1. Any physical examination administered pursuant to NRS 617.455 or 617.457 must include: (a) A thorough test of the functioning of the hearing of the employee; and (b) A purified protein derivative skin test to screen for exposure to tuberculosis. 2. Except as otherwise provided in subsection 8 of NRS 617.457 , the tests required by this section must be paid for by the employer. 3. Except as otherwise provided by the provisions governing privacy in the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as amended, and applicable regulations, or an employees collective bargaining agreement, whichever is more restrictive: (a) The results of a physical examination administered pursuant to NRS 617.455 or 617.457 may only be provided to: (1) The examining physician; (2) The employee; (3) The employers officer who is responsible for risk management or human resources or his or her designee; and (4) If the employee has filed a claim pursuant to NRS 617.455 or 617.457 , the insurer. (b) A person who receives the results of a physical examination pursuant to paragraph (a) may only use the results for the purposes of: (1) Complying with the requirements of NRS 617.455 or 617.457 , as applicable; or (2) Creating a report pursuant to paragraph (c). (c) The employers officer who is responsible for risk management or human resources or his or her designee may create and release a report that is based on the results of a physical examination administered pursuant to NRS 617.455 or 617.457 to any person whom the employers officer determines has a need to know the information in the report. The report must only contain the following information: (1) The name of the employee who was the subject of the physical examination; and (2) A statement that the employee, as applicable: (I) Satisfies the physical qualifications required for his or her employment; or (II) Does not satisfy the physical qualifications required for his or her employment. NRS 617.454 Physical examinations and cancer screenings: Required tests; restrictions on use and dissemination of results of physical examination or cancer screening. [Effective July 1, 2026.] 1. Any physical examination administered pursuant to NRS 617.455 or 617.457 for an employee in the Executive Department of the State Government must include: (a) A thorough test of the functioning of the hearing of the employee; and (b) A purified protein derivative skin test to screen for exposure to tuberculosis. 2. Any physical examination administered pursuant to NRS 617.455 or 617.457 for an employee who is not an employee in the Executive Department of the State Government and any cancer screening administered pursuant to NRS 617.453 must be administered, when possible, by: (a) A physician licensed pursuant to chapter 630 or 633 of NRS; or (b) An advanced practice registered nurse licensed pursuant to NRS 632.237 , who is knowledgeable about the physical demands of fire fighting and law enforcement. 3. Any physical examination administered pursuant to NRS 617.455 or 617.457 for an employee who is not an employee in the Executive Department of the State Government must include: (a) A thorough test of the functioning of the hearing of the employee, which must consist of: (1) An air conduction test; or (2) A pure-tone test that is performed: (I) In a soundproof booth approved by the American National Standards Institute; (II) Using frequencies ranging from 500 hertz to 8000 hertz; and (III) Separately on each ear; (b) A purified protein derivative skin test or tuberculin blood test to screen for exposure to tuberculosis; (c) A physical examination, which must consist of: (1) An examination of the vital signs of the employee, including, without limitation, the height, weight, blood pressure, temperature, heart rate and respiratory rate of the employee; (2) An examination of the head, eyes, ears, nose and throat of the employee; (3) An examination of the neck of the employee; (4) A cardiovascular examination using the methods of inspection, auscultation, percussion and palpation; (5) A pulmonary examination using the methods of inspection, auscultation, percussion and palpation; (6) A gastrointestinal examination using the methods of inspection, auscultation, percussion and palpation; (7) A genitourinary examination; (8) An examination of the cervical, auxiliary and inguinal lymph nodes of the employee; (9) A neurological examination evaluating the general mental status of the employee; (10) A cranial nerve examination; (11) A peripheral nerve examination that tests for sensation, motor function and reflexes; (12) A musculoskeletal examination that tests the range of motion for all joints; and (13) An examination of the skin of the employee for color, vascularity, lesions and edema; (d) An analysis of the blood of the employee, which must include, without limitation: (1) A white blood cell count; (2) A blood differential test; (3) A red blood cell count; (4) A platelet count; (5) An aspartate aminotransferase test; (6) An alanine aminotransferase test; (7) A lactate dehydrogenase test; (8) An alkaline phosphatase test; (9) A bilirubin test; (10) An albumin test; (11) A blood glucose test; (12) A creatinine test; (13) A glomerular filtration rate test; (14) A blood urea nitrogen test; (15) A sodium test; (16) A potassium test; (17) A carbon dioxide test; (18) A calcium test; (19) A full lipid panel test; (20) A thyroid stimulating hormone test; (21) A cortisol test; and (22) A test to detect hepatitis A, hepatitis B and hepatitis C; (e) The pulmonary function test of spirometry; (f) A posterior-anterior chest X-ray, which must be interpreted by a radiologist; (g) An examination of the heart of the employee, which must include: (1) A stethoscopic examination of the heart; (2) A resting electrocardiogram; (3) If the employee is 40 years of age or older or abnormalities were observed in the resting electrocardiogram, a stress electrocardiogram; and (4) If the employee is 40 years of age or older and the test has not been performed in the immediately preceding 3 years, a coronary calcium score test; and (h) A screening of the vision of the employee, which must include: (1) The use of the Bailey-Lovie Chart; and (2) A color vision test. 4. A cancer screening administered pursuant to NRS 617.453 must include, without limitation: (a) An examination of the skin of the employee; (b) Except as otherwise provided in subsection 5, if the employee is a woman who is 40 years of age or older, a mammogram; (c) Except as otherwise provided in subsection 5, if the employee is a woman, a pap smear; (d) If the employee is a man, a prostate-specific antigen test; (e) A thyroid examination to screen for palpable nodules; (f) If the employee is a man, a testicular examination; (g) A urinalysis performed using a dipstick that includes, without limitation: (1) A pH test; (2) A glucose test; (3) A ketones test; (4) A protein test; (5) A blood test; and (6) A bilirubin test; (h) A fecal occult blood test; and (i) If the employee is 45 years of age or older and the test has not been performed in the immediately preceding 10 years, a colonoscopy. 5. An employee who is a woman is not required to submit to a test specified in paragraph (b) or (c) of subsection 4 if the employee provides to the person administering the cancer screening a written certification from the primary care physician of the employee or a medical facility certifying that, in the 12 months immediately preceding the last cancer screening administered on the employee: (a) The test was conducted on the employee; or (b) The primary care physician or medical facility concluded that the test was unnecessary or not recommended for the employee. 6. Except as otherwise provided in subsection 8 of NRS 617.457 , the tests required by this section must be paid for by the employer. 7. Except as otherwise provided by the provisions governing privacy in the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as amended, and applicable regulations, or an employees collective bargaining agreement, whichever is more restrictive: (a) The results of a physical examination administered pursuant to NRS 617.455 or 617.457 or a cancer screening administered pursuant to NRS 617.453 may only be provided to: (1) The examining physician; (2) The employee; (3) The employers officer who is responsible for risk management or human resources or his or her designee; and (4) If the employee has filed a claim pursuant to NRS 617.453 , 617.455 or 617.457 , the insurer. (b) A person who receives the results of a physical examination or cancer screening pursuant to paragraph (a) may only use the results for the purposes of: (1) Complying with the requirements of NRS 617.453 , 617.455 or 617.457 , as applicable; or (2) Creating a report pursuant to paragraph (c). (c) The employers officer who is responsible for risk management or human resources or his or her designee may create and release a report that is based on the results of a physical examination administered pursuant to NRS 617.455 or 617.457 or a cancer screening administered pursuant to NRS 617.453 to any person whom the employers officer determines has a need to know the information in the report. The report must only contain the following information: (1) The name of the employee who was the subject of the physical examination or cancer screening; and (2) A statement that the employee, as applicable: (I) Satisfies the physical qualifications required for his or her employment; or (II) Does not satisfy the physical qualifications required for his or her employment.
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