Petition calls for additional medical review for workers with abnormal urine samples or conditions that interfere with specimen collection
WASHINGTON — For some truck drivers, providing a urine sample on demand — especially with someone watching — is easier said than done.
To that end, the U.S. Department of Transportation (USDOT) is seeking public comments on a petition that would give truck drivers and other transportation workers more opportunities to provide medical documentation when health conditions affect the results of federally mandated urine drug tests.
The petition calls for changes to federal regulations addressing invalid test results and workers who have difficulty providing urine samples under direct observation. If adopted, the changes would establish additional medical review procedures for workers whose medical conditions could explain abnormal test results or interfere with specimen collection.
USDOT has not proposed a new rule or decided whether to adopt the requested changes.
Petition seeks additional medical safeguards
The petition, submitted by Darcy Kern on February 27, 2026, calls for changes to 49 CFR Part 40, which governs drug and alcohol testing for transportation workers in safety-sensitive positions.
Under current regulations, certain invalid urine drug test results, including those involving abnormal pH levels, can result in cancellation of the test and mandatory recollection under direct observation.
According to the petition, existing regulations do not require a standardized process for evaluating medical conditions that could explain certain abnormal results before proceeding with observed recollection. The petitioner argues that additional safeguards could help ensure consistent treatment of workers who have legitimate medical explanations for their test results.
The petition proposes giving affected workers up to 72 hours to submit supporting documentation from a licensed medical provider. A medical review officer (MRO) would then be required to issue a written determination addressing that documentation before directing a repeat collection under observation.
If a worker fails to provide documentation within the specified period, or if the documentation is deemed insufficient, the directly observed collection would proceed under existing requirements.
Medical conditions could receive additional consideration
The petition also addresses workers with diagnosed urological conditions or functional voiding disorders, including paruresis (commonly known as “shy bladder syndrome”). For workers with these conditions, providing a urine sample while being directly observed can be difficult or impossible.
Under the requested changes, an MRO would be required to consider consulting a licensed urologist or mental health professional familiar with the condition before issuing a final determination.
In addition, before verifying a refusal to test based on a worker’s inability to provide a sufficient urine sample under direct observation, the MRO would have to document consideration of previously submitted medical evidence indicating a condition that could interfere with specimen collection.
The petitioner maintains that the requested changes would not eliminate directly observed testing, weaken safeguards against specimen tampering or alter existing laboratory standards. Drivers who fail to provide sufficient medical documentation could still face the consequences of refusing a drug test.
USDOT invites public comments
The petition points to the serious consequences drivers can face if they are deemed to have refused a drug test, including impacts on their CDL, reporting to the Federal Motor Carrier Safety Administration’s Drug and Alcohol Clearinghouse and mandatory return-to-duty requirements.
USDOT is requesting comments and supporting information to help determine whether to grant the petition and initiate rulemaking. The department has not made a decision on the proposed amendments.
Comments can be submitted through Regulations.gov using docket number DOT-OST-2026-3664. All comments will be posted publicly, including any personal information submitted.
Linda Garner-Bunch has been with The Trucker since 2020, picking up the reins as managing editor in 2022. Linda has nearly 40 years of experience in the publishing industry, covering topics from the trucking and automotive industry to employment, real estate, home decor, crafts, cooking, weddings, high school sports — you name it, she’s written about it. She is also an experienced photographer, designer and copy editor who has a heartfelt love for the trucking industry, from the driver’s seat to the C-suite.
