The involvement of a Medical Review Officer (MRO) often creates anxiety for the tested individual, who may assume a call indicates a failed screening. The MRO’s primary function is not to deliver bad news but to act as a crucial independent intermediary in the drug testing process. This physician ensures the fairness and scientific accuracy of the laboratory results before reporting them to an employer. A call from the MRO is a mandatory step in several different scenarios, many of which still lead to a clear, negative result.
What is a Medical Review Officer?
A Medical Review Officer is a licensed physician with specialized training in substance abuse disorders and the toxicology of drugs of abuse. This specialized education allows them to understand the complex science behind drug testing and interpret results accurately. The MRO maintains an independent position, meaning they are explicitly not employed by the testing laboratory or the company requesting the test.
This separation of roles is legally mandated to ensure impartiality throughout the review process. The MRO receives confirmed laboratory results and determines if there is a legitimate medical explanation for any detected substance. Only after this thorough medical review, which may require contacting the donor, does the MRO report the final, verified determination to the employer.
The Direct Answer: Why MROs Call You
The most common reason for an MRO call that does not result in a failed test is the verification of legally prescribed medication. The laboratory analysis may have detected a substance, such as certain opioids or ADHD medications, that is present in the donor’s system. The MRO contacts the individual to gather documentation, such as the prescribing physician’s details or a copy of the prescription itself. Once the MRO confirms the substance is consistent with a current, valid prescription taken at therapeutic levels, they report the final result to the employer as a Verified Negative.
Another scenario prompting a call involves a lab flag for specimen validity, relating to the integrity of the sample itself. A specimen may be flagged as dilute if creatinine and specific gravity levels suggest excessive water intake. Other concerns include substitution (sample inconsistent with human urine) or adulteration (a foreign substance added to interfere with the test). The MRO calls to discuss mitigating circumstances for these flags, which can result in a canceled test or potentially a refusal to test.
The MRO contacts the donor when the test is confirmed positive for a prohibited substance and no obvious medical explanation is on file. The MRO process mandates direct communication before the final result is reported to the company. This conversation provides the donor a final opportunity to present documentation or medical evidence that might account for the detected substance. If a legitimate medical explanation cannot be provided, the MRO verifies and reports the result to the employer as a Verified Positive.
Navigating the MRO Verification Call
Individuals receiving a call should know the conversation is strictly confidential and protected by medical privacy regulations. The MRO is fulfilling their professional duty to seek medical justification for the lab findings, rather than acting as an agent of the employer. Preparation is beneficial; the donor should have contact information for prescribing physicians and relevant prescription receipts readily available. The MRO will confirm the dosage, frequency, and treatment duration to ensure the medical use aligns with the detected substance concentration. Being truthful and cooperative during this conversation significantly streamlines the review process and helps the MRO reach a swift and fair determination.
Potential Outcomes After the MRO Review
Following the MRO’s review, the physician reports one of three final determinations to the employer, closing the drug testing process.
Verified Negative
This is reported when no prohibited substances are detected or when a detected substance is consistent with a valid prescription. The employer is only told the test was negative, and specific medical information remains confidential.
Verified Positive
This is reported if the MRO finds no legitimate medical explanation for a confirmed positive result. This finding confirms the presence of a prohibited drug above federal cutoff levels.
Canceled Test
This means the MRO could not report a result due to insurmountable issues, such as a procedural error or unresolvable specimen validity concerns. A canceled test usually requires the donor to undergo immediate recollection to complete the testing requirement.
Your Rights in the MRO Process
Individuals who receive a Verified Positive result maintain specific rights to appeal the finding. The most important right is the ability to request a test of the Split Specimen, or “B sample,” collected simultaneously with the original sample. This request must be made within a specific timeframe, typically 72 hours, and the donor is usually responsible for the cost of this second analysis at a different certified laboratory.
The MRO process also allows the tested individual to have a medical or legal representative consult with the MRO regarding the findings. However, primary communication regarding medical history and justification must occur directly between the donor and the MRO. This ensures the integrity of the medical review process and protects the donor’s medical privacy during the appeal.