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What Employees Need To Know About DOT Alcohol & Drug Testing. Part 3.

What are Medical Review Officers (MRO)?

Under DOT regulations, MROs are licensed physicians with knowledge and clinical experience in substance abuse disorders. They must also complete qualification training courses and fulfill obligations for continuing education courses. They serve as independent, impartial gatekeepers to the accuracy and integrity of the DOT drug testing program. All laboratory results are sent to an MRO for verification before a company is informed of the result. As a safeguard to quality and accuracy, the MRO reviews each test and rules out any other legitimate medical explanation before verifying the results as positive, adulterated or substituted.


How is an alcohol test administered?

The DOT performs alcohol testing in a manner to ensure the validity of the testing as well as provide confidentiality of the employee’s
testing information. At the start of the test, a Screening Test Technician (STT) or a Breath Alcohol Technician (BAT), using only a DOT-approved device, will:
• Establish a private testing area to prevent unauthorized people from hearing or seeing your test result.
• Require you to sign Step #2 of the Alcohol Testing Form (ATF).
• Perform a screening test and show you the test result. If the screening test result is an alcohol concentration of less than 0.02, no further testing is
authorized, and there is no DOT action to be taken. The technician will document the result on the ATF, provide you a copy and provide your
employer a copy.
If the screening test result is 0.02 or greater, you will be required to take a confirmation test, which can only be administered by BAT using an Evidential Breath Testing (EBT) device. The BAT will:
• Wait at least 15 minutes, but not more than 30 minutes, before conducting the confirmation test. During that time, you are not be allowed to eat, drink, smoke, belch, put anything in you mouth or leave the testing area.
Remember: Leaving the testing area without authorization may be considered a refusal to test.
• Perform an “air blank” (which must read 0.00) on the EBT device to ensure that there is no residual alcohol in the EBT or in the air around it.
• Perform a confirmation test using a new mouthpiece.

• Display the test result to you on the EBT and on the printout from the EBT.
• Document the confirmation test result on the ATF, provide you a copy and provide your employer a copy.
• Report any result of 0.02 or greater immediately to the employer.


If after several attempts you are unable to provide an adequate amount of breath, the testing will be stopped. You will be instructed to take a medical evaluation to determine if there is an acceptable medical reason for not providing a sample. If it is determined that there is no legitimate physiological or psychological reason, the test will be treated as a refusal to test.

Confirmation test results are the final outcome of the test. Result Action

Less than 0.02 No action required under 49 CFR Part 40.

0.02 – 0.039 Varies among DOT agencies. For example, FMCSA requires that you not resume safety-sensitive functions for 24 hours [382.505], while the FRA requires 8 hours [219.101(a)(4)]. The FTA & PHMSA require only that you test below 0.02 or cannot work until the next scheduled
duty period but not less than 8 hours from the time of the test [655.35 & 199.237 respectively]. And, the FAA requires only that you test below 0.02, if the employer wants to put you back to work within 8 hours [14 CFR Part 121, Appendix J, Sect. III.G]. Also, be sure to check other agency specific regulations for their restrictions.

0.04 or greater Immediate removal from safety-sensitive functions. You may not resume safety-sensitive functions until you successfully complete the return-to-duty process.


Should I refuse a test if I believe I was unfairly selected for testing?

Rule of Thumb: Comply then make a timely complaint. If you are instructed to submit to a DOT drug or alcohol test and you don’t
agree with the reason or rationale for the test, take the test anyway. Don’t interfere with the testing process or refuse the test.
After the test, express your concerns to your employer through a letter to your company’s dispute resolution office, by following an agreed upon labor grievance or other company procedures. You can also express your concerns to the appropriate DOT agency drug & alcohol program office. (See contact numbers listed in the Appendix.) Whomever you decide to contact, please contact them as soon as possible after the test.


What is considered a refusal to test?

DOT regulations prohibit you from refusing a test. The following are some examples of conduct that the regulations define as refusing a test (See 49 CFR Part 40 Subpart I & Subpart N):


• Failure to appear for any test after being directed to do so by your employer.
• Failure to remain at the testing site until the testing process is complete.
• Failure to provide a urine or breath sample for any test required by federal regulations.
• Failure to permit the observation or monitoring of you providing a urine sample (Please note tests conducted under direct observation or monitoring occur in limited situations. The majority of specimens are provided in private).
• Failure to provide a sufficient urine or breath sample when directed, and it has been determined, through a required medical evaluation, that there was not adequate medical explanation for the failure.
• Failure to take a second test when directed to do so.
• Failure to cooperate with any part of the testing process.
• Failure to undergo a medical evaluation as part of “shy bladder” or “shy lung” procedures.
• Failure to sign Step #2 of the ATF.
• Providing a specimen that is verified as adulterated or substituted.


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