Human Resources News & Insights

Is ‘shy bladder syndrome’ a disability?

Does being unable to pee on cue qualify as a disability?

That question came up recently in an informal opinion letter from Peggy Mastroianni, a lawyer with the EEOC. And, apparently, the answer could be “yes.”

Mastroianni was responding to an inquiry from an employer who, we assume, had run into a problem in its regular drug testing regimen. Apparently, an employee claimed he or she couldn’t provide a urine sample for testing because of “bashful bladder syndrome.”

There is, indeed, a recognized condition — officially dubbed paruresis — in which an individual can’t urinate in public bathrooms or in close proximity to other people. It’s “generally considered to be an anxiety disorder, and typically is treated with congnitive-behavioral therapy,” according to the EEOC opinion letter.

So it appears that drug users now have a convenient way to avoid company drug tests — just say you’re suffering from paruresis, and you’re home free.

At least that’s what we think Mastroianni’s letter indicates. Here’s her final word of advice to the employer:

As was true prior to the ADAAA, a person with paruresis is required to show individually that he or she meets the definition of “disability.” The ADAAA and its implementing regulations make this showing much easier, by including bladder and brain functions as major life activities, lowering the standard for establishing that an impairment “substantially limits” a major life activity, and focusing the determination of whether an individual is “regarded as” having a disability on how the individual has been treated because of an impairment, rather than on what the employer may have believed about impairment. No negative inference should be drawn from the fact that paruresis is not specifically mentioned in the EEOC’s regulations implementing the ADAAA.

Got that?

What’s an employer to do?

The case of the balky bladder is just the latest chapter in the story of the ADA Amendments Act, which so broadened the official definition of disability that it’s pretty likely everybody in your company suffers from some kind of condition that could require accommodation.

What are your options should you run into the “shy bladder syndrome”?

Jonathan Segal of the law firm Duane Morris offered three suggestions on his blog.

First, employers can ask employees to provide medical certification that confirms they’re suffering from paruresis. That, of course, could cost both money and time — time that could allow a drug user to clean out his system and avoid a positive test result.

Second, Segal says, the company could set up a system wherein any individual who couldn’t provide a urine specimen would have to provide a hair sample instead.

Seems like a good idea, but then there is a medical condition called Alopecia universalis, which causes the complete loss of hair all over the body. Wonder what a reasonable accommodation for that condition might be.

Segal’s got one more suggestion for dealing with the paruresis issue, and it’s our favorite:

Offer assertiveness training so that every bladder can realize its full potential.

Seems like an appropriate approach in the wacky world of the new ADA.

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  1. Why not just do an oral fluids test instead on these people? Just as effective as a urine test, but a lot less invasive.

  2. I work with indiviudals with disabilities and not one of them would consider this an actual disability that impairs an individual’s ability to function in work or society.

    But, if it is an actual documented condition for the person as an emloyer you have to take it seriously. I would suggest using a testing facility that has the capability to do a urine, hair or blood test and to spend the extra money to get the test done in a timely manner so that you do not risk your company’s assests. But, the statistics on this syndrome are pretty small, as are the statistics for people with alopecia. I would be surprised if anyone came across this problem.

  3. My goodness….. if it is not one thing it is another.

    Just as the article says….. with these new regs, just about anyone in the workforce can qualify for something.

    Sooner or later the employers will be working for the employees

  4. HR Gal has it right …oral fluids are a lot less invasive and doesn’t embarass anyone. After all the main objective is to see if someone is taking drugs or not.

  5. I, myself, have suffered from paruresis for some 46yrs & it is, indeed, a major disability (worse than anorexia, which I also had & was not recognized as a disorder).
    All paruretics are asking for is reasonable accomodation in the area of urine-only drug testing which now exists in the workplace. Heck, I was even willing to pay for this accomodation (also refused by the current drug policy).
    By the way, I am in favor of drug testing, I only want it to be done without discrimination.

  6. I personally just got diagnose with paruresis. I was hired for my job, and I knew that there were random testings dont, which i have no probem with. But when it was time i was unable to give a sample due to my condition. The next day i was discharged form my worker. I even offered to pay to have my blood taken and still I was dismissed. This is not right . I do everything i can to find a decent job today and becasue of a condition i was let go. How would you feel about that? Its not a good feeling and I am beyond pissed about this.

  7. I don’t have a problem with drug screening for a job. I do have a problem with having 3 minutes to produce a substantial amount of urine in a cup or having the test sent back as “refusal”. I definitely have this condition, and I have for years, although I just found out there is an actual name for it. I am definitely worried I’m going to lose my job offer just because I couldn’t complete the test within the time limit- even though I did give them two samples but neither was enough. I’d be willing to do a hair, blood AND saliva test if they want, but I don’t know if I’ll be given the option.

  8. Someone correct me if I am wrong, but those who have a medical condition that would or could inhibit the ability to provide a urine sample on the spot could ask for “reasonable” accomodation under the ADA (Americans with Disabilities Act) to be able to meet the job requirement. I would request to provide a specimen through another method and state you are doing so under ADA reqs, because there would be no reason whatsoever that any employer should not be able to meet this request. If the company’s policy or practice is urine only, it would probably be deemed too narrow and restrictive by a court. After all, the object of the test is to determine whether one uses drugs or not (not whether one can pee in a cup on the spot which is hardly a job requirement) and there are alternative methods as some have already stated. As one has currently stated “I work with indiviudals with disabilities and not one of them would consider this an actual disability that impairs an individual’s ability to function in work or society” it really doesn’t matter as the ADAAA has more broadly defined a disability and an employer’s requirements for accomodation than under the former ADA.

  9. Hulkster80 says:

    No, dumbass. This isn’t about avoiding drug testing. The issue is if someone suffers from a medical condition that makes it very difficult to provide urine, an alternative test such as hair, saliva, or blood should be incorporated. Common sense, to me, should suggest that if it’s taking someone hours to urinate, then there is a problem. Forcing these individuals to drink large amounts of water and endure this torture of extended strong pain urges to urinate for 3 hours is not an accommodation…it’s cruel and unusual punishment. After all, what is the purpose of a drug test?… to determine if someone is using drugs…not to determine if he or she can urinate on demand. Administer an alternative test…problem solved…plain and simple. Why is such stupidity allowed to persist?

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