What happens when an individual is unable to provide a sufficient amount of specimen for a pre-employment follow-up or return-to-duty test because of a permanent or long-term medical condition? (§ 40.195)

This section outlines procedures for situations where an employee has a permanent or long-term medical condition that prevents them from providing a sufficient urine specimen for a pre-employment, follow-up, or return-to-duty drug test.  Please note that these reasons for test require that the employe receive a negative result. Other reasons for test do not. See also  § 40.61(e) for urine or § 40.72 for oral fluid collection.

Medical Review Officer (MRO) Responsibilities:

  1. Determine Drug Use Evidence: The MRO must assess if there is clinical evidence of illicit drug use by conducting or arranging a medical evaluation and consulting relevant physicians.
  2. Ensure Medical Evaluation: If the MRO does not personally conduct the evaluation, a licensed physician acceptable to the MRO must do so.
  3. Alternative Testing: If needed, the evaluation may include an alternative test (e.g., blood) to check for drug use.

Reporting Results:

  • If No Drug Use Evidence: The MRO reports a negative result to the employer, documenting the medical condition and the findings. The MRO must check “Negative” on the Custody and Control Form (CCF) and sign and date it.
  • If Drug Use Evidence is Found: The MRO reports the test as cancelled, documenting the medical condition and signs of drug use. A cancelled test does not allow the employee to begin or resume safety-sensitive duties.

Definition of Permanent or Long-Term Medical Conditions:

  • These are physiological, anatomic, or psychological abnormalities that existed before the attempted test and are unlikely to be corrected.
  • Examples include renal failure, urinary tract damage, or severe psychiatric disorders related to urination.
  • Temporary conditions (e.g., cystitis, urethritis, prostatitis) do not qualify for these exceptions.