Once a drug test specimen is collected, it goes through a detailed, regulated process designed to ensure accuracy, fairness, and confidentiality. Here’s what happens behind the scenes.
Step 1: Specimen Shipment & Lab Accessioning
- The specimen is shipped to the laboratory via courier or FedEx.
- Upon arrival, the lab accessions the specimen:
- Confirms receipt
- Logs it into the system
- Reviews the Chain of Custody Form (CCF) for errors or missing information
- Confirms receipt
Step 2: Initial Laboratory Screening
- An initial screening test is performed.
- A certifying scientist reviews the results and releases them to the Medical Review Officer (MRO).
Results at this stage:
- Negative: Reported to the MRO as negative.
- Non-negative: The specimen must undergo confirmatory testing.
Step 3: Confirmatory Testing (If Required)
If a non-negative result occurs, confirmatory testing is performed using advanced methods such as:
- Gas Chromatography/Mass Spectrometry (GC/MS or LC/MS/MS)
- Identifies and quantifies specific drug(s)
Once complete:
- A certifying scientist reviews the findings.
- Results are released to the MRO.
Step 4: Medical Review Officer (MRO) Review
Negative Results
The MRO and their team will:
- Review Copy 2 of the CCF for errors or flaws
- Review the laboratory test results
- Confirm the CCF is legible and signed by the donor
- Sign and date the CCF, marking the test as negative
- Report results confidentially
Positive (or Non-Negative) Results
For confirmed non-negative results, the MRO must:
- Review Copy 2 of the CCF for errors or flaws
- Review the lab report
- Confirm a legible, signed CCF is on file
- Conduct a verification interview with the employee
DOT Regulation Reference (§ 40.131)
The MRO must directly contact the employee (confidentially) to determine whether they wish to discuss the result. If the employee declines, the test may be verified as positive or as a refusal, depending on the circumstances.
Step 5: Verification & Final Determination
- If a legitimate medical explanation exists, the MRO may:
- Contact the pharmacy to verify a prescription
- Request medical documentation (e.g., emergency room records)
- Contact the pharmacy to verify a prescription
- If verified as legitimate:
- The result is adjudicated and reported to the employer accordingly.
- The result is adjudicated and reported to the employer accordingly.
- If no legitimate medical explanation exists:
- The MRO must verbally notify the Designated Employer Representative (DER) of the positive result.
- The MRO must verbally notify the Designated Employer Representative (DER) of the positive result.
- The MRO documents:
- All interviews and communications
- Record reviews
- Dates and times of contact
- All interviews and communications
All results are reported in a confidential and compliant manner.
Why Are Results Sometimes Delayed?
Several factors can impact turnaround time, including:
- The collection site did not ship the specimen promptly
- The specimen missed the daily courier pickup
- Weather-related shipping delays
- Missing or incomplete CCF details requiring affidavits:
- Temperature box not checked
- Electronic CCF reprinted without a wet signature
- Temperature box not checked
- Confirmatory testing can take 5–7 business days, depending on substances detected
- Timing delays between the lab reporting results and the MRO receiving them
- Results reported over the weekend may not be reviewed until Monday
- The CCF was not sent to the MRO and must be located
- Lab results not yet imaged in the system
- Difficulty contacting the employee:
- Unanswered calls or messages
- Incorrect phone number on the CCF
- Prescription information unavailable
- Pharmacy closed
- Unanswered calls or messages
- DER unavailable to assist with contact or receive the MRO’s call
Our Commitment to Accuracy
At Tom Allen Enterprises, Inc., we pride ourselves on doing things the right way. We treat every drug test as if it could be reviewed in court. While speed is important, accuracy, compliance, and integrity matter more.