DOT drug screen medical reviews

Substance Abuse Consultants - MROs

The Office of Drug and Alcohol Policy and Compliance serves as the principal advisory body to the Secretary on matters pertaining to national and international drug testing and control. It offers guidance on rules concerning drug and alcohol testing for safety-sensitive transportation workers across various industries such as aviation, trucking, railroads, mass transit, and pipelines. The office is responsible for publishing regulations and issuing official interpretations regarding testing procedures, including guidelines for conducting tests and protocols for evaluating and treating employees following testing infractions. Additionally, it coordinates the Department's participation in the President's National Drug Control Strategy on an annual basis. It is our job as qualified Medical Review Officers (MRO) to validate drug test results to be accurate and reliable for the safety of everyone on our roadways. Furthermore, to make sure hardworking individuals that make their living driving, get the respect they deserve while trying to provide for their families. 

What is the Clearing House for the DOT?

The Dept of Transportation best practice guidelines are there to ensure the safety of our roadways as it pertains to truck drivers, as they should. Our medical reviews follow the guidelines and rules set forth by the DOT to the strictest standards, and our partner collection affiliates are regularly monitored to make sure they adhere to the guidelines as instructed by our MROs.

The Clearinghouse provides FMCSA, SDLAs, and employers the necessary tools to identify only drivers who are prohibited from operating a CMV based on U.S. Department of Transportation (DOT) drug and alcohol program violations, and ensure that such drivers receive the required evaluation and treatment before operating a commercial motor vehicle (CMV) on public roads.

The Clearinghouse serves as a secure online repository providing real-time information to employers, the Federal Motor Carrier Safety Administration (FMCSA), State Driver Licensing Agencies (SDLAs), and State law enforcement officials regarding violations of drug and alcohol programs by holders of commercial driver’s licenses (CDL) and commercial learner’s permits (CLP). Its establishment was mandated by an act of Congress directed to the Secretary of Transportation.

By centralizing this information, the Clearinghouse empowers employers to identify drivers who have committed drug and alcohol program violations while employed by one company but have failed to disclose this information to subsequent employers as required. 


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The initial Clearinghouse final rule mandates FMCSA-regulated employers, medical review officers (MROs), substance abuse professionals (THAT'S US), and consortia/third-party administrators (C/TPAs) to report any violations of drug and alcohol regulations outlined in 49 Code of Federal Regulations, Parts 40 and 382 by both current and potential employees.

Furthermore, the first Clearinghouse rule necessitates the following:

- Employers must conduct queries on the Clearinghouse database for any drug and alcohol infractions by current and prospective employees before allowing them to operate a Commercial Motor Vehicle (CMV) on public roads.
- Employers are obligated to perform annual queries on the Clearinghouse for each driver currently employed by their company.

The second Clearinghouse final rule, known as Clearinghouse-II, is in line with FMCSA's goal of guaranteeing that only eligible drivers possess and uphold a Commercial Driver’s License (CDL). Starting November 18, 2024, State Driver Licensing Agencies (SDLAs) will be required to withdraw commercial driving privileges for drivers labeled as "prohibited" in the Clearinghouse. This action will lead to a temporary downgrade of their CDL until they satisfactorily complete the return-to-duty (RTD) process.

Additionally, Clearinghouse-II imposes the following requirements at defined by the DOT:

- SDLAs must conduct queries on the Clearinghouse before issuing, renewing, upgrading, or transferring CDLs, as well as issuing, renewing, and upgrading Commercial Learner's Permits (CLPs).
- SDLAs are obligated to review a driver’s information upon notification from FMCSA regarding any changes in the driver's Clearinghouse status.

Employers and medical review officers (MROs), or their designated representatives, are required to report information about positive drug test results, alcohol test results greater than 0.04 blood alcohol content, refusals to test and other non-test violations of FMCSA's drug and alcohol regulations. In addition, Substance Abuse Professionals (SAPs) are required to report information about drivers undergoing the return-to-duty drug and alcohol rehabilitation process. READ MORE -> 

About Us

With 30 + years in occupational drug screening, DOT, & physicals our staff are your go to experts for medical review officer services in the United States.

Our Lab Partners
  • LabCorps - MedTox
  • (CRL) Clinical Resource Labs
  • Quest Diagnostics
  • Omega Labs
  • Abbott Labs

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