New employer requires I bring my antidepressant Rx and get "cleared" from my MD

MunoRN, RN · Sep 19, 2015

After a conditional offer of employment has been made, an employer does actually have the right to ask what medications you are taking if you going to be working in a "safety sensitive" position such as direct care nursing, just like pilots or truck drivers are also usually required to declare any medication they are taking. The ADA only prevents employers from asking about medications when there is no job related need to know, but the law is very clear that working in a "safety sensitive" position constitutes a reasonable need to know if you are taking any medications that could affect safety. I've never worked anywhere that I didn't have to disclose any medications I was taking. The employers I've worked for don't accept your Physicians view on whether or not it's safe to work with certain medications, their own docs made that decisions, so I would at least consider yourself lucky that all you might need is a note from your MD (which shouldn't be hard since neither of those medications are considered significantly altering for safety purposes).

SummitRN, BSN, RN · Sep 19, 2015

They can ask you, but you are NOT required to tell them.

Safety sensitive is not carte blanche for a company to essentially have your whole medical record at their disposal.

Look at one the most safety sensitive industries out there. No, it is not healthcare... healthcare sucks terribly at safety. I'm talking about air travel. Pilots have to pass FAA flight physicals with an independent aerospace medicine physician. They can get VERY specific about what meds are allowed, when, and how much, including OTC meds. But that doesn't mean pilots have to give an employer a list of all meds and conditions.

IANAL but companies are currently trying to push this to the limit because recently some green eyeshade wearers started spouting about reducing insurance exposure by eliminating potential risk factors in the form of prescription med taking employees despite a lack of evidence. Companies have bumped into and overstepped the limit. There is case law here, some of it new.

Never assume HR has actually discussed their policy with medico-legal specialists.

Lastly, no employer is going to drug test for antidepressants unless there is a severe incident that raises very specific suspicions, and then it would be extraordinarily rare. Most companies use the DOT panel (49 CFR Part 40 Subpart F) to screen and that only covers marijuana, opiates, amphetamines, cocaine, and PCP. Few industries, notably mining, nuclear, and air travel, add typically just a few more to that (alcohol, benzos, synthetic opioids).

MierKat · Sep 19, 2015

They can ask you, but you are NOT required to tell them.
Safety sensitive is not carte blanche for a company to essentially have your whole medical record at their disposal.
Look at one the most safety sensitive industries out there. No, it is not healthcare... healthcare sucks terribly at safety. I'm talking about air travel. Pilots have to pass FAA flight physicals with an independent aerospace medicine physician. They can get VERY specific about what meds are allowed, when, and how much, including OTC meds. But that doesn't mean pilots have to give an employer a list of all meds and conditions.
IANAL but companies are currently trying to push this to the limit because recently some green eyeshade wearers started spouting about reducing insurance exposure by eliminating potential risk factors in the form of prescription med taking employees despite a lack of evidence. Companies have bumped into and overstepped the limit. There is case law here, some of it new.
Never assume HR has actually discussed their policy with medico-legal specialists.
Lastly, no employer is going to drug test for antidepressants unless there is a severe incident that raises very specific suspicions, and then it would be extraordinarily rare. Most companies use the DOT panel (49 CFR Part 40 Subpart F) to screen and that only covers marijuana, opiates, amphetamines, cocaine, and PCP. Few industries, notably mining and air travel, add typically just a few more to that (alcohol, benzos, synthetic opioids).

This is incorrect. Until 2010, per the FAA, pilots could not take antidepressants and were not medically cleared if they took them. In 2010 they were granted "amnesty" by the FAA as long as they disclosed and were cleared by physicians as being "safe" to work. And lying to an employer may never be a problem...until it is. If an employee was found to have lied on an application, it would be grounds for termination.

I agree with others above who state that if it's an outside screening agency that you are disclosing to and they are going to decide if a new employee - you- is cleared to work, they are probably not violating any laws and your privacy is protected. If it's the internal HR department that will see the records, that would be concerning. But either way, lying on an application is never a good idea.

SummitRN, BSN, RN · Sep 19, 2015

This is incorrect. Until 2010, per the FAA, pilots could not take antidepressants and were not medically cleared if they took them. In 2010 they were granted "amnesty" by the FAA as long as they disclosed and were cleared by physicians as being "safe" to work.

At no point did I make any statement about that. Only that the FAA is far more strict that virtually any other sector, and that pilots don't have to disclose detailed med lists directly to their employer.

And lying to an employer may never be a problem...until it is. If an employee was found to have lied on an application, it would be grounds for termination.

Sure... unless the employee is protected from having to disclose such information to an employer... which was my point.

If an employer asks if I plan to have children, it is illegal. If I say "no" instead of suing them, they cannot legally fire me if they hear I am planning to have children on the basis that I "lied."

dec2007 · Sep 19, 2015

This certainly is an invasion of privacy; however, it is the foreseeable consequence to the combination of mandated electronic health care records and the intrusion of government into health care. No information about anyone's health is truly "confidential" anymore. HIPPA is laudable in theory, but does not exist in reality, except on paper.

SookieBSN · Sep 19, 2015

Yes, antidepressants do show up on drug screens, but it is often as a false positive. All positives have to be confirmed, which then confirms the the medication you are taking. So if they asked you to disclose what antidepressants you are on, you don't, and then your urine screen comes up positive for an antidepressant, you may be terminated. (Examples of antidepressants that cause false positives: Zoloft - benzodiazepines, Pristiq - PCP (U S Food and Drug Administration Home Page)). Always better to be honest, in my humble opinion.

SummitRN, BSN, RN · Sep 20, 2015

Yes, antidepressants do show up on drug screens, but it is often as a false positive. All positives have to be confirmed, which then confirms the the medication you are taking. So if they asked you to disclose what antidepressants you are on, you don't, and then your urine screen comes up positive for an antidepressant, you may be terminated. (Examples of antidepressants that cause false positives: Zoloft - benzodiazepines, Pristiq - PCP (U S Food and Drug Administration Home Page)). Always better to be honest, in my humble opinion.

If someone tested positive because of Zoloft, the independent testing company's MRO (Medical Review Officer) would call the tester to verify if there is a potential source for the false positive. If the MRO gets a valid prescription for the confounding med, the MRO changes the positive to a negative and that is what the employer sees: a negative. The MRO does not tell the employer "nurse so and so is taking Zoloft."

DowntheRiver · Sep 20, 2015

If someone tested positive because of Zoloft, the independent testing company's MRO (Medical Review Officer) would call the tester to verify if there is a potential source for the false positive. If the MRO gets a valid prescription for the confounding med, the MRO changes the positive to a negative and that is what the employer sees: a negative. The MRO does not tell the employer "nurse so and so is taking Zoloft."

I work in Occ Health and this is exactly how it works.

nurseswholovenursing · Sep 20, 2015

The laws must vary from state to state. We are not allowed, under HIPPA, to ever ask what medication an employee takes. It is between you and the place yor employer has contracted with to screen your drug test. We only test for 5 drugs, which is the most common urine test done, because I'm sure it is cheaper. But I assume that other drugs could cause false positives, as others have stated here happens. It's probably been about 3 years ago, that new employees did have to give us a list of whatever meds they were taking. But no more. It is considered a HIPPA violation to ask. You can not (should not) be discriminated against because of depression, which is actively being treated. We don't even ask on our medical history anymore.

BuckyBadgerRN, ASN, RN · Sep 20, 2015

You wait until a med shows up on the drug screen and THEN show proof of a valid script. You tipped your hand....

No, I didn't divulge. This is on the form that is given to all new hires. Only asked about antidepressants. Since I had to give urine sample I thought I'd better comply and not risk losing the position. But geeâ€¦.

BuckyBadgerRN, ASN, RN · Sep 20, 2015

HIPAA. Sweet baby Jesus, it's HIPAA.

The laws must vary from state to state. We are not allowed, under HIPPA, to ever ask what medication an employee takes. It is between you and the place yor employer has contracted with to screen your drug test. We only test for 5 drugs, which is the most common urine test done, because I'm sure it is cheaper. But I assume that other drugs could cause false positives, as others have stated here happens. It's probably been about 3 years ago, that new employees did have to give us a list of whatever meds they were taking. But no more. It is considered a HIPPA violation to ask. You can not (should not) be discriminated against because of depression, which is actively being treated. We don't even ask on our medical history anymore.

SummitRN, BSN, RN · Sep 20, 2015

You wait until a med shows up on the drug screen and THEN show proof of a valid script. You tipped your hand....

No. Read my last post