What Happens If You Refuse a DOT Drug Test?

DOT test refusals are treated the same as failures in most cases.

While some differences exist for pre-employment DOT drug test refusals vs. others, refusing a test can interfere with your career and subject you to the DOT return-to-duty process.

But what counts as a refusal? Here’s what to know about refusals and their consequences for safety-sensitive workers.

What Counts as a Refusal to Test?

Under 49 CFR Part 382, § 382.107, you can be counted as refusing a DOT drug test for numerous actions, including the following:

1. Failing to Show up for a Drug Test

When your employer tells you to go to a facility to take a DOT drug test, you’ll be given a specific time frame within which you must show up.

If you fail to appear for your DOT drug test, it will be counted as a refusal.

Showing up after the period specified by your employer also counts as failing to show and as a refusal.

For example, if your employer tells you you have to go to a DOT testing facility within the next two hours, you’ll be counted as refusing to test if you show up three hours later instead.

2. Leaving the Facility Before Testing is Complete

You must remain at the testing facility until your DOT drug testing process is complete.

The drug testing process for collectors is described in 49 CFR Part 40, §§ 40-61, 40-63, 40-65, and 40-71 and includes the following steps:

• Check your government-issued ID to verify your identity
• Match your name to the paperwork
• Mark your arrival time
• Provide the collector’s identification to the individual if requested
• Explain the testing process
• Ask you to remove your outer clothing (jacket, hat, coat, coveralls) and/or purse and leave them with the collector during testing
• Ask you to empty your pockets and show the collector
• Ask you to wash your hands and not to rewash them until delivering the specimen to the collector
• Select the sealed collection container
• Break the seal in front of you
• Direct you to go into the room for sample collection (bathroom)
• Tell you your sample must be at least 45 ml
• Explain how to close and deliver the sample to the collector
• Pay careful attention to your behavior throughout the process and write down notes if you act suspiciously
• Check the sample volume and temperature
• Inspect the sample for signs of tampering (unusual color, excessive foaming when shaken, bleach odor)
• Immediately ask for a second sample if the first one is insufficient, outside of the acceptable temperature range, or shows signs of tampering
• Pour 30 ml of the sample into the primary testing container and at least 15 ml into a second container as a secondary testing container for split specimen testing
• Place tamper-proof seals over the caps of both containers
• Write the date on the tamper-proof seal tape
• Ask you to initial the tamper-proof seals

Leaving after the testing process has commenced but before all of these steps have been completed is treated as a refusal.

3. Failing to Provide a Urine Specimen

If you fail to provide a urine specimen for any DOT drug test, it will be counted as a refusal.

This includes failing to provide a large enough sample (at least 45 ml) without a valid medical explanation.

4. Refusing to Undergo Direct Observation When Required

Under 49 CFR Part 40, § 40.67, your employer or the testing site collector may direct you to provide a sample under direct observation for the following reasons:

• Providing an invalid specimen without a valid medical explanation
• MRO reports that a split-specimen test couldn’t be conducted on an original positive, adulterated, or substituted specimen
• Providing a negative-dilute specimen with a creatinine concentration of less than 5 ng/ml but greater than 2 ng/ml
• The collector observes evidence that you brought materials with you to tamper with the specimen
• Providing a sample with an out-of-range temperature
• Evidence that the seal was tampered with
• Any return-to-duty (RTD) or follow-up test

If you refuse to submit a directly observed sample under one of these circumstances, your refusal will be counted as a failed drug test.

5. Refusing a Follow-up Test

Failing to take a second test when directed to do so by the testing site collector or your employer counts as a refusal.

Similarly, failing to submit to a follow-up test after going through the RTD process counts as a refusal.

6. Tampering with a Specimen

You’ll be counted as refusing a DOT drug test if the medical review officer (MRO) reports your sample was adulterated or that there is other evidence you tampered with the specimen.

For example, if you added bleach or another substance to your urine to try to fudge the results, you’ll be counted as refusing your drug test.

7. Substituting a Specimen

If the MRO reports you submitted a substituted sample, you’ll be counted as refusing a DOT drug test.

For example, if you brought in synthetic urine and poured that into the specimen cup, it would be counted as a refusal.

8. Failing to Follow the Testing Procedures and Instructions

Failing to follow any of the instructions given to you at the testing site counts as a refusal.

For example, if you refuse to remove your jacket or empty your pockets in front of the collector, it will count as you refusing your DOT drug test.

You’ll also be counted as refusing your test if you act in a confrontational way that disrupts the testing process.

Consequences of Refusing a DOT Drug Test

The consequences of refusing a DOT drug test differ based on whether you refuse pre-employment testing or a different DOT drug test:

Refusing a Pre-Employment DOT Drug Test

The consequences for refusing a pre-employment DOT drug test are straightforward – You’ll be denied employment.

DOT-regulated employers aren’t allowed to hire someone for a safety-sensitive job who fails or refuses a DOT pre-employment drug test.

If you’re a CDL driver, your refusal of a pre-employment DOT drug test won’t be reported to the Federal Motor Carrier Safety Administration (FMCSA) Drug & Alcohol Clearinghouse.

You also won’t have to undergo the RTD process since you weren’t officially employed in a safety-sensitive job.

However, the employer might document your refusal internally, which could negatively affect you if you subsequently try to apply for a job with the same company in the future.

Refusing Any Other DOT Drug Test

If you refuse to undergo any DOT drug test other than a pre-employment drug screen (e.g., random, post-accident, RTD, or follow-up tests), you’ll face the following consequences:

• Your refusal will be treated as a failed DOT drug test.
• You’ll face immediate removal from safety-sensitive duties.
• Your refusal will be reported to the FMCSA Clearinghouse (if you’re a CDL holder), and the record will remain until you complete the RTD process.
• Depending on company policy, your employer might terminate you.
• Your violation will remain on your record for five years or until you complete the RTD process.
• No other DOT-regulated employer will be able to hire you until you complete the RTD process.
• If you hold a CDL, your CDL license will be immediately suspended.

How to Return to Work After a Refusal

To return to work after a refusal or DOT drug test failure, you’ll need to complete the following steps of the RTD process:

1. Immediate Removal from Safety-Sensitive Duties

Your employer must immediately remove you from safety-sensitive duties for any violation of the US Department of Transportation’s (DOT) drug and alcohol rules.

2. Contact American River Wellness, Your DOT-qualified Substance Abuse Professional (DOT SAP)

When you refuse a DOT drug test, you must find a DOT-qualified SAP.

American River Wellness is a DOT-qualified SAP and can help you start the process quickly.

3. Schedule your SAP Evaluation

Once you’ve found a DOT-qualified SAP, contact them to schedule your evaluation.

American River Wellness offers same- and next-day appointments to get you back to work faster.

We also offer virtual evaluations to increase convenience.

4. Prepare for Your SAP Evaluation

Prepare for your SAP evaluation by taking the following steps:

• Gather information about your refusal (MRO report, site collector report, and/or employer report)
• Abstain from using drugs or alcohol
• Review your employer’s drug and alcohol policies
• Check with HR about whether your employer will pay for your SAP evaluation (most don’t)
• Review the steps of the RTD process to understand your obligations and what to expect

5. Attend Your SAP Evaluation

During your evaluation, your SAP will ask you about your refusal, the circumstances surrounding it, your substance use history, and your medical history.

They will use the information they gather to create a detailed plan outlining their recommendations based on their findings.

6. Complete Recommended Education and Treatment

You must complete all treatment and education recommendations your SAP provides.

Depending on your needs, your recommendations might include any of the following:

• Drug and alcohol education
• Outpatient substance abuse counseling
• Support groups
• Inpatient treatment (when warranted)

Your SAP will monitor your progress throughout the process.

7. Meet Your SAP for a Follow-Up Evaluation and RTD Test

Your SAP will review your progress once you’ve completed your treatment and education recommendations.

You’ll need to submit to a return-to-duty drug test.

This test must be directly observed, and it must be negative before you can return to work.

If you refuse or fail your RTD test, you’ll have to start the process over.

The SAP will write a report clearing you to return to work and outlining your follow-up testing recommendations.

They will upload it to the FMCSA Drug and Alcohol Clearinghouse. They’ll also transmit it to your employer.

8. Employer Decision

Ultimately, your employer decides whether to take you back.

If your employer decides not to retain you, you’ll have to find a new job. You’ll still be required to complete follow-up testing with a new DOT-regulated employer.

9. Follow-Up Testing

Whether your employer reinstates you or you find a new job, you must complete follow-up testing.

At a minimum, you’ll have to complete at least six random follow-up tests during the first 12 months.

You may have to submit to follow-up testing for up to five years.

American River Wellness is available to you throughout the follow-up testing process if you have any questions or need help.

Trust American River Wellness to Get You Back to Work Quickly After a Refusal

DOT drug test refusals are treated as failures and can negatively impact your career.

Other than for a pre-employment test, a refusal will require you to complete the RTD process before you can return to work.

American River Wellness is a DOT-qualified SAP and helps most safety-sensitive workers return to work within a week through our streamlined DOT SAP program.

Contact us today to get started by calling (833) 436-8727.

DISCLAIMER: This information is intended solely for educational and informational purposes. It should not be interpreted as legal counsel or guidance.

FAQ

About the Author

Graham Sargent 

CEAP, CADC-III-ICADC, IS, SAP

Graham has more than 14 years of experience working with safety sensitive employees, criminal justice involved individuals, families in the child welfare system as well as individuals and families affected by drug and alcohol use. Graham has built American River Wellness around a simple but powerful mission: to provide personalized, compassionate support for every individual navigating the return-to-duty process.