What Happens in the MRO Verification Interview, and What If the Employee Cannot Be Reached?

When a laboratory reports a confirmed positive, adulterated, substituted or invalid result, the MRO does not simply pass it on. The MRO first offers the employee a confidential interview to look for a legitimate medical explanation. Sections 49 CFR 40.131 and 40.133 set the contact steps and the limited cases where the MRO can verify a result without talking to the employee.

The first contact. The MRO contacts the employee directly and confidentially, meaning the MRO actually talks to the employee, to find out whether the employee wants to discuss the result. The MRO explains that if the employee declines, the MRO will verify the test as positive or as a refusal (49 CFR 40.131(a)).

What MRO staff may do. Staff under the MRO's personal supervision may make the first contact, but only to schedule the discussion and explain the consequences of declining. Staff must not gather medical information or explanations, though they may tell the employee to have prescriptions and similar information ready (49 CFR 40.131(b)).

When the employee cannot be reached. The MRO or staff make reasonable efforts, at least three attempts spaced reasonably over 24 hours, using the day and evening phone numbers on the CCF. If those fail, the MRO documents the attempts and contacts the DER. The MRO tells the DER only to have the employee call the MRO, and does not reveal the lab result (49 CFR 40.131(c)).

The DER's part. The DER tries to contact the employee immediately, protecting confidentiality as much as possible. The DER tells the employee to contact the MRO immediately and explains the consequence of not doing so within 72 hours. If three attempts over 24 hours fail, the DER may place the employee on temporary medically unqualified status or medical leave and leaves a message by any practicable means (49 CFR 40.131(d)). DER responsibilities cover this role more broadly.

Verification without an interview. The MRO may verify a positive or refusal without an interview in three cases (49 CFR 40.133(a)):

• The employee expressly declines to discuss the result.
• The DER reached the employee and told the employee to contact the MRO, and more than 72 hours have passed.
• Neither the MRO nor the DER could reach the employee within ten days after the MRO received the result.

An invalid result follows the same three paths but is verified as cancelled, with an immediate observed recollection (49 CFR 40.133(b)).

Reopening. After such a verification, the employee has 60 days to show the MRO that serious illness, injury or other circumstances unavoidably prevented contact. The MRO may then reopen the verification (49 CFR 40.133(d)).

During the interview. The employee can explain medications that might cause a positive. Only a legitimate medical explanation changes the result.