MRO Confidentiality & Ethics 3 — Questions and Answers
Question 1: An MRO is contacted by a journalist investigating workplace drug testing at a major trucking company. The journalist asks for employee test results. The MRO should:
- Provide anonymized results to support public interest journalism
- Decline to release any information and cite confidentiality obligations (Correct answer)
- Consult the employer before deciding
- Release only confirmed positive results
Correct answer: Decline to release any information and cite confidentiality obligations
Media inquiries do not constitute a legal exception to MRO confidentiality requirements under DOT Part 40.
Question 2: Under 49 CFR Part 40, how long must an MRO retain records of verified negative test results?
- One year (Correct answer)
- Three years
- Five years
- Ten years
Correct answer: One year
DOT requires MROs to retain records of verified negative results for one year.
Question 3: An employer instructs the MRO to automatically report all positive results to a specific supervisor rather than to the designated DER. The MRO should:
- Comply because the employer controls the testing program
- Follow the DOT-defined reporting chain and report to the properly designated DER (Correct answer)
- Report to both the supervisor and the DER simultaneously
- Refuse to process results until the employer clarifies the chain of command
Correct answer: Follow the DOT-defined reporting chain and report to the properly designated DER
DOT rules designate the DER as the proper recipient of MRO reports; MROs cannot be directed to bypass this requirement.
Question 4: Which of the following scenarios represents an appropriate disclosure by an MRO to a treating physician?
- Informing the treating physician of all past positive test results without the employee's knowledge
- Providing test results to a treating physician after the employee provides written consent (Correct answer)
- Automatically forwarding results to listed emergency contacts
- Sharing results with the treating physician at the employer's request
Correct answer: Providing test results to a treating physician after the employee provides written consent
Disclosure to treating physicians is permissible when the employee provides written authorization for that specific disclosure.
Question 5: An MRO verified a positive result and reported it to the DER. The employee later claims the MRO discriminated based on disability during the verification interview. To defend against this claim, the MRO's best protection is:
- A statement from the employer supporting the MRO's decision
- Complete and contemporaneous documentation of the interview and decision process (Correct answer)
- The laboratory's chain-of-custody records
- A note from the MRO's attorney
Correct answer: Complete and contemporaneous documentation of the interview and decision process
Thorough contemporaneous documentation of the MRO's interview and reasoning provides the strongest defense against allegations of bias or discrimination.
Question 6: A split specimen test confirms the original result. The employee asks the MRO to keep the split specimen result confidential from the employer. The MRO must:
- Honor the request because split specimen results are medical records
- Report the confirmed positive to the DER as required by DOT regulations (Correct answer)
- Seal the split specimen result and hold it pending employee appeal
- Refer the matter to the laboratory for a final determination
Correct answer: Report the confirmed positive to the DER as required by DOT regulations
Once a split specimen confirms the primary result, the MRO must report the verified positive to the DER regardless of the employee's preferences.
Question 7: Which of the following best defines 'MRO independence' as required by DOT Part 40?
- The MRO must operate a solo practice with no staff
- The MRO must be free from employer and laboratory influence in making verification decisions (Correct answer)
- The MRO may not be licensed in the same state as the employer
- The MRO must rotate among multiple employers every two years
Correct answer: The MRO must be free from employer and laboratory influence in making verification decisions
MRO independence means that verification decisions must be made based on medical and scientific evidence, free from external pressure by the employer or laboratory.
MRO Confidentiality & Ethics 3
An MRO is contacted by a journalist investigating workplace drug testing at a major trucking company.
The journalist asks for employee test results.
The MRO should: