A call from a Medical Review Officer (MRO) can cause concern, but it is a formal and confidential step in the workplace drug testing process. This notification signifies that your laboratory results require further medical review. The MRO acts as an impartial intermediary, ensuring the accuracy and integrity of the testing procedure, and is not an agent of your employer. Understanding this process helps demystify the call and guides you on how to prepare for this necessary discussion.
The Role of the Medical Review Officer
The Medical Review Officer is a licensed physician with specialized training in substance abuse testing and toxicology. They operate as an independent gatekeeper between the testing laboratory and the employer. The MRO’s primary duty is to receive and interpret confirmed results from the testing facility and review the chain of custody documentation to ensure the specimen’s integrity was maintained.
The MRO’s work protects the privacy of the tested individual while upholding the testing program’s scientific validity. This professional determines whether a non-negative lab result is due to illicit drug use or a legitimate medical explanation, such as a legally prescribed medication. They ensure the accuracy and fairness of the process, preventing individuals from being incorrectly penalized due to prescription drug use or procedural error.
Why Your Drug Test Result Triggered a Call
A call from the MRO is initiated only when the laboratory reports a finding that is not a straightforward negative result, requiring a confidential discussion. The most common reason for contact is a laboratory-confirmed positive result, where the concentration of a tested substance exceeds the established cutoff level. The MRO must then investigate whether this finding is caused by a valid prescription or another medical reason.
The MRO will also call regarding structural anomalies in the specimen that suggest possible manipulation. This includes an adulterated specimen, where the lab identifies a substance added to interfere with the test’s chemical reactions, such as glutaraldehyde or a nitrite. Another trigger is a substituted specimen, characterized by unphysiologically low creatinine and specific gravity values, suggesting the sample was replaced with a non-urine liquid.
The MRO may also contact you if the lab reports an invalid result, meaning a specific test component could not be analyzed due to an interfering substance or an unusual physical characteristic. These non-negative findings are not immediately reported to your employer as a failure. The MRO must first verify the result’s context directly with you to gather the necessary medical information and finalize the result status.
Navigating the Verification Call Process
The verification call is a confidential, one-on-one interview where the MRO informs you of the specific substance detected and the nature of the laboratory finding. During this discussion, the MRO is required to explain that declining to discuss the result will lead to it being reported as a verified positive or a refusal to test. This conversation is protected by medical confidentiality standards, such as HIPAA.
If you claim a legitimate medical explanation for the non-negative result, you must be prepared to provide verifiable documentation. This typically includes the prescribing physician’s name and contact information, the pharmacy name, and a valid prescription showing the dosage and prescribing dates. The MRO will then contact the prescribing doctor or pharmacy to verify the prescription’s legitimacy and confirm that the dosage is consistent with the drug levels found in your specimen.
Cooperation and a timely response are important during this step. The MRO must make reasonable attempts to reach you, often at least three times within 24 hours. If you are unreachable, the MRO will contact your employer’s Designated Employer Representative (DER) to direct them to have you call immediately. Failure to respond within a set timeframe, typically 72 hours, usually results in the test being reported as a verified positive or a refusal to test.
The MRO’s Final Determination
After completing the verification interview and reviewing all supporting medical documentation, the MRO issues a final determination. If you provide a legitimate medical explanation for the confirmed positive result, and the MRO verifies the prescription and dosage, the result is reported to the employer as a Verified Negative. This outcome signifies that the laboratory finding was medically justified and does not constitute a violation of the drug testing policy.
If the MRO determines there is no legitimate medical explanation for the confirmed positive result, or if you fail to provide the required documentation, the result is reported as a Verified Positive. Similarly, if the specimen was confirmed as adulterated or substituted and you cannot provide an acceptable medical reason for the anomaly, this is reported as a Refusal to Test.
The MRO’s report to the employer is deliberately limited to protect your privacy, providing only the final status of the test: Verified Negative, Verified Positive, or Refusal to Test. The employer does not receive information regarding the specific drug detected or any personal medical history.