Positive Results & Refusal-to-Test Instructions

🟢 Positive Results Instructions

• DOT Requires Employers to Immediately Remove Drivers from the Road and give Drivers an SAP Referral who Test Positive or Refuse-to-Test

🟢 Find an SAP Referral (Substance Abuse Professional) - Click Here

• SAPlist.com is a Database to find a Substance Abuse Professional (SAP).  Document the Driver was given an SAP Referral

🟢 Reporting Positive Results to the Clearinghouse - Click Here

• Express Labs Medical Review Officer (MRO) Reports Positive Results to the FMCSA Clearinghouse

🔵 Refusal-to-Test Instructions

• DOT Requires Employers to Remove Drivers from the Road Immediately, give Drivers an SAP Referral & Report the Violation (Refusal-to-Test) to the FMCSA Clearinghouse
• DOT Requires the DER (Designated Employer Representative) to make the Determination if a Driver has Refused-to-Test based on Conversations with the Driver, Collector and any Notes on the Custody & Control Form
• DOT's Definition of Refusal-To-Test (Page 25) - Click Here

🔵 Find an SAP Referral (Substance Abuse Professional) - Click Here

• SAPlist.com is a Database to find a Substance Abuse Professional (SAP).  Document the Driver was given an SAP Referral

🔵 Reporting a Refusal-to-Test to the Clearinghouse - Click Here

• Employers must Report the Violation (Refusal-to-Test) & Positive Alcohol Results to the FMCSA Clearinghouse

Frequently Asked Questions - Click Here

• Everything you need to know to keep your Company in Compliance

🔵 Can Drivers be Re-Tested for a Positive Drug Test Results?

• No.  DOT does not allow Drivers to be Re-Tested with a new Collection

🔵 Can Drivers Contest Positive Drug Test Results? (Split Specimen Confirmation Test)

• Yes.  The Driver may Request Sample B from the same Collection to be sent to another Laboratory for Testing.  Your company is charged $200 for Quest Diagnostics to ship sample B to another Laboratory for Testing

🔵 What happens if a Driver Requests a Split Specimen Test?

If the Driver Authorized a Split Specimen Confirmation the Process will begin Immediately upon Review of Documentation and the Driver's Verbal Request.  The MRO Authorizes the Transfer of Bottle B to another SAMSHA Certified Laboratory.

• 🟢 Express Labs charges $200 for Sample B to be Hazmat Shipped by FedEX to another Laboratory
• 🔵 If the Driver wants to Rescind the Request, and the Process has not been Initiated, they may Contact the Medical Review Officer at 800-526-9341
• 🔴 Federal Law Prohibits the Employer from Delaying or Canceling this Testing Process with regard to any monetary issues

🔵 What is a Split Specimen Confirmation Test?

A Split Specimen Confirmation Test is a safeguard provided to DOT Regulated Drivers who fail a Drug Test.  It allows the Driver to challenge the accuracy of their original test result by requesting that the "Split" portion of their urine sample be retested at a different DOT Certified Laboratory.  How the Split Specimen Process Works (49 CFR Part 40.171-40.185):

Initial Test (Primary Specimen "A" Bottle)

• The Driver provides a urine sample, which is split into two containers: Bottle "A" and Bottle "B"
• The "A" Bottle is tested first at a DOT Certified Lab
• If the Result is Positive, Adulterated or Substituted the Employer is notified by a Medical Review Officer (MRO)

Driver Requests a Split Specimen Test

• The Driver has 72 hours from the time they are Notified of the Positive Results to request a Retest of the "B" Bottle
• The MRO arranges for the Split Sample ("B" Bottle) to be sent to a different DOT Certified Lab for independent testing

Split Specimen Testing Outcomes

• If the Split Test confirms the original Positive Result, the Positive Result stands, and the Driver must complete the Return-to-Duty (RTD) Process with a Substance Abuse Professional (SAP)
• If the Split test is Negative, the original Result is Canceled, and the Driver is not penalized

🔵 What is Refusal-to-Comply?

• "Refusal-to-Comply" means that the Driver being Tested provided a Sample that was Determined to be Substituted by the Laboratory that is not Consistent with Human Urine (e.g., Abnormal Creatinine and Specific Gravity Levels).  A "Refusal-to-Comply" is treated the same as a Positive Drug Test Result under DOT Regulations.  Drivers are not permitted to Drive a Commercial Vehicle until they complete DOT's Return-to-Duty Process

🔵 What is a Refusal-to-Test?

A Refusal-to-Test under DOT regulations happens when a driver fails to comply with the drug and alcohol testing process in a way that is considered a refusal. Since a refusal is treated the same as a positive test result, the driver is immediately prohibited from performing safety-sensitive duties, including driving, until they complete the Return-to-Duty (RTD) process with a Substance Abuse Professional (SAP).  Reasons a test may be considered a refusal include:

• Failure to appear at the testing site without a valid reason
• Failure to provide a sufficient urine or breath sample without a legitimate medical explanation
• Refusal to cooperate with the testing process (e.g., refusing to sign necessary paperwork)
• Tampering with or adulterating the sample
• Leaving the testing site before the process is completed
• Delaying the test without a valid reason
• Failing to permit direct observation when required
• Failing to take a second test when directed by the collector
• Failing to cooperate with any part of the testing process (e.g., refusing to empty pockets, sign paperwork, or remove outer clothing when required)
• Admitting to the collector that you tampered with or adulterated the sample
• Possessing or using a device to cheat or alter the test

🔵 What happens to a Driver who Refuses to Test?

Once the Refusal is reported to the FMCSA Clearinghouse it remains on the driver’s record.  The driver must complete the SAP process before returning to DOT regulated safety-sensitive work (Driving).  This means:

1. Immediate Removal from Safety-Sensitive Duties: The driver is prohibited from operating a commercial motor vehicle (CMV) or performing other safety-sensitive functions
2. Return-to-Duty Process Required: To return to work, the driver must complete the DOT’s Substance Abuse Professional (SAP) process, which includes an evaluation, possible treatment or education, and a follow-up testing program
3. Possible Employment Consequences: Employers may terminate or suspend the driver based on their company policy
4. Record on the FMCSA Clearinghouse: The refusal is recorded in the FMCSA Drug & Alcohol Clearinghouse, impacting the driver’s ability to get another job in the industry

🔵 What happens if an Employer does not Report a Refusal to Test?

If an Employer fails to report a refusal to test under DOT regulations, they can face serious consequences, including civil penalties, enforcement actions, and potential liability.  Here’s what can happen:

• DOT Compliance Violations: The Federal Motor Carrier Safety Administration (FMCSA) or other applicable DOT agency may cite the Employer for Non-Compliance with 49 CFR Part 40 and Part 382
• Civil Penalties & Fines: The FMCSA can impose significant Fines per Violation.  Employers who knowingly allow a Driver who Refused testing to continue performing Safety-Sensitive (Driving) duties may face higher penalties
• Increased Liability: If an unreported Driver is involved in an Accident, the Employer may be held Legally Responsible for Negligence.  Lawsuits and claims could arise if it is discovered that the Employer did not properly remove or report the Driver
• FMCSA Clearinghouse Violations: Employers are Required to Report Drug and Alcohol Testing Violations (Refusals & Positive Alcohol Tests) to the FMCSA Drug & Alcohol Clearinghouse within 3 Business Days (per 49 CFR § 382.705).  Failure to Report could result in Suspension of DOT Operating Authority or further Compliance Investigations
• Potential Loss of DOT Operating Authority: Repeated Violations or willful Non-Compliance may lead to the Revocation of an Employer’s DOT Registration or Ineligibility to perform Safety-Sensitive functions (Driving)

🔵 What happens if the Results are Positive?

• If a DOT Drug Test Result is Positive, the Medical Review Officer (MRO) follows a strict process outlined in 49 CFR Part 40 to ensure fairness and compliance.  Here’s what happens:

1. MRO Receives the Positive Result

• The MRO, a Licensed Physician trained in substance abuse testing, receives the Confirmed Positive Lab Result and Reviews the Custody and Control Form (CCF) for any issues with the collection or testing process

2. MRO Contacts the Driver

• The MRO must attempt to contact the Driver confidentially
• The Driver has the right to explain the positive result (e.g., prescription medications, medical conditions)
• Only the MRO is authorized to discuss prescriptions with drivers
• If the MRO cannot reach the Driver within 24 hours, the MRO:
  • Asks the Employer to have the Driver contact the MRO within 72 hours
  • If no contact is made, the result is verified without a Driver Interview

3. MRO Evaluates Legitimate Medical Explanations

• If the Driver provides valid Medical Documentation (such as a legal prescription), the MRO may verify the test as Negative
• Important: DOT does not allow certain medications as a defense for positive results (e.g., medical marijuana, even if legal in the Driver’s state)

4. MRO Reports the Final Determination

• If the MRO verifies the Result as Positive (or Refusal-to-Comply), they:
  • Report the Results to the Employer’s Designated Representative (DER) email
  • Informs the Driver of their right to request a Split Specimen Test within 72 hours
  • Reports Positive, Adulterated or Substituted drug test results to the FMCSA Clearinghouse

5. Driver’s Right to a Split Specimen Test (Contested Results)

• The Driver can request a Retest of their Bottle B sample at another SAMHSA Certified Laboratory
  • If the Split Specimen Test confirms a Positive, the result stands
  • If the Split Specimen Test is Negative or Invalid, the original result may be canceled

6. Employer's Responsibility for a Positive Result

• The Employer must Immediately Remove the Driver from safety-sensitive duties (Driving) and give the Driver an SAP Referral
• The Driver must:
  • Complete an Evaluation with a DOT Qualified Substance Abuse Professional (SAP)
  • Pass a Return-to-Duty Drug Test (negative results required).
  • Undergo Follow-Up Testing (at least 6 tests in 12 months, up to 5 years)

🔴 What if an Owner Operator Test Positive?

• Express Labs does not Manage the Return-to-Duty/Follow-Up Process for Owner Operators.  Owner Operators who have a Violation in the FMCSA Clearinghouse can not Enroll in Express Labs Consortium.  Owner Operators who Test Positive for Drugs or Alcohol or Refuse-to-Test will be Terminated from Express Labs Consortium