DOT Positive Drug Tests

By Mike Every, Foley

As we addressed in our last article, “DOT Return-to-Duty & Follow-Up Testing,” the consequences of receiving a positive test result are pretty steep, and can create a difficult situation for the employer. That’s why it’s important to be prepared and understand the DOT testing processes.


“A positive result? It must be a mistake!”

This is a fairly common claim that employers hear when confronting an individual who has received a positive result. This is why it’s important to understand the measures the DOT has in place to address this argument.

  • After an employee takes a drug test, the urine specimen is split into two separate vials — Vial A and B — and shipped to a laboratory.
  • The laboratory tests Vial A. If drugs are detected in the sample, the specimen goes into further testing to confirm the presence of drug metabolites. It is then 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:
    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, it is at this time that the split specimen comes into play. The MRO will offer the employee the option of having Vial B tested in order to verify that no error was made. 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 different laboratory than the one that tested Vial A.
  • After the medical review process is complete, the final result is reported to the employer.
  • If the MRO is unable to reach the employee to conduct the interview after a minimum of three contact attempts, the result will be reported to the employer as a “non-contact positive.”


“But I have a prescription!”

It’s understandable that an employee may be concerned about a positive test result if they are on certain prescription medications, but thanks to the MRO review process, there is no need to worry.

If during the MRO interview the employee states that he or she is taking a prescribed medication, the employee 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.

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

For more information on DOT Drug & Alcohol Testing, please call Foley at 800-253-5506.

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