What does 49 CFR 40.160 (What does the MRO do when a valid test result cannot be produced and a negative result is required?) require?

Based on 49 CFR 40.160, when a valid drug test result cannot be produced and a negative result is required, the Medical Review Officer (MRO) must determine if there is clinical evidence that the individual is currently an illicit drug user.

To do this, the MRO must take the following practical steps:

* Conduct a Medical Evaluation: The MRO must personally conduct, or cause to be conducted by an acceptable licensed physician, a medical evaluation of the employee. The MRO may also consult with the employee's physician if appropriate.

* Use Alternative Tests: As part of the medical evaluation, the MRO or evaluating physician may conduct an alternative test, such as a blood test.

* Handle Results with No Clinical Evidence of Drug Use: If the evaluation shows *no* clinical evidence of drug use, the MRO must report it to the employer as a negative test result. The report must include written notations explaining the medical exam, why it was required, and the basis for determining no signs and symptoms of drug use exist. The MRO must also check "Negative" (Step 6) on the CCF, and sign and date it.

* Handle Results with Clinical Evidence of Drug Use: If the evaluation reveals clinical evidence of drug use, the MRO must report the result to the employer as a cancelled test, including written notations of the exam results, why the exam was required, and the reason for determining that signs and symptoms of drug use exist. Because it is a cancelled test, the employer cannot use it as a negative result to allow the employee to begin or resume performing safety-sensitive functions.