👨‍⚕️ Integrated Care's Exams: Fit For Duty And Return To Work

Drug testing plays a key role in keeping workplaces safe, compliant, and productive. While there are many testing options, three collection types are used most often:

• Urine drug screens
• Oral fluid (saliva) drug screens
• Hair follicle drug screens

Below is an easy-to-understand overview written for employers, safety professionals, and individuals who may be asked to test, explaining how each type works, what it’s best for, and what to expect at a clinic like Integrated Care.

Why drug testing methods matter

Different test types do not do the same thing. They vary in:

• Detection window – how far back drug use may be detectable
• Type of use they’re best at seeing – recent vs. longer-term patterns
• Practical considerations – speed, privacy, cost, and resistance to tampering

Choosing the right method (or combination) is important for matching your testing program to your risk, regulations, and workplace policies.

1. Urine Drug Screening

Urine testing is the most common drug testing method in the United States and remains the standard for many regulated and non-regulated programs.

How urine testing works

A urine drug test looks for drug metabolites – substances produced when the body breaks down drugs. Commonly tested drug classes can include:

• Marijuana (THC metabolites)
• Cocaine
• Opiates/opioids
• Amphetamines/methamphetamines
• Benzodiazepines and others, depending on the panel ordered

Panels can be customized based on employer needs and regulatory requirements.

Typical detection window

Urine testing is generally good at detecting recent use, typically:

• Hours to several days after use for many substances
• In some cases (e.g., heavy or chronic use of certain drugs), up to several weeks

Exact detection times vary by substance, frequency of use, and individual metabolism.

What to expect during a urine collection

At a clinic like Integrated Care, a standard urine collection generally includes:

• Verification of identity and completion of required paperwork
• A sealed collection cup provided to the donor
• Use of a restroom designated for collections
• Basic integrity checks in line with applicable guidelines and regulations
• Chain-of-custody documentation to ensure results are legally defensible when needed

For regulated programs (such as DOT), the process follows very specific federal collection and documentation procedures.

When urine testing is a good choice

Urine drug screening is commonly used for:

• Pre-employment testing
• Random testing, especially in transportation and other safety-sensitive industries
• Post-accident and reasonable suspicion testing
• Return-to-duty or follow-up monitoring

It offers a well-established, cost-effective method with a broad available test menu and well-understood cutoff levels.

2. Oral Fluid (Saliva) Drug Screening

Oral fluid (saliva) testing has grown in popularity, especially where very recent use and observed collection are important.

How oral fluid testing works

Oral fluid tests measure drugs and metabolites present in saliva. Collection typically uses a small swab or pad placed in the mouth for a short period until enough saliva has been absorbed.

Like urine, oral fluid can test for multiple drug classes, and panels can be tailored to employer needs.

Typical detection window

Oral fluid testing is especially sensitive to recent use:

• Often detects use starting within minutes to a few hours after ingestion
• Detection typically lasts up to about 24–48 hours for many substances
• In some cases, a bit longer depending on the drug and pattern of use

Because of this, it’s particularly suited for determining recent impairment risk, rather than long-term use.

What to expect during an oral fluid collection

Key features of an oral fluid collection:

• The test is directly observed (no restroom needed), which makes tampering more difficult
• The donor holds a swab under the tongue or against the cheek until a collection indicator shows enough sample has been obtained
• The device is sealed, labeled, and documented for shipment to the laboratory when required

Many donors appreciate that oral fluid testing is less invasive, quick, and does not require urine.

When oral fluid testing is a good choice

Oral fluid is often preferred for:

• Post-accident or reasonable suspicion testing, when timing is critical
• Worksites where bathroom access or privacy is limited
• Programs that want observed collections to reduce the risk of substitution or adulteration
• Certain non-regulated workplace policies focused on recent on-the-job use

3. Hair Follicle Drug Screening

Hair testing is primarily used when employers want to understand longer-term patterns of drug use, not just what happened in the last day or two.

How hair testing works

Hair follicle drug testing looks for drug metabolites that become trapped in the hair shaft as the hair grows. A small sample of hair (typically from the scalp) is collected and sent to the laboratory.

Panels can include a broad range of commonly abused drugs, similar to urine testing, but the information it provides is different.

Typical detection window

Hair testing is designed to show patterns of use over time, not immediate impairment:

• A standard sample (about 1.5 inches from the scalp) can reflect approximately up to 90 days of use history
• Hair does not reliably detect very recent use (the last day or two), because it takes time for the hair to grow out of the follicle

This makes hair testing useful for identifying repeated or chronic use over weeks to months.

What to expect during a hair collection

At a clinic:

• A collector will confirm identity and complete the necessary forms
• A small lock of hair is cut from close to the scalp, usually at the back or crown so it is not cosmetically noticeable
• For donors with little or no head hair, body hair may be used within specific guidelines
• The sample is sealed, labeled, and documented for shipment to the lab

The process is quick and generally well-tolerated.

When hair testing is a good choice

Hair testing is often recommended for:

• Pre-employment programs where employers want insight into longer-term drug use patterns
• High-trust positions or safety-sensitive roles where ongoing use is a concern
• Situations where resistance to tampering is a high priority

Because it is more specialized, hair testing usually has higher lab costs and a longer turnaround time than standard urine screens.

Choosing the right test for your workplace

There is no single “best” test for every situation. The right approach depends on:

• Whether your workforce is regulated (e.g., DOT) or non-regulated
• Whether you are more concerned with recent impairment risk or long-term use patterns
• Practical factors like your work environment, budget, and frequency of testing

Many employers use a combination of methods—for example:

• Urine for DOT-regulated and ongoing random testing
• Oral fluid for post-accident or reasonable suspicion situations
• Hair testing for pre-employment in higher-risk roles

How Integrated Care can help

Integrated Care provides professional collection services for urine, oral fluid, and hair drug testing. We work with employers to:

• Design testing policies tailored to their regulatory requirements and risk profile
• Select the most appropriate testing method(s) for pre-employment, random, post-accident, and reasonable suspicion situations
• Coordinate with certified laboratories and Medical Review Officers where required
• Ensure collections are handled professionally, respectfully, and in line with applicable guidelines

If your organization is reviewing its drug and alcohol testing program or considering adding new collection types, our team can walk you through options and help you build a program that supports safety, compliance, and fairness for your workforce.

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When recovering from an injury or illness, one of the most important questions is: “Am I ready to return to work safely?” At Integrated Care, we provide Functional Capacity Evaluations (FCEs) to help answer that question with confidence and clarity.

What Is a Functional Capacity Evaluation?

A Functional Capacity Evaluation is a comprehensive, objective assessment designed to measure your physical abilities in relation to the specific demands of your job or daily activities. The evaluation helps determine whether you can safely resume work tasks or if accommodations are needed.

Why Choose Integrated Care for Your FCE?

At Integrated Care, our licensed provider, Dr. Alex E. Ferrer, DPT, brings expertise in rehabilitation and occupational health to every evaluation. Dr. Ferrer carefully administers each FCE to ensure accurate, reliable results tailored to your unique situation.

Our FCE services can help:

• Evaluate physical abilities after injury or illness
• Guide safe return-to-work decisions
• Support workers’ compensation and disability claims
• Provide clear documentation for employers and insurers

Who Can Benefit from an FCE?

FCEs are valuable for employees, employers, case managers, and insurers. Whether you’re an individual seeking medical clearance, an employer ensuring workplace safety, or a claims professional requiring documentation, an FCE provides the evidence-based insight you need.

Schedule Your Evaluation

If you or your employee requires a Functional Capacity Evaluation, Integrated Care is here to help.

📍 Integrated Care, Omaha, NE
📞 Call us today at 402-502-1819 to schedule your appointment.

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SimplifyingCompliance with Our Comprehensive Random Management

Consortium Program

For many businesses, meeting Department of Transportation(DOT) requirements and maintaining a safe, compliant workplace can be adaunting task. With our Random Management Consortium Program, Integrated Caremakes compliance easier and more affordable for companies of all sizes—whetheryou're looking for a DOT-compliant program or a non-DOT option tailored to yourneeds.

Why Choose a Random Management Consortium?

In many industries, including transportation and logistics,employers must follow strict guidelines for random drug and alcohol testing.This is essential for maintaining safety, meeting regulatory standards, andavoiding penalties. However, managing a compliant testing program can betime-consuming and requires ongoing attention to federal regulations, such as49 CFR Part 40 and 49 CFR Part 382.

Our Random Management Consortium Program ensures that yourcompany remains fully compliant, taking the complexity out of testing andrecord-keeping. When you join our consortium, you’re not just paying fortesting—you’re investing in peace of mind. Our team handles everything, frommanaging random selections to reporting results, so you can focus on runningyour business.

Our Services and Pricing

We offer affordable pricing options that cater to businessesof all sizes. Our services include:

• DOT     Random Program Annual Fee: $150
      For companies enrolled in the DOT program, the annual fee ensures     comprehensive support, random selection, and detailed record-keeping     throughout the year.
• DOT     Drug Screen: $50
      This price covers each DOT drug test conducted as part of the random     program, with testing performed by certified professionals in a safe,     controlled environment.
• DOT     Breath Alcohol Test: $35
      In addition to drug testing, we offer breath alcohol testing to meet DOT     compliance standards, ensuring quick and accurate results.

Upon enrollment and payment of the annual fee, we provide a Certificateof Compliance for your records. This certificate demonstrates yourcommitment to a compliant, safe workplace and serves as proof of participationin a DOT-compliant random drug and alcohol testing consortium.

Key Benefits of Our Consortium Program

Our consortium program offers several advantages:

1. Simplicity:     Managing compliance can be overwhelming, but our program simplifies the     process. We handle all aspects of the random testing program, from     selecting employees for testing to delivering results, allowing you to     focus on your core operations.
2. Affordability:     With clear, transparent pricing, our program offers cost-effective     solutions for your compliance needs. From the annual fee to per-test     rates, we keep costs low to provide exceptional value.
3. Compliance     with Federal Standards: Our program adheres to the strictest standards     as outlined in DOT regulations. By partnering with Integrated Care, you’re     ensuring your program meets all required protocols.
4. Certificate     of Compliance: Upon payment of the annual fee, you’ll receive a     Certificate of Compliance, which can be easily presented during audits or     when requested by clients or regulatory bodies.
5. Comprehensive     Support: Our knowledgeable team is here to help. Whether you have     questions about specific requirements or need assistance enrolling, we’re     just an email away.

Join Our Consortium Program Today!

We understand that compliance is crucial to your business.Whether you're a small business or a large fleet, Integrated Care has theexperience and resources to manage your testing program efficiently. For moreinformation or to sign up, contact Eric at eric@integratedcarellc.com.

With Integrated Care, you can rest assured that your randomtesting needs are fully managed, allowing you to meet industry standards andkeep your workplace safe and compliant year-round.

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