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Introduction
Breath alcohol tests are a vital tool in ensuring workplace safety and compliance with various regulations. These tests are designed to measure the alcohol concentration in an individual's breath, thus indicating their level of intoxication. Understanding when to request these tests is crucial for employers, especially in industries where safety is paramount. This article will discuss the contexts in which breath alcohol tests are typically requested: pre-employment, post-accident, random testing, and reasonable suspicion.
1. Pre-Employment Testing
Pre-employment breath alcohol tests are conducted as part of the hiring process. This screening ensures that new hires do not have a history of alcohol abuse that could impair their ability to perform their job safely. This is particularly important in industries where employees operate heavy machinery, drive vehicles, or are responsible for safety-critical tasks.
Key Points:
- Risk Management: Reduces the risk of hiring individuals who may pose a safety risk.
- Compliance: Ensures compliance with industry regulations and company policies.
- Standard Practice: Common in transportation, construction, and manufacturing sectors.
2. Post-Accident Testing
Post-accident breath alcohol testing is performed after a workplace incident or accident. This test determines whether alcohol consumption by the involved employees contributed to the incident. It's a crucial step in the investigation process and helps in understanding the causes of the accident, thereby preventing future occurrences.
Key Points:
- Accident Investigation: Essential part of incident analysis.
- Liability Issues: Helps in determining responsibility and liability.
- Regulatory Compliance: Often required under various safety regulations.
3. Random Testing
Random breath alcohol testing is used to deter alcohol use among employees. Employees are randomly selected for testing without prior notice. This method is effective in promoting a safe and sober work environment, as employees are aware that they could be tested at any time.
Key Points:
- Deterrence: Acts as a deterrent against alcohol use on the job.
- Fairness: Random selection ensures fairness in testing.
- Safety Culture: Reinforces a culture of safety and responsibility.
4. Reasonable Suspicion Testing
Reasonable suspicion testing is initiated when there are grounds to believe that an employee is under the influence of alcohol while at work. This suspicion is usually based on observable signs such as slurred speech, the smell of alcohol, or erratic behavior.
Key Points:
- Immediate Action: Allows for prompt intervention in case of suspected alcohol use.
- Supervisor Training: Requires training for supervisors to identify signs of intoxication.
- Legal Compliance: Must be handled carefully to comply with legal standards and to respect employee rights.
Conclusion
Breath alcohol testing is a key component in maintaining a safe and compliant workplace. The contexts in which these tests are requested – pre-employment, post-accident, random, and reasonable suspicion – each serve a specific purpose in promoting workplace safety and accountability. Employers must be diligent in implementing these testing protocols not only to comply with legal and regulatory requirements but also to foster a culture of safety and responsibility among their employees.

Navigating New DOT Physical Submission Requirements: What Carriers and Clinics Need to Know
As of June 23, 2025, a new federal directive will require that DOT physical exam results be submitted directly by certified medical examiners (CMEs) to the FMCSA National Registry. This change aims to streamline and standardize how states access medical certifications for commercial driver’s license (CDL) holders. While this directive marks a significant step toward centralized compliance, it is already causing confusion across state lines as some jurisdictions begin early enforcement.
The Transition: Electronic Over Walk-In
Historically, many states allowed CDL holders to present a copy of their DOT physical certificate directly to their local Department of Motor Vehicles or licensing authority. However, under the new mandate, states will only accept certifications transmitted electronically through the FMCSA’s National Registry system. This has effectively eliminated the ability for drivers to "walk in" and submit physicals manually in certain states—Missouri being a recent example.
One recent case involved a driver who attempted to update their CDL in Missouri using a valid physical taken through a compliant clinic. The state rejected the in-person submission, citing the new requirement for electronic transmission by the CME. Such incidents underscore the urgency for carriers and clinics to understand and comply with the updated process.
Integrated Care's Current Compliance Status
Integrated Care, LLC is already positioned to meet these requirements. All DOT physicals conducted under our program are being submitted through the National Registry portal. Our certified medical examiners are active within the Registry, ensuring that submissions are both compliant and trackable by state licensing agencies.
Still, as implementation varies by state and occasional system inconsistencies arise, we remain committed to verifying every submission and assisting clients whose drivers encounter issues.
Communication Challenges with Regulatory Bodies
Despite best efforts by compliant clinics and carriers, navigating communication with federal and state agencies remains difficult. As one industry professional noted, “It is difficult to influence the Federal and State government. They don’t make it easy to communicate or explain.” This frustration is shared across the transportation sector and highlights the need for clearer guidance and responsive systems during such transitions.
What Carriers Should Do Now
- Verify CME Registration: Ensure your DOT physicals are conducted by CMEs listed on the FMCSA National Registry.
- Confirm Submission: Ask for confirmation that physicals have been electronically submitted to the FMCSA.
- Educate Drivers: Let drivers know they may no longer be able to walk in to update their CDL with a printed physical.
- Monitor State-Specific Changes: Not all states may adopt the new system on the same timeline; staying informed can prevent surprises.
Looking Ahead
Integrated Care will continue monitoring this transition and updating partners as needed. While the goal of this policy is improved efficiency and accountability, the implementation phase will likely include growing pains. By working together and maintaining open communication, we can reduce friction and ensure drivers remain compliant and on the road.

The Process of Becoming an Occupational Health Client at Integrated Care
Choosing the right occupational health provider is critical for any business concerned with employee well-being, regulatory compliance, and productivity. Integrated Care makes this decision easy by offering a non-contractual, service-first approach—clients stay with us because they value our support, not because they’re locked into a contract.
1. Simple Inquiry and Open Conversation
The journey begins with a straightforward inquiry—reach out through our website, call, or email. From the start, you’ll experience our transparent, client-centered philosophy. A dedicated team member will:
- Listen to your company’s occupational health needs and goals.
- Answer any questions about our services, compliance requirements (like DOT or OSHA), and our processes.
- Outline how Integrated Care operates—no binding contracts, just clear, reliable service.
What Sets Us Apart:
There’s no commitment required. You don’t need to sign a long-term agreement or worry about cancellation clauses. You’re always free to choose what’s best for your company.
2. Customized Needs Assessment and Proposal
Every business is unique. Integrated Care takes time to understand your specific needs by:
- Conducting a customized needs assessment for your workforce, compliance requirements, and safety goals.
- Providing a clear service proposal—including recommended solutions, transparent pricing, and how our team will support you.
- For DOT-regulated employers, we outline exactly how we help maintain compliance with 49 CFR Part 40 and 49 CFR Part 382.
Key Services May Include:
- DOT and non-DOT drug & alcohol testing
- Physical exams and capacity profiles
- Hearing/vision screenings
- Injury care and case management
- Wellness and vaccination programs
Remember:
You’re never locked in. If our services don’t fit your needs, you can walk away at any time—no questions asked.
3. Fast, No-Hassle Onboarding
Once you’re ready to move forward:
- We collect your business and employee info to get your account set up quickly.
- You receive all needed forms and information packets—digitally or in print.
- We provide training and support for your team, including how to access results, schedule services, and use any online portals.
- If you use HR, scheduling, or EHR systems, we’ll help integrate them for convenience.
No Formal Agreements:
Unlike most providers, we don’t require a signed contract. Our philosophy is simple: if you’re not happy, you’re never stuck.
4. Ongoing Support—No Strings Attached
You’ll have a dedicated account manager for questions, support, and program improvements. Integrated Care manages compliance tracking, random testing (for DOT clients), and regular reporting—always with the understanding that you are in control.
- Stay because you love our service—not because you’re locked in.
- Feedback is always welcome and helps us keep our standards high.
- If you want to stop using our services, just let us know—there are no penalties, fees, or formal exit process.
5. A Partnership Built on Trust and Performance
At Integrated Care, our only “contract” is the quality of our work. We believe in earning your trust every day. If our services ever fall short, you’re free to move on—no hassle, no hard feelings.
Our Promise:
We’re only as good as our services. If you’re not satisfied, you’re never obligated to stay.
Get Started Today—No Strings Attached
Becoming an occupational health client at Integrated Care is as easy as reaching out. Experience what it’s like to work with a provider that lets service—not contracts—do the talking.
Contact Integrated Care
Phone: 402-502-1819
Website: integratedcarellc.com
Integrated Care: Your partner in occupational health—on your terms, always.

Meet Our Expert DOT Medical Examiners: Dr. Christian Busby and Dr. Louis Nutter
At Integrated Care, we're dedicated to providing top-tier occupational health services, and that includes DOT physical exams for your CDL holders.
We're proud to promote two exceptional providers on our team: Dr. Christian Busby and Dr. Louis Nutter, both certified DOT medical examiners and registered on the Federal Motor Carrier Safety Administration (FMCSA) National Registry.
Expertise You Can Trust
Dr. Busby (National Registry #6348555835) and Dr. Nutter (National Registry #2250190636) bring extensive experience in occupational health, chiropractic care, and physical rehabilitation. Their thorough understanding of DOT regulations ensures accurate and efficient medical examinations for commercial vehicle operators.
Both doctors undergo ongoing training and certification updates, staying informed about the latest guidelines and requirements set forth by FMCSA. This ensures your employees receive comprehensive exams that help maintain both safety standards and regulatory compliance.
Why Choose Integrated Care for Your DOT Physicals?
- Efficient Service: Quick scheduling, minimal wait times, and convenient locations in West Omaha and South Omaha.
- Comprehensive Care: Detailed evaluations covering all FMCSA-required aspects, including vision, hearing, blood pressure, and medical history assessments.
- Proactive Compliance: Expert advice and guidance to help your employees pass DOT physicals and stay compliant year-round.
About Our Providers
Dr. Christian Busby, DC (South Omaha Clinic)
Dr. Busby is known for his meticulous attention to detail and patient-centric approach. His commitment to accuracy and compassion makes him a trusted examiner, ensuring drivers feel comfortable and confident during their examinations.
Dr. Louis Nutter, DC (West Omaha Clinic)
Dr. Nutter is highly regarded for his professional excellence and personable interaction with patients. He prioritizes clear communication, ensuring employees fully understand the outcomes and requirements of their DOT physical exams.
Schedule Your DOT Physical Today
Ensure your team stays compliant with FMCSA regulations by scheduling your DOT physicals with Dr. Busby or Dr. Nutter. Trust Integrated Care to keep your drivers healthy, compliant, and on the road safely.
For appointments and inquiries:
- West Omaha Clinic: 14450 Meadows Blvd, Omaha, NE 68138
- South Omaha Clinic: 4832 S. 24th Street, Omaha, NE 68107
Call or text us at 402-502-1819, or visit our website at www.integratedcarellc.com.
Integrated Care: Your partner in occupational health excellence.