I saw two employees for federal D.O.T. urine drug tests last week with shy bladders that they each attributed to fasting during Ramadan. One case was a random test where a negative result is not required. The other was a return-to-duty test with a negative result required. I wasn't able to find clear guidance from the regulations or elsewhere for how to handle these cases, or cases akin to this that may arise in the future, for example, someone fasting during Christian Lent. My inclination is not to consider fasting as a valid medical explanation for a shy bladder condition for federal D.O.T. tests, but I can envision at least four possible ways of handling these cases, and was hoping for guidance:
1) Consider fasting not to be a valid explanation (with or without a referring physician's opinion, which would seem superfluous if my decision was to reject fasting as a valid explanation), and verify each as a refusal to test.
2) Consider fasting to be a valid explanation, and cancel each test. In the case of the return-to-duty test with a required negative result, I could envision a few possible approaches:
A) Since the condition is not permanent, repeat the test as often as necessary, perhaps timing the test with times when the employee can drink water, until a valid urine sample is obtained. (Without a verified negative, the employee would not be allowed to return to work until a definitive test result is obtained.)
B) Wait until the fasting season is over and re-test at that point, thus removing the claimed reason for the shy bladder.
C) Use an alternative test - saliva or hair, for instance. But is this acceptable with a condition that is clearly not permanent? But what if the test were at the very beginning of a month-long fast, or in the case of Lent, a 6-week fast? Would that be considered sufficiently "long-term" to permit the use of an alternative test?
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