.png)
Drug and alcohol reasonable suspicion is a term used in the workplace to describe a situation in which an employer has reason to suspect that an employee may be under the influence of drugs or alcohol while on the job. This suspicion can be based on a variety of factors, including the employee's behavior, appearance, speech, and performance.
Reasonable suspicion can arise from observations such as slurred speech, erratic behavior, difficulty walking or standing, red or watery eyes, or the smell of alcohol on an employee's breath or clothing. In order for an employer to take action based on reasonable suspicion, the suspicion must be based on specific and objective observations rather than on speculation or stereotypes.
Once an employer has reasonable suspicion that an employee is under the influence of drugs or alcohol, they may be required to follow certain protocols, such as conducting drug or alcohol testing, to determine whether the employee is impaired. These protocols may be outlined in the company's drug and alcohol policy or in applicable federal or state laws. The purpose of these protocols is to ensure the safety of all employees in the workplace and to prevent accidents or injuries that may result from impaired workers.
Integrated Care offers reasonable suspicion drug and alcohol training for supervisors and managers.
Managers play a critical role in ensuring the safety and productivity of their teams, and they may be the first to observe behavior or performance that raises concerns about drug or alcohol use.
By receiving training in drug and alcohol reasonable suspicion, managers can better identify signs of impairment and understand the steps they need to take to address the situation. This may include initiating a drug or alcohol test, referring the employee to an Employee Assistance Program (EAP), or taking disciplinary action if necessary.
Training can also help managers understand the legal and regulatory requirements related to drug and alcohol testing, as well as the company's policies and procedures. This can help ensure that managers handle situations appropriately and consistently, reducing the risk of liability for the company.
Overall, providing training in drug and alcohol reasonable suspicion is an important step in creating a safe and productive workplace. It can help ensure that managers are equipped to handle situations without discrimination or the appearance of favoritism involving drug or alcohol use in a professional and responsible manner.
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.