Under DOT rules, a refusal to test has the same consequences as a verified positive result. The employee must be removed from safety-sensitive functions immediately and cannot return until completing the return-to-duty process with a Substance Abuse Professional (SAP) (49 CFR 40.23 and Part 40, Subpart O).

What counts as a refusal

49 CFR 40.191 (drug tests) and 40.261 (alcohol tests) list the conduct that is a refusal. Examples include failing to appear for a test within the time the employer sets, leaving the collection site before the test is complete, failing to provide a specimen without a valid medical explanation, and an adulterated or substituted specimen as verified by the MRO.

Only the collector, the MRO, or the employer (DER) can determine a refusal, each within the limits of the rule. Refusals by FMCSA-regulated drivers are also reported to the FMCSA Drug and Alcohol Clearinghouse.

Record the outcome of a test request · 49 CFR Part 40, Subpart O: Return-to-duty process