“We have a provider who in the past worked in a facility that whenever a driver has a history of previous illegal substance abuse they gave them a drug screen (non dot) with every physical in order to certify.

Today we had a driver that admitted to previous use and refused a drug screening for his physical. 

Do you have any thoughts?  I am stumped as I never have had a provider drug screening during a physical without the request of a company.”

It is the certified medical examiner’s discretion to require/order a non-DOT drug test for DOT Physical based on history, exam findings or any other criteria the examiner wishes.  For example, often there is a shared medical record in healthcare systems where the examiner has access to previously and current prescribed medications.  This may be a reason to order/require a drug test.

If the examiner decides they need such a test in order to qualify the driver and the driver refuses, the examiner may disqualify the driver and report it to the national registry.  This would cause the FMCSA to investigate should they then receive a qualified entry shortly thereafter from another examiner who may not be made aware of the driver’s history.

The DOT physical exam requirements do not include a drug test, only  requires  a  a urine sample. This is used to screen  kidneys for potential medical conditions.

There is no Federal prohibition resulting from a driver testing positive on a non-DOT drug test. 49 CFR §40.13 requires that DOT and non-DOT testing be completely separate.

There are circumstances when a DOT driver admits to using controlled substances to a company official that would in some cases as defined in the National Institute of Drug Abuse (NIDA-5) for a 5 panel DOT drug test, however,  the self-admission does not meet the criteria under 49 CFR § §382.121 ( a) (1-4)382.121 (a) (1-4) or the employer does not have a qualified voluntary self-identification program under 49 CFR §382.121 (b). Does this trigger a DOT Evaluation and the return-to-duty process?  (Yes. If an employee admission does not fall under 49 CFR §382.121 , then by default the admission provides the employer with “actual knowledge” of drug or alcohol use, which triggers a DOT SAP return-to-duty process under Part 382, Subpart B.)

    This is true for DOT drug test under CFR 382. 

    Under medical examination of the driver 49CFR391.41, medical examiner can order/require a drug test for DOT exam or whatever test they deem necessary to make a determination, non-DOT drug test, sleep test, EKG, pulmonary functions, etc completely at the discretion of the medical examiner.

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