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The MRO may change a verified test
result (§40.149) only if additional
information is obtained from the employee,
laboratory, or other source (e.g., prescribing
physician) that impacts the MRO’s
determination. The MRO has the sole
authority under the regulation to make
medical determinations, and as such is the
only one that may change a verified test
result. An arbitrator or employer is not
permitted to overturn the medical judgment
of the MRO regarding whether there is a
legitimate medical explanation for a nonnegative
test result.
The MRO may only consider test results
in the verification process that were obtained
in accordance with Part 40. Thus, results of
tests conducted by other entities or tests
using hair or blood specimens cannot be
used by the MRO. Likewise, DNA test
results must be ignored. The MRO must not
play a role in any disputes with the employer
regarding the circumstances leading up to
the test, nor should he/she be sympathetic to
employee assertions of inadvertent contact,
unknowing use, or other explanations that
do not constitute a legitimate medical use.
The MRO cannot accept any explanations
for the presence of phencyclidine or 6-AM
in a specimen. Nor is it possible to have a
urine specimen with bleach, soap, or
glutaraldehyde or one without creatinine.
MROs cannot take into consideration the use
of marijuana under “medicinal marijuana”
state laws that are not recognized by the
DOT or the use of hemp products.
Not all physicians have the specific
clinical experience or knowledge necessary
to become MROs. The basic knowledge
requirements, qualifications training, and
continuing education requirements will
further limit the availability of MROs.
However, there are a number of MRO trade
associations that offer the required training
and certification programs to interested
physicians. Each of these organizations
offer listings of qualified MROs that could
serve as a starting point when an agency
tries to identify a new or replacement MRO.
These organizations are listed in the
following chart.
Organization
Contact
Information
American www.aamro.com
Association of
Medical Review (800) 489-1839
Officers
American Society www.asam.org
of Addiction
Medicine (301) 656-3920
American College www.acoem.org
of Occupational and
Environmental (847) 818-1800
Medicine
Medical Review www.mrocc.org
Officer Certification
Council (847) 303-7210
When selecting a qualified MRO, you
should:
1. Review qualifications, medical
license, memberships, dates of
qualification training and subsequent
continuing education training, and
other relevant training and
experience to ensure minimum
standards are met;
2. Have the MRO describe his or her
methods for remaining informed of
MRO policies and practices (e.g.,
attending conferences, additional
training, memberships, newsletters,
etc.);
3. Check references for similar work
performed;
4. Assess ability to work with
collection sites, testing laboratories,
Chapter 7. Drug Testing Procedures 7-23 August 2002