Positive Results & Refusal-to-Test Instructions

Positive Drug Test Results Instructions

Remove the Driver from the road immediately and provide a Substance Abuse Professional (SAP) Referral.

SAP Referral

• DOT requires the Employer to Document that the Driver was given a SAP Referral
• Find an SAP Referral

Clearinghouse Reporting

• Positive DOT Drug Test Results are reported to the Clearinghouse by the Express Labs MRO

Can Drivers be Re-Tested?

• A new Drug Test cannot be used to overturn a verified Positive Result.  Drivers may request Split Specimen Testing through the MRO.

Split Specimen Testing

If a Driver requests Split Specimen Testing (Contested Results) through the MRO, Sample B is sent to a second SAMHSA-Certified Laboratory for Testing.

• Employers may not delay, cancel, or interfere with the process
• Express Labs charges $200 per Positive Drug Test for Split Specimen Shipping and Testing

Refusal-to-Test Instructions

Employers must review all available information and circumstances before determining whether a Driver’s conduct constitutes a Refusal-to-Test.  This may include Collector’s Notes and conversations with the Collector and Driver.

• Remove the Driver from the road immediately and provide a Substance Abuse Professional (SAP) Referral.  A Refusal-to-Test is treated the same as a Positive Result.
• Failure to Get Tested Immediately when Notified for Random Testing is a Refusal-to-Test.

SAP Referral

• DOT requires the Employer to Document that the Driver was given a SAP Referral
• Find an SAP Referral

Clearinghouse Reporting

DOT requires Employers to report Refusal-to-Test Violations to the Clearinghouse.

• Clearinghouse Reporting

DOT Refusal-to-Test Definition & Examples

• DOT Refusal-to-Test Rule – 49 CFR §40.191
• DOT Refusal-to-Test Consequences
• DOT Policy for "Get Tested Immediately"  (page 19)

Positive Alcohol Test Instructions

Remove the Driver from the road immediately and provide a Substance Abuse Professional (SAP) Referral.

SAP Referral

• DOT requires the Employer to Document that the Driver was given a SAP Referral
• Find an SAP Referral

Clearinghouse Reporting

DOT requires Employers to report Alcohol Test Results of 0.04 or higher and Refusal-to-Test violations to the Clearinghouse.

• Clearinghouse Reporting

Alcohol Test Results

• 0.04 or higher - Remove the Driver from the road immediately and provide a Substance Abuse Professional (SAP) Referral.
• 0.02–0.039 — Remove the Driver from the road immediately for 24 hours
• Below 0.02 — Negative Result

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