A negative drug screen is a negative drug screen and a positive is positive, right? Employers calling our facility ask this question often. The answer is “not necessarily.” Regardless of the screen, when a negative result is determined, the answer to the question is “yes.” Turnaround time for this result ranges from almost immediate to 48 hours. However, if the test doesn’t yield a negative result, the initial outcome is reported as a “non-negative” and can take up to a few days to confirm the result.
The longer reporting time is caused by an interim step that ensures the rights of the employee before the testing facility determines someone to be positive for illegal substances. It’s termed the “medical review” process, and it’s during this step that many employers become frustrated at the “delayed” reporting. However, results truly aren’t delayed; simply, the medical review officer (MRO) is following specific protocols to confirm the results. The process is extremely detailed, so for the sake of clarity, let’s turn to an example.
A specimen for a DOT screen is collected and sent to the lab. An overnight carrier transports the specimen to the lab, and the lab, in turn, analyzes the specimen. The lab reports test results to the MRO. If the specimen is negative, the MRO receives and immediately reports the result to the employer.
However, if the specimen is positive for a targeted substance, the MRO must take extra steps to ensure the validity of the result. In most cases, the MRO follows specific guidelines and documents each step to ensure consistency with positive test results and provides a legally sound position for the employer and MRO.
In brief, the MRO must attempt to contact the employee at least three times in the first 48 hours to review the results. After 48 hours, the physician may use the employer as a means of contacting the employee. Once contact has been successful, the MRO reviews any possible medical reasons (possible legal medications in the specimen, for example) the employee could have a non-negative result. If none exist, the MRO informs the employee the test is a positive and that it’s his right to challenge the result by an independent lab. If the employee indicates he won’t challenge the results, the MRO signs off on a positive result and then reports it to the employer.
After the MRO reviews the findings to the employee, he has the right to challenge the results. The MRO reviews this right with the employee. If the employee is ambivalent, he can initiate a challenge verbally to the MRO within 72 hours. During a challenge, the lab will send the original specimen to another lab for confirmation. During this process, employer notification includes only that a review is ongoing, but results aren’t available.
As you can see, the process of validating results through the MRO process can be time consuming. In most cases—especially the case of a medically reviewed result—the time is well spent. It ensures consistency and accuracy. IBI