The short version
- A refusal carries the same consequences as a verified positive, and a non-DOT refusal is not a DOT refusal (49 CFR 40.191(c) and (e))
- The list is long: fail to appear when directed, fail to remain, fail to provide, fail to permit observation, fail to take a directed additional test, fail to undergo a directed evaluation, fail to cooperate, possess an interference device, admit adulteration or substitution, or a verified adulterated or substituted result (49 CFR 40.191(a) and (b))
- Leaving before a pre-employment collection begins is not a refusal; an insufficient specimen becomes one only after the five-day medical evaluation finds no explanation (49 CFR 40.191(a)(2), (a)(3), (a)(5), 40.193)
- The employer decides whether a refusal occurred; the collector documents, the MRO decides only adulteration and substitution, and a C/TPA may decide only an owner-operator's no-show on a test it scheduled (49 CFR 40.191(d), 40.355(i) and (j))
- A mishandled refusal is a common source of disputes; train supervisors to document the facts and leave the determination to the DER
