JUNE 21, 2017 – Circumstances can get pretty complicated in the event of a positive drug test result – especially for companies regulated by the Department of Transportation. The DOT has strict regulations regarding the steps that must be taken afterwards. So let’s get into it:  What happens if an employee tests positive?

I received a positive drug test result, but the employee says it’s a mistake because he’s never used drugs

This is a fairly common claim that employers encounter after receiving a positive result, which is why it’s important to understand the measures the DOT has in place to address this argument:

  • After a drug test is taken, the urine specimen is split into two separate vials – Vial A and B – which are shipped to a laboratory.
  • The laboratory tests Vial A. If drugs are detected, the specimen goes into further testing to confirm the presence of drug metabolites, and is eventually reported to a DOT Medical Review Office (MRO) as positive for at least one controlled substance.
  • Once the MRO receives a positive laboratory result, a “medical review” takes place. This review consists of the following steps:

1.   A DOT qualified physician – the Medical Review Officer – attempts to make contact with the employee in order to conduct an interview.

2.  During the interview, the MRO will determine whether there is a valid medical explanation as to why the specimen may have tested positive.

3.  If the MRO determines there is no medical explanation, they will offer the employee the option to have Vial B tested (as described above) in order to verify that no error was made.

  • After the medical review process is complete, the final result is reported to the employer as a verified positive.
  • If the MRO is unable to reach the employee to conduct the interview after a minimum of 3 contact attempts have been made, the result will report to the employer as a “non-contact positive.”


Split-Specimen Testing

If the employee opts to have the split specimen tested, he or she must make the request to the MRO within 72 hours. At that time, Vial B will be shipped to a laboratory for testing. This cannot be the same laboratory used to analyze the first sample.


I have an employee who is on prescribed medication and doesn’t want to test for fear that the result will be positive

This is another fairly common scenario, but thanks to the medical review process, it should be of no concern. If during the MRO interview the employee states that he is taking prescribed medication, he will be given the opportunity to provide proof of the prescription to the MRO. Once a valid prescription is received, and it is determined that the employee is using the medication as prescribed, the final result will report out to the employer as a verified negative.

An employee who has been prescribed medication may be required to obtain a note from the prescribing physician that the medication will not affect their ability to perform safety-sensitive functions.


The DOT Return-to-Duty Process

As you might expect, if an employee does test positive, the process they must complete prior to resuming safety-sensitive functions is often not a quick one. This process consists of the following steps:

  • An initial Evaluation with a DOT-qualified Substance Abuse Professional (SAP) – This face-to-face interview will determine the course of action the employee must take.
  • Education/Treatment – The employee must comply with the SAP’s recommendations. This could be anything from attending several group meetings to in-house rehabilitation.
  • Follow-Up Evaluation – This must take place with the same SAP who conducted the initial evaluation and will determine whether the employee has satisfied the recommendations.
  • DOT Return-to-Duty Drug Test – When this test comes back negative, the individual may resume safety-sensitive functions. It must be completed under direct observation, meaning a person of the same sex must accompany him or her during the urination process.
  • DOT Follow-Up Testing – The SAP will provide the employer with a schedule of follow-up tests, in which a minimum of 6 unannounced tests conducted under direct observation are to be scheduled over at least a 12 month period. This process may continue for up to 5 years.


My FMCSA-regulated driver admitted to me that she uses drugs

This is what’s known as “Actual Knowledge” and it carries the same consequences as a positive result.

If you are regulated by a DOT agency other than the FMCSA, please call 800-253-5506 for assistance.


An employee refused to take a required test. Now what?

This is what’s known a “Refusal to Submit.” It carries the same consequences as a positive result.


Does a positive alcohol test carry the same consequences as a positive drug test?

Yes. Stay tuned for our next blog, which will focus specifically on alcohol testing.