Who decides when a DOT drug test is a refusal to test?

Use the following list of drug-testing situations (as specified in 49 CFR Part 40) to know whether your designated employer representative (DER) must make the judgment call or leave it to the Medical Review Officer (MRO).

The following situations require the decision maker to:

• Evaluate the circumstances,
• Compare them against the regulations, and
• Then decide whether the event qualifies as refusal to test.

The DER makes the determination when:

• The driver fails to appear at the site or spends too much time getting there.
• The collector reports that the driver left before the testing process was complete.
• The collector reports that the driver left the collection site before providing a required specimen.
• The driver doesn’t permit an observed collection when ordered by the employer or allow a monitored or observed collection when instructed by the collector.
• The driver fails or declines to take an additional test when directed by the employer or collector (when required or permitted by the DOT).
• The driver fails to cooperate with any part of the collection process, including:
  • Refusing to empty pockets when directed;
  • Behaving in a confrontational manner that disrupts the collection process;
  • Refusing to remove hat, coat, gloves, or coveralls when directed; and
  • Failing to wash hands when directed.
• For an observed collection, the driver fails to follow the instructions to raise and lower clothing and turn around.
• The driver possesses or is wearing a device designed to carry clean urine or a urine substitute.
• During the collection process, the driver admits to the collector that they adulterated or substituted the specimen.

Examples when the MRO acts as the decision maker include:

• The driver fails to provide sufficient specimen, and the MRO finds no medical explanation.
• The driver fails to undergo a medical examination or evaluation as directed by the MRO or employer.
• The lab reports an adulterated or substituted urine specimen, and the MRO finds no medical reason during the verification process with the driver.
• During a medical review, the driver admits to the MRO that they tampered with the specimen.