Civil service medical check: high blood pressure, asthma
How high blood pressure or asthma is assessed for UK public-sector and US federal jobs, when medical checks happen and what to bring.
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If you have high blood pressure or asthma and you are going for a UK public-sector or US federal role, the medical check is mostly about your course. It is not about your diagnosis label. You bring a dated record of readings and treatment, on paper or in the blood pressure diary in Sam. Sam sums the period up as a doctor report PDF. This text is general information, not legal advice.
In the UK, get individual advice from ACAS, Citizens Advice, the Equality Advisory Support Service, your union or an employment lawyer. The Equality Act 2010 applies in England, Scotland and Wales; Northern Ireland has separate disability law, so ask the Equality Commission for Northern Ireland or the Labour Relations Agency there. In the US, the Job Accommodation Network (JAN), the EEOC and the employing agency are the right points for your case.
Does a chronic condition stop you from public-sector work?
No, a condition alone does not rule you out. In the UK, the Equality Act 2010 makes it unlawful to exclude you automatically because of a disability or medical condition. In US federal service, the rules are explicit: you may not be disqualified for a position solely on the basis of medical history.
What matters is whether you can do the role, with or without reasonable adjustment, without risk to yourself or others. That reading is individual, not statistical. A diagnosis of high blood pressure or asthma does not, by itself, decide anything.
When does the medical check happen?
The timing is protected in both countries. In the UK, the Equality Act largely bans health questions during early recruitment, before a job offer. The few exceptions include making reasonable adjustments for an assessment, checking an intrinsic job function, and national security vetting.
In the US, ADA rules reach federal agencies through the Rehabilitation Act. They stop an agency from asking disability-related questions or requiring medical exams before a job offer. After a conditional offer, an agency may require an exam if it requires it of everyone entering the same job category. So the health check usually follows success at the assessment stage, not the application.
Who decides, and by what standard?
In the UK, the recruiting body commissions an occupational health adviser. The adviser gives a fitness-for-role opinion. The employer must avoid direct discrimination, so it cannot reject you just because of the condition.
For competitive-service jobs in US federal service, the employing agency acts under 5 CFR Part 339. It applies medical standards only where the duties are arduous or hazardous, or for roles with high public responsibility or national security. Standards must be written, applied evenly and linked to the actual duties. A routine pre-employment exam is only appropriate for positions with such standards, and it follows a tentative offer.
How is high blood pressure assessed?
A doctor reads your course. That means home readings with dates, your current treatment, how blood pressure sits alongside it, and whether it stays stable. The guide on living with high blood pressure covers what daily data shows, and record your readings and bring the overview is the natural next read.
Your treating clinician is the one who describes your trend. Bring a record: dates, values and medication. In Sam you enter readings and take the report as a PDF to the conversation. The symptom diary holds anything between appointments.
What about security-cleared and reserved roles?
Security vetting is not the same as medical fitness. In the UK, the Baseline Personnel Security Standard checks identity, right to work, employment history and unspent convictions, and the higher clearance levels add further background checks. They are not medical fitness checks, though the Equality Act allows health questions for national security vetting. Cases are weighed individually, and a condition is not an automatic bar.
In the US, suitability and national security standards sit apart from workplace medical fitness. OPM regulates suitability under 5 CFR Part 731, and medical qualification runs under Part 339. The two do not collapse into one test.
What can you do if the decision goes against you?
Ask what the reasons are, and act before deadlines. In the UK you can ask the recruiting body for its reasons and whether it will review the assessment. A union or an Equality Act adviser can explain the decision and the options, including a claim of disability discrimination.
In US federal service, 5 CFR Part 339 gives applicants without veterans' preference a right to a higher-level review of a medical disqualification within the agency. For a preference-eligible veteran, OPM must approve the agency's reasons. JAN advises on reasonable accommodation. A federal applicant who believes an agency discriminated must usually contact an agency EEO counselor within 45 days, and the EEOC oversees that complaint process. Start with the people who know the specific scheme. The guide on telling your employer about a chronic condition helps with the decisions around disclosure.
What do you bring to the assessment?
Bring a record that a clinician can read quickly. For high blood pressure that is a dated log of readings and your treatment over the last months. For asthma, it is your control over the last four weeks and the year behind it. A doctor visit checklist for a chronic condition helps you gather the right paperwork, and reasonable adjustments at work explains what to ask for in the UK or US once you are in.
Your record supports the assessment. It does not replace a medical opinion, and it never justifies answering a health questionnaire dishonestly. Fill every form fully and truthfully. If a question is unclear, ask before you answer.
Bring a dated blood pressure record to your appointment
You walk in with your course in numbers instead of a story you rebuilt from memory, and that is what the assessment relies on.
- Instead of paper slips: readings go into the blood pressure diary with a date, and readings already in Apple Health sit in the same app, a few taps away.
- Instead of screenshots: the doctor report sums the period you choose as a PDF, from one month up to the whole record, so your clinician sees the trend at a glance.
- Instead of memory: anything between appointments goes into the symptom diary, so it does not depend on memory.
The report is a memory aid for the conversation, not a certificate for an agency, and Sam does not measure blood pressure for you.
Try Sam HealthSam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.
General information, not legal advice. Laws, deadlines and agency practice change, and your case may differ. Before applications, deadlines and conversations with employers, insurers or agencies, get advice from an adviser or lawyer.
Related reading
- Must you tell your employer about a chronic illness?
- Reasonable adjustments at work for a chronic illness
- Doctor visit checklist for a chronic condition
- Record your blood pressure at home and bring the overview
Sources
Updated: October 2026
- GOV.UK: Equality Act 2010: ban on pre-employment health and disability questions (quick start guide)
- GOV.UK: Equality Act 2010 guidance (England, Scotland and Wales; Northern Ireland guidance linked)
- GOV.UK: National security vetting: clearance levels (BPSS, SC, DV)
- ACAS: Reasonable adjustments at work
- eCFR: 5 CFR Part 339, Medical Qualification Determinations (ss 339.103, 339.202, 339.204, 339.206, 339.301, 339.306)
- EEOC: Pre-Employment Inquiries and Disability and Enforcement Guidance: Preemployment Disability-Related Questions and Medical Examinations and Overview of the federal sector EEO complaint process
- OPM: Suitability and Fitness and eCFR: 5 CFR Part 731, Suitability and Fitness
More on High Blood Pressure
Frequently Asked Questions
Can a chronic condition stop me from getting a public-sector job?+
Usually not on its own. In the UK the Equality Act 2010 stops employers from screening you out on a condition or disability alone, and in the US federal rules say you must not be disqualified solely on medical history. The decision turns on whether you can do the role safely, now and for a reasonable time ahead.
When is a medical check allowed in the recruitment process?+
In both countries the health check generally comes after a conditional job offer, not at application. In the UK, under the Equality Act you usually cannot be asked health questions before a job is offered. In the US, ADA rules, which reach federal agencies through the Rehabilitation Act, allow a medical exam after an offer if everyone entering the same job category gets it, and the results stay confidential.
Who decides if a condition is a problem, and by what standard?+
In the UK the recruiting body and an occupational health adviser assess fitness for the specific role. In the US the employing agency applies any job-related medical standard, with OPM oversight in federal service. The standard must link to the actual duties, not to a diagnosis in general.
How is high blood pressure assessed?+
Doctors look at your own record: dated home readings, your medication and how your blood pressure has behaved over recent months. A well-documented, well-controlled course is the point. There is no single threshold, so your clinician reads your numbers against the role.
What about security-cleared or reserved roles?+
Security vetting is separate from medical fitness, and a health condition alone is not a bar. In the UK, the Baseline Personnel Security Standard and higher clearances check identity and background, not medical fitness, and each case is looked at individually. In the US, suitability and national security standards are separate from workplace medical fitness.
What can I do if I am turned down on medical grounds?+
In the UK you can ask the recruiting body for its reasons and a review, and get help from a union or an Equality Act adviser such as ACAS or the Equality Advisory Support Service. In the US, applicants without veterans' preference have a right to a higher-level agency review of a medical disqualification, and JAN and the EEOC advise on disability rights. Get advice before any deadline.