Frequently Asked Questions

Yes.  As defined in the Rules and Guidelines, "Medical Review Officer" or "MRO" means a licensed physician who meets the following criteria:

•  Is employed with or contracted with a covered employer

• Has knowledge of substance abuse disorders, laboratory testing procedures, and chain of custody collection procedures

• Verifies positive, confirmed test results

• Has the necessary medical training to interpret and evaluate an employee’s positive test result in relation to the employee’s medical history or any other relevant biomedical information.

The MRO should be used to review all positive tests with the employee or applicant before the employer is advised of the test results. Using an MRO provides the employer with a medically qualified interpretation of a positive test result, which would be defensible in a court of law. The MRO helps to protect both the employer and the employee.

The Medical Review Officer may only consider prescriptions issued within six months prior to a positive confirmed drug result for the purposes of determining a valid prescription and immunity from actions authorized by the TN Drug-Free Workplace Program following a positive confirmed drug result.

If testing is done in accordance with the Rules and Guidelines, (Chapter 0800-2), the results are highly accurate and reliable. However, misconceptions still exist.

1. Sometimes, you'll hear that urine drug tests can be "beaten".  Although this was true in the past, collection site and laboratory procedures make tampering nearly impossible today.  
2. Another misconception is that drug testing is prone to inaccuracy with so-called "false" positives. Today, tests have been refined to the point where this does not occur. 

A more legitimate concern is that of true "false" positives. That is, where the laboratory accurately determined the presence of a drug, but its presence is not the result of abuse or illicit use. Certain foods and medicines do contain detectable amounts of "controlled" drugs. In these cases, a Medical Review Officer (MRO) can determine if the drug is being properly and legitimately used. 

Yes. Employment decisions based on a substance abuse test result can be contested. The Courts favor employee testing that is based on procedures that are clear, fair, consistent, and communicated in a written policy statement.

The United States Constitution, which restricts governmental but not private actors from arbitrarily interfering with individual rights, prohibits the Government from unreasonably infringing on workers' rights relating to privacy and job security. With respect to workplace privacy, the Fourth Amendment to the U.S. Constitution prohibits unreasonable "searches." In 1989, the Supreme Court, considered the issue of workplace drug testing for the first time; The Court concluded that a public employer taking blood, urine, or breath specimen for the purpose of alcohol and other drug testing, (or testing conducted by a private employer at the request of the Government), constitutes a search under the Fourth Amendment because it implicates significant privacy concerns. The Court further held that the determination of whether such testing is "reasonable" and therefore constitutionally valid, requires a balancing of the degree of invasion on the individual's privacy interest against the promotion of the employer's legitimate interests.

Employers participating in the Bureau’s Drug Free Workplace program may conduct point of collection pre-employment drug testing of job applicants. Important facts about this include: 

• Point of collection testing allows employers to obtain immediate drug tests results onsite in a cost-effective manner. It is restricted to those job applicants that have been offered employment conditioned upon the results of the test. This testing is very similar to the Initial Screening Test usually conducted in a certified lab and does not include the more precise confirmatory testing required for all urine specimen that have a positive Initial Screening Test. 

• Any positive test must be confirmed by a certified laboratory pursuant to the Program’s rules, just as all positive Initial Screening Tests in federally regulated testing must be followed by a more precise confirmatory test (typically a GC/MS test or gas chromatography-mass spectroscopy). 

• To be approved for use, the product used in point of collection testing must conform to the standards required by the US Department of Transportation and the Substance Abuse and Mental Health Services Administration. 

• This means the test kit must use a bio-chemical method approved for Initial Screening Tests for federally regulated testing and the “cut-off” levels at which a test is considered to be positive must be identical to the SAMHSA Initial Screening Test “cut-off” levels. 

• If you want to confirm the test kit you would like to use conforms to the program’s rules and is approved for use, please submit product information, including the test methodology and cut-off levels to dfw.program@tn.gov. 

• For more information, please consult the program rules.

Testing facilities must be licensed and approved by the TN Department of Health or the US Dept. of Health and Human Services (HHS), College of American Pathologists, or other recognized authority authorized by the Commissioner.  The lab must comply with the procedures established by the Federal Department of Transportation (DOT).  Labs that perform confirmation tests must also be certified by either the Substance Abuse or Mental Health Services Administration (SAMSHA) or by the College of American Pathologists—Forensic Urine Testing Programs (CAP-FUDT).

Follow your company policy! When developing the company policy, it is extremely important to spell out the consequences for violating it. Termination of the employee is not required by this program, but do not discipline one employee and look the other way for another employee. If you do terminate employees as part of your DFWP program, you must enforce the policy uniformly.