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dilutants and masking agents. To ensure reliability and accuracy of the lab result prior to review by <br />the MRO, an initial lab positive, adulterated, substituted or invalid test result will be followed by <br />confirmation tests performed in accordance with 49 CFR 40 and DHHS regulations. <br />The split sample method of collection is mandatory for DOT -regulated drug testing. Under this <br />methodology, the employee must provide at least 45 milliliters (ml) of urine, which is then divided into <br />primary (30 ml) and secondary (15 ml) specimen bottles by the collector. In the event that the primary <br />specimen is verified by the MRO as positive, adulterated or substituted, the second bottle will be sent <br />by the primary testing lab to a second (DOT -approved) lab at the employee's request, which may be <br />verbal or in writing. <br />c. medical review of lab results <br />General: The Company's Medical Review Officer (MRO) will review all drug test results confirmed <br />by the lab as positive, adulterated, substituted, or invalid. Prior to reporting such results to the <br />Company, the employee will be given a reasonable opportunity (72 hours from the time of contact by <br />the DER, if not contacted directly by the MRO) to discuss the lab results with the MRO and to present <br />a legitimate medical explanation (if any) for the lab result. <br />The MRO has the discretion to extend the verification process for up to five days, if the MRO <br />determines that there is a reasonable basis to believe that the employee will be able to produce <br />relevant evidence concerning a legitimate medical explanation within that time. <br />In the case of a confirmed positive for Opioids, the MRO may also require <br />the employee to present him/herself to be examined for clinical evidence of substance abuse. <br />Refusal to comply is equivalent to expressly declining to discuss the test result. <br />If neither the MRO nor the DER are able to contact an employee within 10 days of the MRO's <br />receipt of a certified test result from the lab, the MRO will verify the test result as a positive or refusal <br />to test, as applicable, without the employee's input. <br />For a period of 60 days from the MRO's verified report to the DER, the MRO must allow the <br />employee to present information documenting that serious illness, injury, or other circumstances <br />unavoidably precluded contact with the MRO and/or DER; and may, on the basis of such information, <br />reopen the verification, allowing the employee to present information concerning whether there is a <br />legitimate medical explanation for the confirmed test result. <br />Even if an employee presents a legitimate medical explanation and the employee's drug test is <br />verified as negative, the MRO may be required to bring fitness -for -duty considerations to the attention <br />of third parties. [See 40.327] <br />Once notified of a required drug test, the employee must remain <br />available for contact by the Company and the MRO and must make <br />contact with the Company at least daily. Failure to maintain contact <br />with the Company shall be cause for disciplinary action up to and <br />including discharge, solely at the option of the Company. <br />ii. Except for the use of methadone, THC (or Marijuana), and medications <br />containing alcohol, nothing in this policy prohibits an employee's use of a <br />medication legally prescribed (for an FDA -approved use) by a licensed <br />physician who: <br />(a) is familiar with the employee's medical history and specific safety - <br />sensitive duties, and <br />(b) has advised the employee that the prescribed medication will not <br />adversely affect the employee's ability to perform his or her safety - <br />sensitive duties (e.g., to drive a commercial motor vehicle). <br />iii. Medications prescribed for someone other than the employee will not be <br />considered lawfully used by the employee under any circumstances. <br />iv. Medications containing alcohol will not be considered lawfully used by the <br />employee while on duty or within 4 hours prior to going on duty. <br />2020 Drug Screens Plus_ All Rights Reserved_ (16) FMCSA 20200101 266 <br />