Objective: The objective of the pilot program was to evaluate the utility of the psychomotor vigilance test (PVT) in aiding clinicians in making fitness for work determinations. Methods: A 10-minute PVT was incorporated into fitness for work examinations by occupational health staff at two integrated refining/petrochemical plants. Based on all evidence from the clinical examination, including PVT results, clinicians made their fitness for work determination. Results: Employees who were determined to be fit for work had significantly fewer PVT errors than did employees determined to be unfit for work or fit for work with limitations, with t(98) = -14.71, P < 0.001. Conclusions: The pilot assessed a new application of the PVT as an adjunct to occupational health evaluations focused on determining fitness for work. Results demonstrated that the PVT can be a valuable tool for this purpose. [ABSTRACT FROM AUTHOR]