What violations trigger follow-up drug and alcohol testing under DOT/FMCSA?
If a driver has a verified positive drug test, an alcohol test with a BAC of 0.04 or more, or refuses to submit to a required test under 49 CFR Part 382 Subpart B, then after completing the Return-to-Duty process the driver will be subject to follow-up testing
How many follow-up tests are required after a violation?
A minimum of six unannounced follow-up tests must occur within the first 12 months after Return-to-Duty, and depending on the SAP’s recommendation testing may continue up to five years.
Does a refusal to test count as a violation that triggers follow-up testing?
Yes — a refusal to undergo a drug or alcohol test is treated the same as a positive result under DOT regulations and triggers the same Return-to-Duty and follow-up requirements.
What is the role of the Substance Abuse Professional (SAP) in follow-up testing?
The SAP evaluates the driver after violation, develops a treatment or education plan, oversees the negative Return-to-Duty test, and prescribes the follow-up testing plan (frequency, length up to 5 years).
Can follow-up testing be substituted for random DOT testing?
No — follow-up tests are separate from random testing and cannot replace them. They are in addition to the already required random tests.
Who is responsible for managing the follow-up testing schedule?
The employer is responsible for implementing the follow-up testing plan prescribed by the SAP, ensuring tests are unannounced and documented, and reporting to the Clearinghouse where required.
Does the follow-up testing plan stay with the driver if they change employers?
Yes — the follow-up testing plan stays with the driver even if they change employers. The new employer must continue the plan until the SAP says it is complete.
What happens if a driver fails a follow-up test?
If a driver fails a follow-up test, they must again undergo the Return-to-Duty process, be cleared by a SAP, and then resume another follow-up testing sequence. Failure may lead to removal from safety-sensitive duties.
How long does the follow-up testing requirement last?
The minimum duration is generally one year (with at least six tests), but the SAP may require up to five years (60 months) of unannounced testing depending on the case.
Follow-up drug testing is a key part of the DOT’s return-to-duty process. After a drug or alcohol violation, an employee must complete certain steps before going back to work, which is safety-sensitive. Follow-up testing begins once the employee resumes work after providing a negative return to duty drug test and involves a series of unannounced tests over a set period. The specifics of this testing are decided by an expert on substance abuse (SAP) and are implemented by Third Party Administration under federal regulations.
Follow-up testing is a mandatory series of unannounced tests conducted after DOT drug and alcohol policies have been broken by an employee and after the completion of return-to-duty process. It is designed to make sure that the employee remains drug- and alcohol-free once they return to safety-sensitive functions.
Unlike random testing, which is governed by statistical selection, follow-up testing is individually carried out by a Substance Abuse Professional (SAP) and might go on for as long as five years.
Employers who have actual knowledge of a driver using drugs or alcohol on duty must take the employee out of safety-sensitive tasks right away.
49 CFR § 382.205 (Alcohol), § 382.213 (Drugs)
Employees become subject to follow-up drug and alcohol testing when they commit one of the following DOT drug and alcohol violations:
A verified positive drug test result during pre-employment, random, post-accident, or reasonable suspicion testing results in immediate disqualification from safety-sensitive functions. 49 CFR § 40.23(a)
Drivers who test with a Blood Alcohol Concentration (BAC) of 0.04 or more violate DOT alcohol regulations and must follow the return-to-duty process before returning to safety-sensitive duties. 49 CFR § 382.201
Refusing a drug or alcohol test is treated the same as a positive result. Refusals include failure to appear, refusal to stay at the testing location, or tampering with the test.
Once a violation occurs, the worker has to be assessed by a qualified SAP, who determines the required treatment and education. Only after successful completion of this program can the employee take a return-to-duty test and begin follow-up testing.
CFR Reference: 49 CFR § 40.289
goMDnow, a Consortium/Third-Party Administrator (C/TPA) plays a crucial role in the DOT return-to-duty process, as it coordinates the required testing, including directly observed return-to-duty and follow-up tests. The C/TPA also collaborates with Substance Abuse Professionals (SAPs) and Medical Review Officers (MROs) to ensure compliance, schedule tests, report results, and maintain accurate records as well as report it into the clearinghouse.
Ready to enroll for follow-up drug testing? Or looking for more information? Call our experts today at 980-655-4455.
Follow-up testing is strict and specific. Here's what both employees and employers should know:
Frequency and Duration
All follow-up drug tests must be carried out while being closely observed—a trained observer watches the employee provide the urine sample.
CFR Reference: 49 CFR § 40.67(b)
Follow-up tests cannot be counted as random tests. They are completely separate and must not be altered or skipped.
Employers play a crucial role in ensuring DOT compliance. Here are the key duties:
After a Violation:
CFR Reference: 49 CFR § 382.503
For Employers:
For Employees:
Ready to initiate the follow-up drug and alcohol tests while being compliant with all federal regulations? Call us today at 980-655-4455.
An employer can hire an employee who has a DOT drug or alcohol violation only after the employee completes the SAP process and passes a RTD test.
A Consortium/Third-Party Administrator (TPA) serves the employer, not the driver. They can only conduct follow-up drug testing if hired and authorised by the employer to handle compliance.
For owner-operators—CDL holders running under their own DOT number—they are both the employee and employer, meaning they can independently hire a TPA for follow-up testing.
Follow-up drug and alcohol testing is not just a requirement—it's a crucial part of maintaining the safety and integrity of the transportation industry. By understanding the violations that trigger follow-up testing and complying with the requirements set forth by the FMCSA and DOT, both employers and employees can help execute a safer, more responsible workplace.
Contact goMDnow your trusted partner for follow up drug testing after a DOT Drug violation.
*Include Observed Urine Drug Test For $99.95*
*FMCSA Clearinghouse Reporting $30.00*
Note: (Step 1 to 4) SAP Assessment are not included in this price. goMDnow is not responsible for any SAP Assessments. SAP Assessment must be completed by independent SAP before submitting Return to duty drug test.
*Include Follow-Up Plan Setup For $100.00*
*FMCSA Clearinghouse Reporting $30.00*
