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June 2020: The MRO Process

In recent weeks I have received several e-mails from SAPs who don’t fully understand the MRO process in Part 40.
The MRO must contact every employee who has a laboratory positive, and must investigate an employee’s claim that his/her prescription medication caused the positive test result.
In conducting this investigation, the MRO often calls the prescribing medical professional to verify the prescription, and calls the pharmacy to verify that the prescription was indeed supplied to the employee.
If the MRO finds that 1) the prescription was legitimate, and 2) the pharmacy actually dispensed the prescription to the employee, then the MRO is required by the law, to downgrade the test result to negative, and the employee would not have a violation and would not be needing a SAP evaluation. 
On the other hand, if the MRO discovers that there was no prescription, or that the pharmacy has no record of providing a prescription to the employee, then the MRO can only conclude that the employee is lying about having a prescription, and therefore is using drugs illegally, likely purchasing drugs on the street.
40.293(f) says “For purposes of your [SAP] role in the evaluation process, you must assume that a verified positive test result has conclusively established that the employee committed a DOT drug and alcohol regulation violation.
Here’s what that means for you as a SAP:
  • You should not pay attention to anything that the employee tells you about a prescription; the MRO has already looked into this and decided it’s not possible.
  • You should ignore what the employee tells you he/she has learned on the web about effects of various drugs combining with foods, alcohol, or over-the-counter medications.  The MRO has also looked into this.
  • You must assume that the MRO's verification is a firm determination that the employee is using drugs illegally
An employee who tries to pull you into a conversation about prescription medications is wasting your valuable time.  Do not let an employee tell you stories about a prescription.

Employers are confused about the return-to-duty test

Unfortunately, there are employers who look at a driver’s record on the Clearinghouse and even though the SAP has entered a date of compliance, the Clearinghouse record shows that the driver is not able to drive.  That’s because he needs a negative return-to-duty result, which only the prospective employer can arrange for.  The moment that the employer enters the date of the negative return-to-duty test, the driver’s dashboard will then show that he can drive.
However, as a SAP you can’t order a return-to-duty test for a driver.  As a service agent, you don’t have authority to order any tests.  Also, a driver can’t decide for himself to take a return-to-duty test.  Only an employer can order a return-to-duty test, and the employer would do that when he hires a driver.  If he is an owner/operator, his C/TPA will order the return-to-duty test and record the result on his record in the Clearinghouse.
Some employers do not understand this.  Even though nothing has changed in the rules, some employers think that the SAP should be ordering a return-to-duty test and entering the date on the Clearinghouse.  But you can’t.  You may have to explain this to an employer.  If you don’t explain this, the driver won’t get hired.  This has happened more than once, and every time, it helped when the SAP got involved by calling the employer and explaining the process.

Clearinghouse Report for June

The June report was published by the Clearinghouse in July.  To view the report,
On page 2, you will see a significant uptick in queries.  That is an indication of more drivers being hired, and the report shows 109,000 full queries.  (When an employer is hiring a driver, the employer is required to conduct a full query.)
On page 3, you will see an increase in positive tests and refusals, which is probably because employers are getting back into the groove of testing, after having cut back on testing and hiring during the COVID shutdowns of March/April/May.

No longer necessary to give copies of SAP reports to a driver

Prior to the Clearinghouse, drivers sometimes requested a copy of your SAP reports, because they wanted to show an employer that they had completed a SAP process, and were ready to return to safety-sensitive functions.  Now, however, a prospective employer can immediately know that, when he queries the driver’s dashboard on the Clearinghouse, making it no longer necessary for the driver to have copies of your SAP reports.  Upon hiring the driver, the employer needs to obtain the SAP's follow-up testing plan from you.  At that time, you should send both SAP reports (Initial Report and Follow-up Evaluation Report) along with the follow-up testing plan.
An employer should always receive copies of TWO SAP reports (Initial Report and Follow-up Evaluation Report).  An auditor will routinely check to see that the treatment that you recommended (on the Initial Report) matches the treatment plan that the employee completed (on the Follow-up Evaluation Report).  If these two items don’t match, the auditor will want to find out who changed them, and why, since 40.297 says that no one can change the SAP's treatment recommendation.

SAPlist UREMINDER: SAPlist U For Your Continuing Ed Requirement

SAPlist U provides 12 hours of continuing education related to DOT's testing rules.  It is endorsed by EACC, NASW, and NBCC.  It’s online, convenient, and you can complete it at your own pace.

Go to SAPlist U Continuing Ed
Until next time,

Lee Mauk signature

Lee Mauk  | and SAPlist U
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