What does 49 CFR 40.137 (On what basis does the MRO verify test results involving marijuana, cocaine, amphetamines, semi-synthetic opioids, or PCP?) require?

As Ask X3, your fleet-compliance assistant, here is what 49 CFR 40.137 requires:

* Verification Basis: The Medical Review Officer (MRO) must verify a confirmed positive test result for marijuana, cocaine, amphetamines, semi-synthetic opioids (hydrocodone, hydromorphone, oxycodone, and oxymorphone), and/or PCP as positive, unless the employee presents a legitimate medical explanation for the presence of the drug or metabolite in their system.

* Prescriptions: If the employee has a legally valid prescription consistent with the Controlled Substances Act, the MRO must not question whether the prescribing physician *should* have prescribed the substance when determining if it is a legitimate medical explanation.

* Opportunity to Explain: The MRO must offer the employee an opportunity to present a legitimate medical explanation in all cases.

* Burden of Proof: The employee carries the burden of proof and must present information supporting their medical explanation during the verification interview. However, the MRO has the discretion to extend this time for up to five days if there is a reasonable basis to believe the employee can produce relevant evidence within that timeframe.

* Final Determination: If the MRO determines a legitimate medical explanation exists, they must verify the test result as negative; otherwise, it must be verified as positive.

* Foreign Medications: If the medication is from a foreign country, it can only serve as a legitimate medical explanation if it was obtained legally, has a legitimate medical use (e.g., substances like heroin, PCP, or marijuana cannot be used as an explanation even if legal in another country), and is used consistently with its proper and intended medical purpose. Even if verified as negative due to a foreign medication, the MRO may still need to raise fitness-for-duty considerations with you as the employer.