In an informal discussion letter issued by the EEOC, the Commission suggests that an employer might be required to let an employee or applicant suffering from paruresis or "shy bladder" syndrome to satisfy drug testing obligations through an alternative test.

According to the discussion letter, paruresis:

is the inability to urinate in public restrooms or in close proximity to other people, or the fear of being unable to do so. Paruresis is generally considered to be an anxiety disorder, and typically is treated with cognitive-behavioral therapy. Your letter states that paruresis is also a chronic pelvic floor dysfunction. Individuals with paruresis sometimes are subjected to adverse employment actions because they are unable to pass standard tests designed to detect the illegal use of drugs, and are denied permission to take alternative tests that do not involve urination.

Assuming that the paruresis constitutes an actual disability rather than a perceived disability, the Commission suggests that the employee or applicant could be permitted to take a saliva, patch or other test (e.g., blood or hair) to satisfy an employer’s drug testing obligation.  A "regarded as" disability is not entitled to any reasonable accommodation.

Is this a widespread issue?  Probably not, but it is important advice for an individual who suffers from paruresis or for an employer that has to address drug testing issues involving employees with this condition.

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