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Service Agents Series: Your Required Medical Review Officer or “MRO”
Your Required Medical Review Officer or “MRO”
This is the third installment in a series about the roles of DOT Service Agents (SAs) the people who help you implement your drug free workplace program.
After an employee participates in a DOT urine drug screen the specimen is sent by the urine collector to and processed by a DOT approved laboratory.
That process generates an initial result that is electronically sent to and reviewed by an Medical Doctors acting in the DOT Service Agent role of Medical Review Officer or “MRO”.
The urine collector also is required to send or electronically transmit the Medical Review Officer copy of the DOT urine collection Control and Custody Form of “CCF” to the MRO.
The MRO’s job is to review the initial result of a drug screen and determine several things:
- Is the result properly documented?
- Have they (the MRO’s office) received their copy (physical or electronic) of the drug screen form yet?
- Does the (the MRO) require additional information to determine the final result of a drug screen and report it.
- Is the test a positive drug screen result requiring an interview with the urine donor (employee that got tested)?
- Make contact with the donor (employee that got tested) when required and contact the employer when required.
- Make the final determination of the result
- Report the result of the drug screen to the donor’s employer either directly or through their (the donor’s employer) service agent authorized to do so.
- Determining and reporting negative DOT drug screen results
Most of the time results are negative and don't require any further action on the part of the MRO’s office so they report them out usually within 24 of receiving the initial results. Most MRO’s offer multiple options for getting a result including secure fax, email, and secure web portal access.
Determining and reporting positive DOT drug screen results
In the event of a positive result depending on how long it takes the MRO to get in touch with a donor (if the MRO needs to speak to them) before determining and reporting a result. Sometimes positive results can take a day or two longer to report.
The DOT requires results be processed and reported in a timely way so generally results are available between 24 to 48 hours after the lab receives the urine sample.
Delays in reporting results
MROs aren't allowed to report a DOT urine drug screen result until they have their copy and are able to determine it was filled out properly.
In some cases when the collection site does not send the MRO copy of the testing form to the MRO, results can end up being delayed until they receive it.
Mydrugtestingprogram.com sets all our clients up with an MRO that offers 24/7 online access to results and records through a secured system as well as 24/7 toll free live customer service.
Service Agent Series 2: Your DOT approved and certified lab
Your DOT approved and certified lab
The DOT regulations require that motor carriers required to have a drug free workplace program work with a laboratory certified by the Substance Abuse and Mental Health Service Administration (SAMSHA).
How do you get set up with an approved lab?
Most motor carriers work with a Third Party Administrators TPA who handles getting you set up with an certified clinical lab and a Medical Review Officer (MRO) (we cover MROs in another blog post).
The lab then has special DOT drug testing collection forms called “control and custody” (CCF) forms customized for you and printed and then sent to you. These are the forms that your driver takes with whenever having any required drug testing done. The collection site staff fills the form out and packages it up with special DOT approved specimen collection kits that are then shipped to the lab for processing.
What the laboratory does:
The Laboratory receives the packaged up urine specimen and the lab copy of the Control and Custody Form filled out during the collection. The Lab follows strict federal guidelines for processing the specimen and testing it for controlled substances.
What drugs does the lab test for and how
For DOT testing the lab runs what’s called a NIDA 5 panel drug screen that tests for the presence of the drug itself or the metabolites that the body produces when the drug is in it’s system.
Here are the five classes of drugs that are tested for:
- Marijuana
- Cocaine
- Opiates – opium and codeine derivatives
- Amphetamines and methamphetamines
- Phencyclidine – PCP
When the lab is finished they transmit preliminary results to the Medical Review Officer (MRO) who then reports the final results to the driver’s employer and/or TPA depending on how they’re set up.
Under the DOT regulations labs are required to store (for a period of time) the second untested half of the urine specimen for retesting if an employee wished to contest a result. In those cases, after the notification of the request to retest, the lab will then send the remaining specimen to another certified lab for additional testing.
Generally you will have no direct contact or interaction with the lab pertaining to your account or test results. Mydrugtestingprogram.com handles getting our clients set up with a certified clinical lab and forms and MRO.
What types of testing are you required to do?
What types of testing are you required to do?
If you are required to have a DOT drug testing under the regulations for motor carriers found in the Code of Federal Regulations (CFR) Title 49 part 382 and 40 , then there are 5 types of drug and 4 types of alcohol testing you must do when required.
DOT approved drug testing for all drug screening is a NIDA 5 panel drug screen, collected at a complying collection site, packaged and shipped in a complying chain of custody processed, tested at a Federally approved clinical laboratory, and reported by a Medical Review Officer (MRO) following DOT guidelines for handling results.
DOT approved alcohol testing comes in two types and two approved methods. The initial screening can be done by any Federally approved breath or saliva screening method. However if an initial alcohol screening test is above the allowed limit, then a second confirmation test must be done using a federally approved Evidential Breath Testing device (EBT). Blood testing is not allowed for either the initial screening or confirmation testing.
Pre-employment drug testing (no alcohol)
The first type of testing is pre-employment drug screening of new employees who are required to be a in a drug-free workplace program. Typically those are employee required to hold a CDL license. There are exceptions to the rule for pre-employment testing (click here to see the post covering it detail).There is no required pre-employment alcohol testing.
Random drug and alcohol testing
Random drug and alcohol testing is to be submitted to by covered employees (generally CDL holders) who have been selected by a scientifically random method at the rate required by the regulations. An employee who has been notified of a required test must proceed immediately for testing. They may not refuse, interfere with, or tamper with the testing in any way or it will be considered a refusal which carries the same consequences as a positive result.
Post-accident drug and alcohol testing
Whenever a covered driver has an accident that either results in an injury to any party, requires any vehicle involved to be towed, or results in a citation to the CDL driver, they are required to submit to post-accident drug and alcohol testing. They are to have the testing done as soon as possible which can sometimes present some challenges depending on the location of the accident and the hour of the day. There are some cases where if the testing is delayed too long it can be skipped but there is some extra documentation required to explain the delay/omission of testing.
The last two types of testing are both for employees that are returning to work after a positive (or violation with the same consequences).
The first is Return to Duty drug or alcohol testing (depending on the circumstance). It/they must be administered and return negative before an employee is allowed to return to safety sensitive duties.
The second is Follow Up testing. This type of testing can vary in frequency which is determined by a Substance Abuse Professional (SAP) who makes the determination (following the DOT guidelines) when/if an employee is allowed to return to safety sensitive duty and how often they are to have follow up testing.
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