Implementation Guidelines - Federal Transit Administration - U.S. ...

efusal to drink is not considered a test
refusal. However, if the 3 hours have
expired and the employee refused to make
the attempt to provide a new urine specimen,
this is considered a test refusal, the process
must be discontinued, and the collector must
notify the DER.
If reattempts are made that also result in
insufficient urine volumes, the specimens
must be discarded. Under no circumstances
can a collector combine urine collected from
separate voids to create one specimen of
sufficient volume.
The only time a specimen with
insufficient volume would be maintained is
if a temperature reading could be obtained
and the reading was out of range or there
were visible signs of tampering or
adulteration. The collector will complete
the process with the insufficient specimen,
initiate a new collection under direct
observation and send both specimens to the
laboratory for analysis.
If the 3 hours have passed and the
employee is still unable to provide an
adequate specimen, the insufficient
specimen shall be discarded, testing
discontinued, and the DER notified. After
consulting with the MRO, the employer
must direct the employee to obtain a medical
evaluation from a licensed physician who is
acceptable to the MRO, and has expertise in
the medical issues raised by the employee’s
failure to provide a sufficient specimen. The
evaluation must be made within 5 business
days of the initial collection effort. The
medical evaluation must determine if the
employee has, or with a high degree of
probability could have, a medical condition
that could have precluded the employee
from providing a sufficient amount of urine.
A medical condition includes an
ascertainable physiological condition (e.g.,
urinary dysfunction) or a medically
documented pre-existing psychological
disorder, but does not include unsupported
assertions of “situational anxiety” or
dehydration. If no medical explanation is
found, the MRO will determine that the
employee refused the test. If a medical
explanation is found, the MRO will deem
the test cancelled for all test categories
except for pre-employment, return-to-duty,
and follow-up tests.
For pre-employment, return-to-duty, and
follow-up tests, the licensed physician
making the medical evaluation must also
determine under the direction of the MRO, if
the medical condition is a serious and
permanent, or long-term disability that is
highly likely to prevent the employee from
providing a sufficient urine specimen in the
future. If so, the MRO must determine via a
medical evaluation and consultation with the
individual’s physician if there is clinical
evidence that the individual is an illicit drug
user. The medical evaluation may include
conducting an alternative test (e.g., blood) as
part of the medical process used to
determine clinical evidence of drug use. If
no evidence of illicit drug use is found, the
MRO must report the test as negative. If
evidence is found, the MRO must report the
test as cancelled.
Observed Collections. As of August
31, 2009, USDOT requires mandatory direct
observation for all return-to-duty and
follow-up testing. This drug testing rule
applies to return-to-duty safety sensitive
employees who have already failed or
refused to take a prior drug test.
In the following circumstances, the
collectors are required to complete the first
collection and immediately require a second
collection made under direct observation:
The employee has presented a urine
sample that falls outside the normal
Chapter 7. Drug Testing Procedures 7-12 August 2002