Can an MRO Change a Verified DOT Drug Test Result?

Yes, in the situations listed in 49 CFR 40.149(a). Section 40.149(c) states that the MRO is the only person permitted to change a verified test result, such as a verified positive or a refusal to test because of adulteration or substitution, because the MRO has "the sole authority under this part to make medical determinations leading to a verified test." The rule gives the example that an arbitrator is not permitted to overturn the MRO's medical judgment.

Under 40.149(a), the MRO may change a result after reopening a verification that was done without an interview, as provided in 49 CFR 40.133(d). The MRO may also change a result on information, not available at the original verification, showing that the laboratory made an error in identifying or testing the primary or split specimen, such as a paperwork mistake or a false positive or negative. A result may also be changed when the MRO made an administrative error and reported an incorrect result.

Within 60 days of the original verification, the MRO may change a result on information that could not reasonably have been provided at the time showing a legitimate medical explanation for the drug or metabolite, or on credible new or additional evidence of a legitimate medical explanation for an adulterated or substituted result. The rule's example is a valid prescription that the employee's physician provides after failing to find it at the time of the original verification. Under 40.149(a)(4), when that information arrives after the 60-day period, the MRO must consult with the DOT Office of Drug and Alcohol Policy and Compliance (ODAPC) before changing the result.

Under 40.149(b), an MRO who changes a result must immediately notify the Designated Employer Representative (DER) in writing. Under 49 CFR 40.167(e), MRO reports are not subject to modification or change by anyone other than the MRO.

Verification without an interview is covered in Why Does an MRO Contact an Employee after a DOT Drug Test?. Cancelled tests are covered in What Does a Cancelled DOT Drug Test Mean?, split specimen requests in How Does a Split Specimen Test Work after a Positive DOT Drug Test?, and MRO reporting deadlines in How Long Does an MRO Take to Report DOT Drug Test Results?.

The MROs category of the MyDrugTesting.com directory lists Medical Review Officers by location.