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Friday, October 3, 2014

DOT Reminder to Medical Review Officers (MROs) Verifying an Employee’s Prescription

As a reminder, when a donor provides a prescription for a non-negative laboratory test result, as the MRO, you are responsible for determining whether the medical explanation is legitimate.   

In your role as the “gatekeeper” in this process, you must review and take all reasonable and necessary steps to verify the authenticity of all medical records the employee provides (see 49 CFR Section 40.141(b)).  For example:

    Call the pharmacy to verify the legitimacy of the prescription; and
    Call the donor’s treating physician if you have suspicions or questions

In accordance with 49 CFR Sections 40.137(c), 40.139(b), and 40.145(e), the donor has the burden of proof that a legitimate medical explanation exists.  The donor must present information meeting this burden at the time of the verification interview.  You may extend the time available for the donor to present the information for up to 5 days.  If the donor fails to provide information you have requested (e.g., does not produce a prescription or does not facilitate the treating physician’s contact with you), you may proceed in making your determination.

Any time you make the determination to verify a laboratory positive result negative because of a legitimate medical explanation, you may have a responsibility to raise fitness-for-duty considerations in accordance with 49 CFR Section 40.137(e)(4) and 40.327.  In raising these concerns, you are only authorized to provide information learned through your verification interview with the employee’s employer, a physician or health care provider responsible for determining the employee’s medical qualifications under a DOT agency’s safety regulations, a SAP evaluating the employee as part of the return to duty process, a DOT agency, or with the National Transportation Safety Board during the course of an accident investigation.