Handling Refusals to Test and Problem Collections for DOT Oral Fluid Testing

Overview

Refusals to test and problem collections are critical scenarios that must be managed carefully during the DOT oral fluid specimen collection process. Properly identifying, documenting, and responding to these situations ensures compliance with 49 CFR Part 40 and maintains the integrity of the drug testing process. This article outlines how collectors should handle refusals to test and address common collection problems.

What Constitutes a Refusal to Test?

An employee's actions can be classified as a refusal to test under DOT regulations if they:

1. Fail to Appear: Do not report for a required drug test within the specified timeframe without a legitimate excuse.
2. Fail to Remain at the Collection Site: Leave the site before the testing process is complete without authorization.
3. Fail to Cooperate: Refuse to comply with any part of the testing process (e.g., refusing to provide a specimen, failing to follow instructions).
4. Tampering or Attempting to Tamper: Attempt to adulterate, substitute, or otherwise tamper with the specimen or collection device.
5. Fail to Provide a Specimen: Fail to provide an adequate oral fluid specimen without a valid medical explanation.
6. Refusal to Sign the CCF: Decline to sign required documentation (with exceptions for specific non-fatal flaws).
7. Possession of Unauthorized Items: Bring unauthorized items (e.g., adulterants, devices) into the collection area.
8. Fail to Remove Items from the Mouth: Refuse to remove gum, candy, or other substances from the mouth when requested.

Collector Responsibilities in Refusal Situations

1. Identify and Document the Refusal

• Clearly identify the employee's behavior that constitutes a refusal to test.
• Document the incident in the Remarks section of the Custody and Control Form (CCF).

2. Notify the Designated Employer Representative (DER)

• Immediately report the refusal to the DER.
• Do not attempt to persuade the employee to comply once the refusal has been identified.

3. Complete the Collection Process (if applicable)

• If a partial collection was initiated, complete the necessary documentation.
• Secure any specimen collected before the refusal occurred.

4. Maintain Professionalism

• Remain calm and professional.
• Do not engage in arguments or confrontations with the employee.

Handling Common Collection Problems

1. Insufficient Specimen (Dry Mouth)

• Provide the employee with up to 8 oz. of water to rinse their mouth.
• Wait 10 minutes before attempting a second collection.
• If the employee still cannot provide a specimen, contact the DER for further instructions.

2. Employee Claims Medical Condition

• If the employee claims a medical condition prevents specimen collection, inform the DER.
• The DER may require a medical evaluation to determine if the condition is legitimate.

3. Tampering or Suspicious Behavior

• If tampering or suspicious behavior is observed, stop the collection immediately.
• Document the behavior in the CCF and notify the DER.
• Secure any specimen collected and follow standard shipping procedures.

4. Employee Brings Unauthorized Items

• If the employee brings an item that could be used to tamper with the specimen:
  • Secure the item if safe to do so.
  • Document the item in the Remarks section of the CCF.
  • Notify the DER immediately.

5. Refusal to Sign the CCF

• If the employee refuses to sign the CCF, note this in the Remarks section.
• Continue with the collection process and notify the DER.

Best Practices for Managing Refusals and Problems

• Stay Calm: Always remain professional, calm, and neutral.
• Document Thoroughly: Record all observations and actions in detail.
• Follow Procedures: Adhere strictly to Part 40 procedures.
• Communicate Clearly: Explain procedures to the employee, but do not argue.
• Secure Specimens: Protect any collected specimen following standard procedures.

Conclusion

Properly handling refusals to test and problem collections is essential to ensuring a compliant and secure DOT oral fluid testing process. Collectors must be vigilant, professional, and thorough in documenting and responding to these situations. Adherence to DOT regulations protects the integrity of the testing program and maintains safety in the workplace.