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Immigration Update! As of 11/3/21 the U.S. Citizenship & Immigration Service (USCIS) has added a vaccination requirement for child immigrants and refugees. All children age 5 and older who are applying for “adjustment of status” must now COMPLETE a COVID-19 vaccination series (with rare exceptions).  For now, this is TWO shots of the Pfizer-BioNTech (the only approved vaccine for children at present) vaccine. The Civil Surgeon cannot sign and date the Form I-693 (Report of Medical Examination and Vaccination Record) for immigrants or “modified’ Form I-693 for refugees until this vaccination requirement has been met.  Call us with any questions about this new requirement.


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Workplace drug testing has long included marijuana as one of the main substances of interest, specifically testing for THC, the psychoactive compound in marijuana. In years past, marijuana was only available “illegally”, but, over the last 25 years, some states have legalized, decriminalized, or allowed for medical use of marijuana. The popularity of another cannabis plant-derived substance, cannabidiol (a.k.a. CBD) has also exploded. Unfortunately, CBD is poorly regulated and the Food and Drug Administration (FDA) does not certify THC levels in any product, including CBD goods. Makers of CBD products may inaccurately represent, poorly monitor, or omit information on THC content. In any event, drug testing for marijuana is directed solely toward detecting THC, and any amount over the predetermined cutoff level will be considered a positive result in virtually all circumstances.  CBD products are not currently considered a legitimate medical explanation for a laboratory-confirmed marijuana result. Employees are cautioned in their decision to use CBD products if they are subjected to any workplace drug testing.


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The Department of Transportation (DOT) requires a negative urine drug test before allowing a Commercial Driver’s License (CDL) holders to begin work and in various other scenarios.  Although this is termed a “5-panel” test, it actually screens for fourteen (14) different drugs. Marijuana is detected specifically through THC (and not CBD). Cocaine (a narcotic) and PCP (a hallucinogenic drug) remain on the standard test panel. Amphetamine testing includes not only amphetamines and methamphetamines (“meth”), but also MDMA (a.k.a. “ecstasy” or “Molly”) and MDA (a.k.a “Sally”, an amphetamine-related drug considered a hallucinogen). in response to opioid crisis, in 2018 testing was expanded to include not only the “traditional” morphine, codeine, and heroin, but also the so-called semi-synthetic opioids hydrocodone (Lortab, Norco), oxycodone (Percocet and others), hydromorphone (Dilaudid, Exalgo), and oxymorphone (Opana). Call us for any questions about DOT mandated drug testing.


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Immigration Update! As of 9/1/21 the U.S. Citizenship & Immigration Service (USCIS) has revised the laboratory screening test requirements for immigrants. Individuals who are applying for “adjustment of status” are subject to new screening criteria for syphilis (usually Rapid Plasma Reagin a.k.a. “RPR” test by blood) and gonorrhea (usually Nucleic Acid Amplification Test a.k.a. “NAAT” by urine) with some exceptions.  Under the new guidelines, applicants UNDER the age of 18 years (0-17) or over the age of 44 years (45 and older) do NOT require screening for EITHER disease. Applicants from age 18-24 years require testing for BOTH syphilis and gonorrhea. Applicants from age 25-44 years require screening ONLY for syphilis. The requirement for screening for tuberculosis (Interferon-Gamma Release Assay a.k.a. IGRA – QuantiFERON or T-SPOT.TB test by blood) remains UNCHANGED and is required of all applicants over the age of two (2) years. The Civil Surgeon cannot sign and date the Form I-693 (Report of Medical Examination and Vaccination Record) for immigrants until these screening requirements and any potential treatment requirements have been met.  Call us with any questions about this new screening schedule.


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The Department of Transportation (DOT) requires a medical examination for all drivers to receive and maintain a CDL (commercial driver’s license). Part of that assessment is a determination of whether the driver has, or requires testing for, sleep apnea (a.k.a. “obstructive sleep apnea” or “OSA”).  If the driver is diagnosed with OSA they must show compliance with use of a CPAP (continuous positive airway pressure) machine. This information must be presented to a certified medical examiner at the time of initial exam or recertification. Typically, a report can be downloaded from the CPAP device or app. This must show use of the CPAP machine at least four (4) hours per night AND at least 70 percent of the time before the driver can be certified; non-compliance is not an option.  Drivers should plan ahead, especially for recertification, and bring the report to the examination to avoid any delays.  Call us to schedule your DOT exam or with any questions about OSA/CPAP requirements.


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Immigration Update! As of 10/1/21 the U.S. Citizenship & Immigration Service (USCIS) has added a vaccination requirement for immigrants and refugees. All individuals who are applying for “adjustment of status” must now COMPLETE a COVID-19 vaccination series (with rare exceptions).  This may include the SINGLE shot Johnson & Johnson vaccine or TWO shots of the Pfizer-BioNTech or Moderna vaccines. Essentially, anyone of any age who meets the requirements for any COVID-19 vaccine must be vaccinated. The Civil Surgeon cannot sign and date the Form I-693 (Report of Medical Examination and Vaccination Record) for immigrants or “modified’ Form I-693 for refugees until this vaccination requirement has been met.  Call us with any questions about this new requirement.


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