What is a SAP? I failed a drug test at work and need to get a SAP evaluation.

A SAP is a professional who has taken specialized training and testing to gain the designation of Substance Abuse Professional (SAP). When a person has a DOT workplace violation, the only person who can perform the required evaluation is a SAP.

If I have a work violation, do I have to go through a SAP?

Yes. DOT regulations require that an employee with a DOT violation must be evaluated by a qualified SAP.

What if I enter treatment on my own?

This will not permit you to return to safety-sensitive duties. DOT regulations require that you go to a qualified SAP for an evaluation, follow the SAP recommendations, and have a follow up evaluation with the SAP prior to being considered for readmission into safety-sensitive functions in the transportation industry.

What happens if I just quit this job and apply to another employer?

A future DOT-covered employer is required to obtain your drug and alcohol testing records from your previous employers for the previous two years. Your previous employer is required to report this violation.  If there is no SAP report indicating compliance, no employer is permitted to hire you for DOT safety-sensitive functions until you have successfully completed the return-to-duty process. At minimum, the previous employer’s file must include the Initial Evaluation by a qualified SAP and the Follow-Up Evaluation indicating your compliance with the SAP’s recommendations. However, if you choose to work for a non-DOT employer, you do not have to complete the SAP process.

What if I just “forget” to list my previous employer on an application form?

Falsification of information is a serious federal offense subject to fines and civil penalties. DOT will hold you responsible under civil penalties when it is discovered that you have provided safety-sensitive functions without having successfully completed the return-to-duty process.

Who is going to pay for the cost of my SAP services?

That decision needs to be made between the employer and employee. Some employers have arranged for SAP services to be covered by an Employee Assistance Program (EAP). Some employers pay the cost of SAP services on behalf of their employees. However, many employers require the employees to pay on their own.

What will this cost?

Correctly carrying out the SAP process requires quite a bit of professional time and expertise on the part of the SAP.  A SAP has considerable liability, since DOT considers the SAP to be ultimately responsible to the traveling public. CAC charges $450 for the SAP services we provide, payable at the first visit.  This fee includes the Initial Evaluation by a qualified SAP, referral services to appropriate providers, continuous monitoring of your progress, reporting to your employer or DER (Designated Employer Representative), communicating with the MRO (Medical Review Officer) as needed, and the Follow-Up Evaluation. As part of the SAP process you will be referred to an education or treatment program. The fees for that provider’s services are not covered in the $450 fee paid to CAC.

Will insurance cover this?

Health insurance covers costs incurred out of “medical necessity”. A positive drug test does not automatically indicate medical necessity.  Therefore, it is not likely that your medical insurance will cover the SAP process.  CAC does not accept medical insurance of any kind, but if you do find that your insurance company will reimburse you for your costs, our office will be happy to provide you with a receipt to submit for potential reimbursement.

What if I can’t afford the plan that the SAP recommends?

If needed, CAC will provide a recommendation to an additional provider if you find that you cannot afford the first provider to whom we refer you.  However, we cannot guarantee that the alternate provider will have a more favorable fee structure. CAC does not determine the fees for the individual provider we may recommend, nor do we have any financial relationship or interest in any of the providers we recommend. If you are unable to comply with the recommendation, you will not be able to return to a safety-sensitive function.

If I don’t agree with the SAP’s recommendation, can I get a second opinion from another SAP?

DOT considers the SAP’s recommendation to be final, and no one can change it. The rule is very clear about this: You cannot get a second opinion. Once you have started an evaluation process with a SAP, you cannot seek the services of a different SAP. If you were to do that, you would be subject to fines by DOT, and if your employer accepted a second SAP’s opinion, your employer would be subject to DOT fines as well.

How long will this process take?

That depends on the treatment recommendation that your SAP makes. This also depends on your own progress in complying with the recommended education or treatment. Your SAP will be monitoring your progress by regularly checking in with your treatment provider. When your SAP feels you have made sufficient progress, you will be called to schedule a clinical Follow-Up Evaluation.  If you are making little or no progress, or if your participation in your program is minimal, the SAP will not yet schedule the Follow-Up Evaluation.

What happens next?

When your SAP conducts a clinical follow-up evaluation and determines that you have complied with the recommendations, your SAP will send a report of compliance to your employer. Your employer then can decide whether to arrange for you to take a return-to-duty test. (Depending on your employer’s written policy, your employer may also decide to terminate you, either before or after the return-to-duty test. Remember that in your employer’s eyes, you may still be a safety risk.)
If your employer decides to take you back, and if you have a negative return-to-duty test, you will be subject to follow-up testing as required by your SAP. There must be at least 6 unannounced follow-up tests in the first year, but the SAP can require any number of tests, and the testing period can extend to five years.

How can I find out what this follow-up testing program will be?

DOT requires that the follow-up testing schedule (when, how often, and how many years) must be confidential. Neither the SAP nor your employer is permitted to share this testing plan with you.

Who pays for these follow-up tests?

This is the employer’s decision. Some employers pay for follow-up testing. Some employers share the cost of the tests with the employee who is being tested. But many employers require the employee to pay for all of those tests, as a consequence of having violated DOT’s rules.

What happens if I test positive on a follow-up test?

If you test positive again, you must go through the entire SAP process again. Many employers terminate an employee for a second violation.  If you have been terminated, and if you want to apply for a safety-sensitive job with another DOT employer, you must first complete the SAP return-to-duty process.