that have more than one question about mental illness may appear in more than one of the categories of questions. Only the relevant question is listed for each type of question.