DOT Drug-Test Notice: Where to Find the Medical Review Officer, Employer Contact, and Written Policy

By HealthDataConsortium.org Research Team

Sources last checked October 7, 2026. DOT guidance changes, so confirm anything time-sensitive with your employer or the Medical Review Officer named on your paperwork.

The Short Answer

Three documents hold almost every contact you need after a DOT drug test: your copy of the federal custody and control form (CCF), your employer’s written testing policy, and the notice or call that directed you to test. The form is where you look for the Medical Review Officer (MRO). The policy and the employer’s notice are where you look for who speaks for the employer. None of them tells you what a result means, and this guide does not try to.

It is written for people covered by DOT testing. If you are not sure your test is a DOT test, start with Federal and Non-Federal Drug Tests: Which Rules Apply to Your Result? and come back.

Step Zero: Check That the Form Says “Federal”

DOT’s employee handbook says every DOT drug test uses the Federal Drug Testing Custody and Control Form and that those words appear at the top of each form (DOT, What Employees Need to Know, p. 8). Treat that as a clue rather than proof. The site’s program-identification guide, linked above, explains why a form alone does not settle which rules apply. If the form and your employer’s policy disagree about what kind of test this was, ask the employer to explain in writing before relying on any DOT contact route below.

Document 1: Your Copy of the Form

DOT’s handbook says the collector gives you the Employee Copy, Copy 5, of the CCF. The MRO receives a separate Medical Review Officer Copy, Copy 2 (DOT handbook, p. 7). Read your copy for these items:

• MRO contact details. DOT’s guidance to MROs refers to “the MRO number on the CCF” and says an employee should not have to work through several directory selections to reach the MRO (DOT, Back to Basics for MROs). Collector and employer checklists also check that the MRO’s name, address, and phone number and the employer’s name and address are listed on the form. If the MRO field is blank or unreadable, raise it with your employer.
• Your own contact details. The collector asks for your name, date of birth, and daytime and evening phone numbers on the MRO’s copy so the MRO can contact you directly with any questions (DOT handbook, p. 7). Those are the numbers the MRO will use.
• The back of your copy. The handbook says the collector may suggest you list any prescription and over-the-counter medicines there, as a reminder if the MRO calls.

If your form does not name an employer contact, the written policy is the next place to look.

A note on specimen type: the walkthrough in DOT’s 2019 handbook describes urine collection, while DOT’s current employee page says oral fluid and urine are both authorized. If your test was oral fluid, details of the paperwork may differ from the handbook, so check DOT’s current materials.

Document 2: The Written Policy and Educational Materials

DOT’s handbook says that, depending on the DOT agency overseeing your industry, your employer may be required to give you educational materials and a company policy explaining the testing rules and procedures. It adds that if you have not received them, you should ask (DOT handbook, p. 2). It describes education and training materials as covering topics such as company testing policies, and says they may include how to reach an employee assistance program. When you have the policy in hand, look for:

• The named employer contact for testing. In DOT’s process the MRO reports verified results to the employer’s Designated Employer Representative (DER). If the policy names a DER or program manager, that person is your employer-side contact for testing questions.
• A complaint or grievance route. DOT’s advice on a test you believe was unfair is “comply, then complain.” Take the test, then raise concerns in writing through the employer’s dispute-resolution office or an agreed grievance procedure (DOT, Employees).
• Employee assistance or referral programs. DOT notes these are not required by its regulations but may exist as company policy.
• Company rules beyond DOT’s. The policy may cover non-DOT testing too. Identify which rules apply to which test.

On the word “appeal”: in the DOT materials reviewed for this guide, the review steps are the MRO’s review, a possible split-specimen request, and complaints through employer procedures or the DOT agency’s program office. Those materials do not describe a separate DOT appeal office for an individual result. Whether your employer’s policy offers an appeal step is a question for the written policy.

Document 3: The Notice That Sent You to Test

Whoever told you to report, by phone, text, email, or in person, created the first date on your timeline. DOT’s handbook overview shows that employees are notified of the reason for the test, such as pre-employment, random, reasonable suspicion, post-accident, or return-to-duty (DOT handbook, p. 6). Write down who contacted you, when, and what reason they gave.

Two Contacts, Two Different Jobs

The MRO

DOT describes the MRO as a licensed physician who receives and reviews laboratory results and evaluates medical explanations for certain results (DOT, Medical Review Officers). Under 49 CFR 40.123, the MRO acts as an independent and impartial gatekeeper for the accuracy of the process and must protect the confidentiality of testing information. The same rule says that reviewing your results does not create a doctor-patient relationship (49 CFR §40.123). Treat the MRO as the contact for the review of your test, not as your treating physician. For questions about your medicines, your own prescriber or pharmacist is the right contact.

The MRO route also matters for a second test. If a split-specimen test is offered, DOT’s MRO guidance says the MRO should not tell the employee to call the employer about it, and payment issues should not hold up the request (DOT, Back to Basics for MROs). DOT’s employee materials describe a 72-hour window to request it. The handbook’s flow chart counts from the MRO interview and its text counts from the verified result, so ask the MRO to state in writing when your window starts. This article does not calculate it for you. For more detail on how screening, confirmation, and medical review fit together, see THC Drug-Test Confirmation: Screening, Confirmation, and Medical Review Explained.

The Employer

The employer is your contact for the written policy, the grievance route, and anything about your job. DOT’s employee page says that all employment decisions belong to the employer and that DOT regulations do not address hiring, firing, or leave. This guide does not predict how any employer will act.

The Date and Time Fields Worth Capturing

Most confusion about contacts turns out to be confusion about dates. Keep a short running record:

• When and how you were told to test, and by whom.
• The collection date shown on your copy of the form.
• When the MRO first contacted you, and by what number or method.
• If you receive a verified result, when the MRO told you, and the start point the MRO gives for any second-test window.
• When you asked the employer for the written policy, and when you received it.
• When you sent any written request for your testing records. DOT’s guidance tells MROs to provide an employee’s drug testing records within 10 days of the employee’s written request.
• When you sent any written complaint to the employer, and to whom.

If a Field Is Blank or a Number Does Not Connect

1. Ask the employer, in writing, for the testing policy and the name and phone number of the MRO for your test.
2. Ask the MRO’s office to confirm which phone number reaches the MRO, and keep a note of the date you asked.
3. For questions about what the DOT rules require, DOT’s Office of Drug and Alcohol Policy and Compliance (ODAPC) publishes the rules and says it is available to answer questions about them. Its published contact is 202-366-3784 or ODAPCWebMail@dot.gov. For your own test, the MRO and your employer remain the contacts named above.
4. To find the program office for your DOT agency, use ODAPC’s agency information page. DOT’s employee page lists that office as a place to raise concerns about a testing event.

What This Guide Leaves Out

• It does not interpret any result or explain result labels.
• It does not cover how to avoid a result or how long any substance stays detectable.
• It is not legal advice and does not calculate a deadline for your situation.

Who to Ask

• The MRO for questions about the review of your result.
• Your prescriber or pharmacist for questions about your medicines. Do not stop or change a prescribed medicine because of a drug test.
• An employment attorney if you face discipline or a dispute about whether the correct program rules were followed.

Sources

• U.S. DOT, ODAPC: Employees
• U.S. DOT, ODAPC: What Employees Need to Know About DOT Drug & Alcohol Testing (2019)
• U.S. DOT, ODAPC: ‘Back to Basics’ for Medical Review Officers
• U.S. DOT, ODAPC: Medical Review Officers
• U.S. DOT, ODAPC: 49 CFR §40.123, MRO responsibilities

HealthDataConsortium.org is an independent publication. It is not a medical practice, a government agency, or the operator of any testing program, and it is not affiliated with DOT or with any former organization that used this domain. Its contributors are researchers, not licensed clinicians. See our Editorial Standards and Medical Disclaimer.