During a pre-employment medical examination and drug screen, an applicant tests positive for Alprazolam, the generic form of Xanax (a medication commonly prescribed for anxiety), a fact she had already disclosed during the examination.
The doctor performing the medical exam and reviewing the drug screen concludes that the applicant is medically acceptable for work as an intake specialist at an inpatient mental health facility. The employer, however, has other ideas. It withdraws the job offer without providing the applicant any opportunity to discuss the results.
The applicant sues, claiming disability discrimination.
(a) The employer, because the ADA permits pre-employment medical examinations and drug screening, and further because there exists a nexus between the applicant ’s underlying mental impairment (anxiety) and her fitness to work at a mental health facility.
(b) The employer, because the ADA only protects physical and mental impairments, not drugs used to treat them.
(c) The applicant, because the employer conducted an illegal medical examination.
(d) The applicant, because the only logical explanation for rescinding a job offer after an applicant tests positive for a prescription drug commonly used to treat anxiety is that the employer regarded the applicant as disabled.
While we may eventually find out the official answer to this puzzle (the EEOC recently filed suit alleging an ADA violation arising from these facts), if you answered (d), grab yourself a Kewpie Doll.
Still, the answer might not nearly be this cut-and-dry. The ADA is remarkably silent on the issue of testing for legally prescribed medications.
Thankfully, courts have stepped in to fill in the ADA’s omission. For example, Bates v. Dura Automotive Sys. (6th Cir. 8/26/14) [pdf].
1. Does the ADA permit an employer to test for prescription medications?
Whether the ADA permits an employer to test employees for prescription medications will hinge on whether the test is a “medical examination.” If the test is a “medical examination,” then the ADA only permits it during employment if the test is “job-related and consistent with business necessity.” According to the Court, whether the prescription-drug screen is a “medical examination” will hinge on whether the test “is designed to reveal an impairment or physical or mental health,” which examines both the employer’s reasons in using the test and the test’s typical uses and purposes.
2. Does the ADA permit an employer to require employees, after a positive test, to disclose medications to a third-party administrator?
The court concluded that there exists a huge difference between a general requirement that employees disclose a list of all prescription medications taken (possibly illegal), versus a policy that only requires the disclosure of job-restricted medications after a positive test.
How can an employer make sense of this discussion? These are difficult issues that balance an employer’s right to maintain a safe workplace against an employee’s right to medical privacy. What is an employer to do?
- Limit testing for the use of prescription drugs to safety-sensitive positions, and then only for those medications that could pose a safety risk.
- Do not ask employees to disclose the underlying medical condition for which they are taking the medication.
- Be consistent in your treatment of employees who test positive.
- Only disclose the results to those who need to know.
In conclusion, I want to focus for a moment on point No. 1 — limit testing for the use of prescription (any?) drugs to safety-sensitive positions and then only for those medications that could pose a safety risk.
Unless one is applying for a job that poses a safety risk, why are we drug testing at all? If you don’t want those who use illegal drugs to work for you, I get that.
That’s your right and your decision. But prescription drugs?
What are you hoping to learn from those tests? Unless you have a legitimate reason to hunt for medications that could impair an employee’s ability to safely perform their job, the risks of the test severely outweigh any benefits to gain.
You’ll learn a heap of protected medical information (or make assumptions based on the physical or mental impairments the drugs are used to treat). Either way, you are opening yourself up to a difficult disability-discrimination lawsuit if you rescind a job offer, as Rogers Behavioral Health in the lawsuit the EEOC recently filed.
Is this risk worth the minimal benefit?