Ask X3What does 49 CFR 40.129 (What are the MRO's functions in reviewing laboratory confirmed non-negative drug test results?) require?
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According to 49 CFR 40.129, before the Medical Review Officer (MRO) verifies and releases a non-negative (confirmed positive, adulterated, substituted, or invalid) drug test result to the DER, they must perform the following functions:
1. Review Copy 2 of the CCF: Check for fatal or correctable errors that might require cancelling the test. (Staff under the MRO's direct, personal supervision can do this administrative review, but only the MRO can verify or cancel a test.)
2. Review Copy 1 of the CCF: Ensure it matches Copy 2, the result is legible, and the certifying scientist signed the form.
3. Request Legible Copies: If any documentation from the collector or laboratory is unclear, ask them to send a legible copy.
4. Conduct a Verification Interview: Directly contact the employee (in person or by phone), except under specific circumstances outlined in § 40.133.
5. Verify the Test Result: Classify and verify the result as negative, cancelled, positive, or a refusal to test due to adulteration or substitution, following specific regulatory criteria.
6. Gather Required Documents: Before reporting a verified result, the MRO must possess Copy 2 of the CCF (or another copy with the employee's signature) and a legible copy of Copy 1 containing the certifying scientist's signature.
7. Complete Paperwork (Copy 2 of the CCF):
- *For positive results:* Check the "Positive" box in Step 6, write down the verified drug(s)/metabolite(s), and sign, date, and complete the verification statement.
- *For cancelled results:* Check the "test cancelled" box in Step 6, write notes in the "Remarks" line, sign, provide your name, and date the statement.
- *For adulteration or substitution:* Check the "refusal to test because:" box, check either "Adulterated" or "Substituted," make notes in the "Remarks" line, and sign and date the statement.
8. Report Confidentially: Release the final result confidentially.
9. Follow Stand-Down Rules: Comply with § 40.21 regarding reporting to the employer before verification is complete. The MRO can only notify the DER of a received result if the employer has an approved stand-down policy (and without sharing details like the specific drug name); otherwise, the MRO must not tell anyone at the company about the result until verification is finished.