Positive Results & Refusal-to-Test Instructions

Positive Results & Refusal-to-Test Process

Positive Result → Removal from Duty → Clearinghouse Required → SAP Process → Return-to-Duty

Overview

If a driver has a positive test or refusal-to-test, they must be:

• Removed from safety-sensitive duties immediately
• Referred to a Substance Abuse Professional (SAP)
• Reported to the FMCSA Clearinghouse

The driver must complete the SAP process and Return-to-Duty testing before returning to driving.

Positive Results Instructions

If a driver has a positive drug test result:

1. Employers must remove the driver from driving immediately
2. Employers must provide the driver with an SAP referral
3. Express Labs MRO reports the positive result to the FMCSA Clearinghouse

SAP Referral (Substance Abuse Professional)

• Find an SAP Referral - View SAPs
• Document that the driver was given a SAP referral

Can Drivers be Re-Tested?

• No. DOT does not allow re-testing of a positive result

Split Specimen Testing (Contested Results)

When a driver requests a split specimen test, the process begins immediately once the driver authorizes the request through the MRO.

The MRO coordinates the transfer of Sample B to a certified laboratory.  Under DOT regulations, drivers have the right to request this test, and employers may not delay or cancel the process for any reason.

Express Labs charges a $200 hazmat shipping fee for Sample B via FedEx.  Only the driver may rescind the request, and only if the process has not yet started, by contacting the MRO at 800-526-9341.

• Only the driver may request testing of Sample B
• Only the driver may rescind the request
• Requests must be made through the Medical Review Officer (MRO)
• Sample B is sent to a second SAMHSA-certified laboratory
• Testing begins immediately after the request is authorized
• The original positive result remains valid unless the split specimen test confirms otherwise

Refusal-to-Test Instructions

DOT requires employers to determine whether a test is a Refusal-to-Test based on the collector's notes and conversations with the collector and driver.

Refusal-to-Test may include:

• Failure to appear for testing
• Leaving the collection site before the test is completed
• Refusing to provide a specimen
• Tampering with a specimen

A refusal-to-test is treated the same as a positive result.

1. Remove the driver from duty immediately
2. Provide the driver with an SAP referral
3. Report the refusal to the FMCSA Clearinghouse within 3 business days

SAP Referral (Substance Abuse Professional)

• Find an SAP Referral - View SAPs
• Document that the driver was given a SAP referral

FMCSA Clearinghouse Reporting – View Instructions

• Employers must report positive tests and refusals to the Clearinghouse
• Express Labs is required by DOT to report violations for owner-operators

DOT Policy for Refusal-to-Test

Drivers who do not complete testing immediately after notification are considered to have refused-to-test, which carries the same consequences as a positive result.

• DOT Policy for Refusal-to-Test - View Policy
• DOT Policy for "Get Tested Immediately" (page 19) - View Policy

Positive Alcohol Test Instructions

If a driver has a positive alcohol test (0.04 or higher):

1. Remove the driver from duty immediately
2. Provide a SAP referral
3. Report the result to the FMCSA Clearinghouse

Alcohol Test Results

• 0.04 or higher (Positive): Remove from duty + SAP process
• 0.02–0.039 (Not Positive): Remove from duty for 24 hours
• Below 0.02: Negative

Important Compliance Notice

Positive tests and refusals are permanent DOT violations recorded in the FMCSA Clearinghouse and must be completed through the SAP process before returning to safety-sensitive duties.

Express Labs FMCSA Random Drug & Alcohol Consortium
Positive Results | Refusal-to-Test | Updated 2026