Pitfalls & Practicalities II: Guidance for the DOT Substance Abuse

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The Adventures of Sandra Sapp
A Course for the Advanced Substance Abuse Professional
Presented by:
American Substance Abuse Professionals® (ASAP)
Reed A. Morrison, Ph.D.
President/CEO, ASAP
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Copyright 2007-2011 American Substance Abuse Professionals, Inc ®
Case #1
Sandra Sapp completed an initial SAP evaluation and referred the
employee to the Baltimore Intensive Recovery Program (BIRP).
Sandra made sure the employee signed a Statement of
Understanding that stipulated how and to whom case information
could be shared. The employee attended an intake and began
treatment at BIRP. After the intake, Sandra faxed a copy of the
Statement of Understanding to BIRP.
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Case #1 (cont'd)
When Sandra called the treatment counselor at BIRP to check on
the employee’s compliance, she was told that HIPAA forbade them
to release client information. What should Sandra do?
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Case #1 (cont'd)
A.
Report BIRP to the DOT for failure to release
information.
compliance
B.
Apologize, then plead with the BIRP counselor to help her out.
C.
Tell the BIRP counselor that he is wrong & that according to
DOT regulations, DOT cases are HIPAA exempt. BIRP must
supply the requested information.
D.
Explain the DOT position on HIPAA. If the BIRP counselor
resists, ask the counselor to originate a HIPAA compliant ROI,
request the employee to sign it and fax/mail it to her.
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Case #1 (cont'd)
The correct answer is “D”
Sandra talked to the BIRP counselor & explained how the DOT
provides for releases of information. The counselor held to his
HIPAA position. Sandra then faxed a traditional ROI to the
counselor. A few days later she received a signed ROI, originated
by BIRP. When she called the counselor for information, he gladly
complied. Sandra vowed that she would never go through this
lengthy process again.
What should she do in the future to avoid this problem?
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Case # 1 (cont'd)
A.
She should ask her SAP clients to sign both a HIPAA ROI and a
Statement of Understanding.
B.
When she makes initial referral contact to a treatment program,
she should discuss policies for releasing information and make
necessary arrangements.
C.
She should cross the obnoxious BIRP program off her referral
list.
D.
She should increase her professional liability insurance coverage.
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Case #1 (cont'd)
The correct answer is “B”
Sandra now discusses release of information policy with treatment
centers when she makes the referral. She is able to avoid
procedural conflicts with treatment programs and instead primes
the relationship for cooperation and effective compliance
monitoring. The HIPAA issue is an important one for the SAP
process. SAPs may wish to refer to DOT guidance found on the
ODAPC website under Questions and Answers.
http://www.dot.gov/ost/dapc/questions/HIPAA_Stmnt_0706.pdf
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Case #2
Downwind Airlines had a close-call on a runway and referred the
pilot, Dizzy Dave to Sandra Sapp for a SAP evaluation. Sandra
performed the evaluation and sent Dizzy to treatment.
Next, she monitored compliance to her recommendations, and
when satisfied, invited Dizzy to return to for a follow-up
evaluation.
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Case # 2 (cont'd)

Sandra performed the evaluation, determined that Dizzy complied
with her recommendations, wrote her follow-up report ,and
mailed it to the Downwind DER.

The DER received the report and immediately called Sandra. The
DER was furious because the SAP report said that Dizzy complied
with recommendations, but it did not say that he was eligible to
be returned to duty by his employer. Instead the report stated:
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Case # 2 (cont'd)
A.
It said that since Dizzy is an FAA/DOT employee he must be
fired after a violation. There are no second chances for pilots
under the FAA/DOT.
B.
It said that because he is a pilot, Dizzy’s eligibility to returnto-duty (RTD) is pending the issuance of a medical certificate
by the Federal Air Surgeon.
C.
Dizzy has psychological problems and should be barred from
even setting foot on an aircraft.
D.
All of the above.
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Case # 2 (cont'd)
The correct answer is “B”
An employer must not permit an employee who is required to hold
a medical certificate in accordance with 14 CFR Part 67 (First,
Second, or Third-Class Airman) to return to covered duty until the
employee has received a medical certificate or a special issuance
medical certificate from the Federal Air Surgeon (in addition to
meeting RTD requirements of 49 CFR Part 40). A SAP follow-up
report is still necessary for RTD, but it alone can not establish
eligibility for a certificate holder to return to safety-sensitive duty.
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Case #2 (cont'd)
In fact, it is the duty of the SAP to ask an FAA employee if they
hold a medical certificate. According to 14 CFR Part 121,
Appendices I & J:
During the SAP interview required for a verified positive test result or a refusal to submit to
a test, the SAP must ask and the individual must answer whether he or she holds or would
be required to hold an airman medical certificate issued under 14 CFR part 67 of this
chapter to perform a safety-sensitive function for the employer. If the individual answers in
the affirmative, the individual must obtain an airman medical certificate issued by the
Federal Air Surgeon dated after the verified positive drug test result date or refusal to test
date. After the individual obtains this airman medical certificate, the SAP may recommend
to the employer that the individual may be returned to a safety-sensitive position. The
receipt of an airman medical certificate does not alter any obligations otherwise required by
49 CFR part 40 or this appendix.
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Case #3
Another Downwind pilot, Kenny Land, heard about Sandra Sapp
from Dizzy Dave and called her for an appointment. He recently
had a DUI conviction and wanted to start the SAP process as soon
as he could. When Sandra heard that Kenny had a DUI conviction,
she said:
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Case #3 (cont'd)
A.
“Have you reported this to FAA’s Security and Investigations
Division? A DUI does not directly result in a DOT alcohol
violation. The FAA’s investigation will determine the course of
action that you must follow.”
B.
“Self-referrals, under FAA regulations, do not require a SAP
evaluation. Call your EAP or a qualified treatment
professional.
C.
“Let’s schedule an appointment for a SAP evaluation and begin
the return-to-duty process, but be aware that you must also
obtain an airman medical certificate issued by the Federal Air
Surgeon dated after your DUI before I can recommend your
eligibility to return to safety-sensitive duty.”
D.
None of the above.
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Case # 3 (cont'd)
The correct answer is “A”
Sandra was aware that, for FAA pilots, a DUI does not directly lead
to DOT 49 CFR Part 40 alcohol violation. Sandra also knew that
under 14 CFR 61.15, all pilots must send a Notification Letter to
the FAA’s Security and Investigations Division, within 60 calendar
days of the effective date of an alcohol-related conviction or
administrative action. She let Kenny know that he could obtain a
template for the Notification Letter and the address for the
Security and Investigations Division on the FAA’s website:
http://www.faa.gov/pilots/medical/
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Case # 3 (cont'd)
Kenny was disappointed by this news, then said, “OK, but what if
I don’t report it? The FAA will never know, right?”
Sandra said:
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Case # 3 (cont'd)
A.
“You got me there Kenny-boy. The FAA will never know and
my professional ethics prevent me from reporting you.”
B.
“The FAA will find out on their own. If they discover that you
failed to report, there are consequences.”
C.
“I have to turn you in because SAPs must report DOT
violations of FAA certificate holders to the Federal Air
Surgeon.”
D.
None of the above.
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Case #3 (cont'd)
The correct answer is “B”
The FAA will find out on their own. Under 14 CFR part 67.7 access to the
National Driver Register: At the time of application for a certificate issued
under this part, each person who applies for a medical certificate shall execute
an express consent form authorizing the Administrator to request the chief
driver licensing official of any state designated by the Administrator to transmit
information contained in the National Driver Register about the person to the
Administrator. The Administrator shall make information received from the
National Driver Register, if any, available on request to the person for review
and written comment.
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Case # 3 (cont'd)
Additionally, under 14 CFR 61.15:
Failure to send a Notification Letter within 60 days to FAA’s
Security & Investigations Division is grounds for:

Denial of an application for any certificate, rating, or authorization issued
under this regulation for up to one year after the date of the motor
vehicle action

Suspension or revocation of any certificate, rating, or authorization issued
under this regulation
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Case #4
The Downwind DER sent Sandra Sapp yet another referral, a
flight attendant named Paul Perkey. Paul registered positive for
cocaine on a reasonable suspicion test while on a stopover in
Paris. He was relieved of duty and flown back to the U.S. where
he was instructed to see Sandra. Sandra met with Paul for 5
minutes, then sent him home. She called the DER and told her:
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Case # 4 (cont'd)
A.
“Paul was too intoxicated to be evaluated. He can return after
he gets inpatient treatment.”
B.
“His test was invalid because the French have different cut-off
levels for positive tests.”
C.
“His test was invalid invalid because it took place in Paris.”
D.
None of the above.
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Case # 4 (cont'd)
The correct answer is “C”
No part of a DOT testing program may be performed outside the
territory of the United States. If an employee is assigned to perform
covered duty outside the U.S., they must be removed from the
random testing pool until they return to covered duty in the U.S.
See 14 CFR Part 121, Appendix I, XII; Testing Outside the Territory
of the United States. A. No part of the testing process (including
specimen collection laboratory processing, and MRO actions) shall be
conducted outside the territory of the United States.
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Case #5
Bob Blaimliss, a railroad engineer, appeared for a SAP evaluation with
Sandra Sapp.
He had refused to take a random test and was told
that he had to see a SAP for an evaluation. Sandra conducted the
evaluation, recommended a course of treatment, then told him that
she would monitor his progress and meet with him again in nine
months. Bob was shocked and protested. He told Sandra he needed
to get back to work as soon as possible. Furthermore, he threatened
to sue Sandra if she persisted with her plan.
Sandra replied:
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Case # 5 (cont'd)
A.
“Sorry Bob, but according to FRA regulations, employees who
refuse to test must be suspended for nine months before they
are permitted to return-to-duty.”
B.
“I’m going to have a baby and I will be on leave for the next nine
months.”
C.
“Bob, your behavior is inappropriate and for that reason I will see
you when I’m good and ready. Besides, my uncle is a
malpractice attorney.”
D.
“OK Bob, please forgive me, you’re correct. I’ll see you as soon
as you complete my treatment recommendations.”
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Case # 5 (cont'd)
The correct answer is “A”
When an FRA employee unlawfully refuses to submit an alcohol or
breath test, the employee is disqualified from the performance of
covered duties for a minimum of nine months (49 CFR 219.107)
and is subject to completion of the return-to-duty (RTD)
procedures 49 CFR 219.104. Upon return-to-duty after the nine
month period, the employee must complete the RTD process
including compliance with SAP recommendations.
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Case #6
Willy Show, a DOT covered truck driver, was referred to Sandra Sapp by
his DER. He tested positive for cocaine on a random DOT test. Willy
called Sandra, as instructed by the DER, but instead told her he would not
attend the SAP evaluation. He claimed that just after he was notified of
the random test, he informed his DER that he accidentally drank a drink
that contained cocaine at a friend’s birthday party and that he would
probably test positive. Furthermore, he said that even though he used
cocaine by accident, he would voluntarily seek treatment. According to
Willy, he would not need a SAP evaluation.
This is what Sandra did:
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Case # 6 (cont'd)
A.
Sandra congratulated Willy for his honesty and recognized his
right to voluntary treatment that released him from his
obligation to enter the DOT/SAP process.
B.
Sandra referred Willy to the DOT Employee Handbook and told
him that he must have a SAP evaluation if he wants an
opportunity to return to safety sensitive duty.
C.
Sandra told Willy to talk to his DER. This issue should be
handled by the DER and not the SAP.
D.
Sandra doubted that Willy accidentally drank cocaine and
insisted that he attend the SAP evaluation.
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Case #6 (cont'd)
The correct answer is “B”
Sandra correctly referred Willy to the ODAPC Employee Handbook
on ODAPC website where it states on page 14:
“Remember: Self-reporting just after being notified of a test
does not release you from your responsibility of taking the test,
and it also does not qualify as a voluntary referral.”
http://www.dot.gov/odapc/documents/EmployeeHandbookOctober2010.pdf
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Case # 6 (cont'd)
Voluntary self-referral occurring before a test notification allows
the employee to seek treatment without entering the DOT/SAP
return-to-duty process.
See Federal Motor Carrier Safety Administration (FMCSA)
regulations: 49 CFR part 382.121.
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Case #7
Henry Hyflier the DER for the Megabucks Corporation called
Sandra Sapp and asked her to manage the follow-up testing
program for a Megabucks DOT covered employee she had
evaluated and for whom she made recommendations for a follow-
up testing plan. He was a very busy man and wanted her to
choose the dates for his employee’s follow-up test schedule and
notify the employee when they are required to test. Money was
no object.
Sandra replied:
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Case # 7 (cont'd)
A.
“I can choose the test dates because I am a SAP, but I can not
notify employees; that’s the DER’s job.”
B.
“Yes I’ll do it. The DOT says that an employer may hire a
service agent to manage follow-up testing programs and SAPs
are service agents.”
C.
“According to the DOT, only the employer/DER may choose
follow-up test dates (unless the employee is an owner-operator
or self-employed). However, if you provide me with the dates,
I can notify the employees.”
D.
“I can do it Henry, but my time is money.”
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Case #7 (cont'd)
The correct answer is “C”
The SAP who performed the Return-to-Duty evaluation must recommend
the follow-up testing plan; the employer/DER must choose the follow-up
test dates which must be unannounced and without a predictable pattern
(40.309 (b); SAPs may be hired to notify employees for the follow-up
testing plan (40.347 (a) & (c).
But remember, the employer may not choose test dates in cases where
the person to be tested is the owner-operator or self-employed individual
(40.355 (g) & (h).
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Case #8
Sandra took a call from Harry Hazzard, an employee of Pipes R
Us’ a pipeline transport company that falls under the auspices of
the Pipeline & Hazardous Material Safety Administration (PHMSA).
Harry tested positive on a random BAT and was given Sandra’s
telephone number to arrange for a SAP evaluation.
Harry launched into a long, involved story with intricate
explanations for the positive test, when Sandra interrupted him
and said:
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Case #8
A.
“Sorry Harry, but you don’t need a DOT SAP evaluation.
PHMSA does not authorize random tests for alcohol. However, I
strongly recommend you call your EAP or a credentialed
alcoholism counselor for an evaluation and treatment.”
B.
“I will be glad to meet with you, but according to PHMSA’s
Office of Drug & Alcohol Policy & Investigations, I need the
referral to come from your MRO.”
C.
“Harry, I’m burned-out on SAP evaluations, let me give you a
referral to another SAP.”
D.
Sorry Harry, according to DOT regulations, PHMSA initial
evaluations are not performed by the SAP; the preliminary
evaluation is carried out by the MRO. The MRO may choose to
refer to the SAP if deemed medically appropriate.
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Case #8 (cont'd)
The correct answer is “A”
Sandra correctly informed Harry that PHMSA does not authorize
random testing for alcohol. They do test for alcohol for postaccident and reasonable suspicion situations (49CFR part
199.225). This fact did not absolve Sandra of her professional
responsibility. Sandra knew that Harry needed help and wisely
referred him to appropriate resources. She also called Harry’s
DER to alert him to Harry’s situation and to PHMSA requirements
for random testing.
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Case # 9
Foggy, a ferryboat operator for the Sea You Later Ferry Service
called Sandra to request a SAP Evaluation. He tested positive on
a random alcohol test. He was removed from safety-sensitive
duty. His employer told him that the return-to-duty process
began with a SAP evaluation and he was referred to Sandra.
Sandra replied:
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Case #9 (cont'd)
A.
“Sorry, a SAP does not provide gatekeeper duties for ferryboat
operators. They are not regulated by the DOT. However, I can
help you with a referral.”
B.
“The USCG does not authorize random alcohol tests. You do
not need a SAP evaluation; however, you should be evaluated
and possibly treated. I can help you with a referral to your
EAP or to an alcoholism treatment specialist.”
C.
“OK, let’s set-up an appointment.”
D.
None of the above.
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Case #9 (cont'd)
The correct answer is “C”
Sandra knows that drug and alcohol testing for ferryboat operators is
subject to regulations of both the Federal Transit Administration (FTA)
and the U.S. Coast Guard (USCG). She also knows that a DOT Final
Rule (effective January 2, 2007) clarified drug and alcohol testing
requirements for ferryboat operators and specified that ferryboat
operators remain subject to FTA requirements for random alcohol
testing. The FTA follows DOT CFR 49 Part 40 guidelines that place
the SAP in the ‘gatekeeper’ role in the return-to-duty process. She
correctly offered an appointment for Foggy.
See 49 CFR Part 655
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Case #10
Keep’em Rolling Transport Company referred truck driver Stanley Stupor
to Sandra Sapp for a SAP evaluation. Stanley tested positive for opiates
on a post-accident test. Sandra performed the evaluation and referred
him to a treatment program that included an inpatient detox phase
followed by a four week intensive outpatient treatment phase followed by
an eight week aftercare phase. Stanley resisted the referral. He was
eager to get back to his job and he had heard about a new program that
quickly returned people to work. The program uses suboxone as a detox
and maintenance therapy. It also had an outpatient counseling
component that he could attend after work.
Sandra said:
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Case # 10 (cont'd)
A.
“Fine. I didn’t know about this program, but as long as it’s
state certified I can send you there.”
B.
“Sorry Stanley, but suboxone is not yet approved by the FDA.
I can’t send you to a program that uses an experimental drug.”
C.
“Sorry Stanley, but suboxone treatment is prohibited by the
DOT. Unless they change their ruling, you will have to seek a
different kind of treatment.”
D.
“Suboxone treatment is fine Stanley and I will be glad to send
you to the program, but you have to keep in mind that you
cannot have a CDL (Commercial Drivers License) and take
suboxone. If you want to return to safety-sensitive work and
drive, you will need to have a different kind of treatment.”
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Case #10 (cont'd)
The correct answer is “D”
Suboxone treatment per se is not prohibited by the DOT, but
driving a commercial motor vehicle (CMV) in interstate commerce
while taking suboxone is. Although suboxone is not yet
mentioned by name in the regulations, it contains buprenorphine
and the DOT considers it in the same category as methadone.
See Federal Motor Carriers Safety Administration (FMCSA) §391.41
Physical Qualifications for Drivers:
Methadone is a habit-forming narcotic which can produce drug
dependence and is not an allowable drug for operators of CMVs.
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Case # 11
Sandra took a call from Larry Lavalite, a California-based truck
driver who was referred by his DER after registering a positive
random test for marijuana. Larry appeared for the evaluation and
brought a prescription with him. It was a prescription for medical
marijuana. He said he had shown it to his employer’s MRO and
the MRO ignored it. Since medical marijuana was legal in
California, he asked Sandra to confirm that he did not need a SAP
evaluation.
Sandra said:
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Case # 11 (cont'd)
A.
“Sorry, this is a bogus prescription; only marinol is legal in
California.”
B.
“Sorry Larry, the legal use of Medical marijuana was overturned by the Supreme Court in 2005.”
C.
“Sorry Larry, your MRO was right. The DOT prohibits the use of
marijuana during the performance of safety-sensitive duties.”
D.
“Dude, it’s cool,; just chill.”
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Case # 11 (cont'd)
The correct answer is “C”
Although California and 16 other states and DC have provisions for the legal
use of marijuana for medical purposes, DOT regulations are federal and
prohibit the use of marijuana in any form while engaged in DOT covered
safety-sensitive duty.
See ODAPC publication: Employee Handbook, p. 4, footnote 5.
While a minority of states allow medical use of marijuana, federal laws and
policy do not recognize any legitimate medical use of marijuana. Even if
marijuana is legally prescribed in a state, DOT regulations treat its use as
the same as the use of any other illicit drug.
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Case # 12
Sandra Sapp performed a follow-up SAP evaluation for Freddy
Frost, an employee of the Deep Freeze Ice Cream Company. On
her follow-up SAP report, Sandra included a follow-up testing
plan. She recommended that Freddy be tested 12 times during
the first year after his return to safety-sensitive duty. The DER,
after receiving the report, called Sandra to say her recommended
follow-up testing plan would not work.
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Case #12 (cont'd)
The DER went on to explain that Deep Freeze planned to lay-off
the majority of their workers, including Freddy, during the winter
months when the ice cream market was slow. They would re-call
them in April. It was October. Does he have to test Freddy 12
times in the next six months? And what becomes of the follow-up
testing plan when Freddy returns in April?
Sandra replied:
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Case # 12 (cont'd)
A.
“Choose the follow-up test dates for Freddy and test him until
the layoff. When he returns in April, test him for the
remaining number of tests.”
B.
“I didn’t know about your lay-off policy. I will revise my
recommendations to the minimum 6 tests during the first year
after return to duty.”
C.
“You must test him according to my recommendations even if
that means testing him during the layoff period.”
D.
“This is an unusual circumstance. Do whatever you think is
best.”
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Case #12 (cont'd)
The correct answer is “A”
The SAP creates the follow-up testing plan. The DER is required
to follow the plan and to choose the dates to satisfy the plan.
According to 49 CFR part 40.307 (e):
The requirements of the SAP's follow-up testing plan “follow the
employee” to subsequent employers or through breaks in service.
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Case # 12 (cont'd)
The DER agreed. He thought her plan was a good one. He liked
it so much that he would ‘help-out’ by throwing-in some
additional tests here and there, just to keep Freddy on his toes.
Sandra replied:
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Case # 12 (cont'd)
A.
“Thanks, I appreciate your help and I’m sure that Freddy
would benefit.”
B.
“I think 12 tests would be enough; however, I can not
interfere if adding tests is part of your company policy.”
C.
“If you think Freddy needs more tests, we can discuss it and,
if I agree, I can revise my recommendations. Otherwise, DOT
regulations say that only the SAP may create the follow-up
testing plan. The employer may not unilaterally add or
subtract tests without violating DOT policy.”
D.
“Whatever.”
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Case # 12 (cont'd)
The correct answer is “C”
DOT regulations prohibit the employer from modifying the SAP’s
recommendations for the follow-up testing plan.
According to 49 CFR part 40.307 (4):
As the employer, you must not impose additional testing
requirements (e.g., under company authority) on the employee
that go beyond the SAP's follow-up testing plan.
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Case # 12 (cont'd)
The SAP may choose to modify the plan. See 49 CFR part 40.307 (f):
As the SAP, you may modify the determinations you have made
concerning follow-up tests. For example, even if you recommended
follow-up testing beyond the first 12-months, you can terminate the
testing requirement at any time after the first year of testing. You
must not, however, modify the requirement that the employee take
at least six follow-up tests within the first 12 months after returning
to the performance of safety-sensitive functions.
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Case #13
Sandra evaluated truck driver Ned Nodder who tested positive for
opiates on a post-accident test. Ned produced a prescription for
pain killers that his doctor wrote for him two years ago. He
maintained they were legitimately prescribed and that he was
taking them per his doctor’s instructions. Furthermore, he had
shown the prescription to the technician at the test collection
facility and to the MRO who verified his positive test. Why, he
asked, did he have to have a SAP evaluation?
Sandra replied:
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Case # 13 (cont'd)
A.
“Obviously a mistake was made. The DOT permits use of
prescribed medications for safety-sensitive employees unless
prohibited by requirements for a specific license or certificate
such as those needed by pilots or mariners.”
B.
“You have to be evaluated because the drugs are pain killers.”
C.
“You have to be evaluated because your prescription is too
old.”
D.
None of the above.
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Case #13 (cont'd)
The correct answer is “C”
The FMSCA prohibits drivers from using prescribed controlled
medications:
If a driver uses a drug identified in 21 CFR
1308.11(391.41(b)(12) or any other substance such as
amphetamine, a narcotic, or any other habit forming drug, The
driver is medically unqualified.
See Frequently Asked Questions – Medical #2 on the FMSCA
website. This section may also be accessed from the ODAPC
website under Frequently Asked Questions
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Case # 13 (cont'd)
This is the case unless a medically documented exception is
made:
… the prescribing doctor can write that the driver is safe to be a
commercial driver while taking the medication. In this case, the
Medical Examiner may, but does not have to certify the driver.
See Frequently Asked Questions – Medical #2 on the FMSCA
website. This section may also be accessed from the ODAPC
website under Frequently Asked Questions
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Case #13 (cont'd)
Sandra, however, knew that even if a prescription was written for
a medically documented exception,
Controlled substances expire no later than one year after the date
of the original prescription.
See Frequently Asked Questions – Medical #2 on the FMSCA
website. This section may also be accessed from the ODAPC
website under Frequently Asked Questions
Ned’s prescription was two years old. Therefore, Ned’s test results
violated DOT regulations and he needed to embark upon the SAP
process if he wanted to become eligible to be returned to safetysensitive duty.
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Case #14
Sandra Sapp received an angry phone call from USCG
credentialed mariner Patty Picton. Sandra had been Patty’s SAP
two years ago when she had complied with recommendations &
was returned to safety sensitive duty by her employer. She was
angry about her follow-up testing schedule. She thought it wasn’t
fair that she was still being tested two years after she returned to
safety sensitive work. Besides, all her tests had been negative.
She accused Sandra of being punitive and demanded that she
change her test recommendations. Sandra replied:
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Case #14 (cont'd)
A.
“Sorry Patty, but a SAP cannot change follow-up test
recommendations.”
B.
“Sorry Patty, but a SAP may not reveal a follow-up testing
plan. I am permitted to revise it if I find warranting
circumstances. I will review your case with your employer’s
DER, but I cannot reveal any revisions that may result from
the review.”
C.
Sorry Patty. I only recommended 6 tests for one year. I will
call your employer right away & demand that he stop testing
you.”
D.
“Sorry Patty, you are a credentialed mariner and according to
USCG regulations, the employer can therefore add any amount
of follow-up tests to a SAP’s recommendations.”
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Case #14 (cont'd)
The correct answer is “B”
Sandra, of course, could not reveal her follow-up test plan to
Patty. She did, however, review her follow-up SAP report for
Patty and saw that she had recommended six follow-up tests
for the first 12 months following return to duty. She next
contacted the DER and found that the MRO had extended
Patty’s follow-up test period three years beyond Sandra’s
original recommendation!
What did Sandra do next?
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Case #14 (cont'd)
A.
She called the DOT and reported the MRO for violating 49 Part
40 regulations.
B.
Called her professional liability insurance agent and asked for
more coverage.
C.
She told the DER that since he did not follow her SAP follow-up
testing recommendations he was in violation of 49 Part 40. He
must immediately cease and desist carrying out the MRO’s
revision.
D.
Nothing. She knew that according to USCG regulations 46
Part 16.201 (f) (1) & (2) the MRO was authorized to extend
the follow-up testing period as long as it did not exceed the 60
month limit.
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Case #14 (cont'd)
The correct answer is “D”
In the practices of most SAPs, USCG cases are relatively rare and
USCG cases where the MRO extends follow-up testing are even
rarer. However, this does happen and the regulations allow for it.
Therefore, there was nothing Sandra had to do. In the future, to
avoid being caught off guard by irate employees, Sandra will
probably ask USCG DERs to let her know when test
recommendations have been extended by the MRO.
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Thank You!
Please feel free to ask questions
Reed A. Morrison, Ph.D.
President/CEO
American Substance Abuse Professionals (ASAP)
888-792-ASAP | go2asap.com
Copyright 2007-2011 American Substance Abuse Professionals, Inc ®
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