Drug & Alcohol Program

Surviving workers compensation – as measured by the bottom line – finds it is imperative every employer have a written Drug and Alcohol program and conduct some level of testing. It is amazing how many employers in today’s drug tolerant climate do not have a written program, do not conduct strategic testing, and fail to understand the difference between a directional program and an expressed written policy.

Drug and Alcohol abuse are major problems nationwide. Of these two drugs are far more devastating to the employer because they often go undetected until an injury surfaces. Statistically 60 % of all Workers Compensation claims have some connection with drugs including illegal drugs, legal drugs used illegally and even simple over the counter (OTC) drugs. Alcohol abuse while part of the same written standard presents itself more visibly leaving little doubt as to its detection within a workplace. But with drugs and alcohol management needs a directive in writing otherwise they can face employee discrimination and privacy challenges.

Surprisingly over fifteen million Americans have some form of prescription drugs involved in their life and many for perfectly valid health related reasons. At issue is that about five million Americans take drugs that were not even prescribed to them, or they continue taking them beyond what was prescribed by the Doctor because they have become addicted. Ultimately, all you need is ONE of them to find you and damage your Work Comp bottom line.

Ironically employers failing to expressly prohibit or forbid drugs and alcohol within their work place are seen by most states to actually condone the use of drugs and alcohol. Moreover employers ignoring this subject will inevitably attract drug test rejects from pro-active employers who have screened and rejected these same people sending them back onto the street looking for an employer who is willing to invite them onto their payroll; and if they succeed in getting on yours – it spells t-r-o-u-b-l-e be it from physical injuries real or feigned, attendance, attitude and/or a variety of personality problems.

On the Work Comp side the primary allure of alleging an injury real or not is the amazingly generous 100% free health and income benefits offered by every state, and void of cause once identified by a physician; and when the dust settles it is all charged back to you the employer.


The law in most states asserts that “any amount” of an illegal drug or illegally used legal drug detected in the system establishes a “rebuttable presumption” that the accident and/or injury is at minimum causally related to the presence of the identified drug. We have had physicians in some states totally disregard this “rebuttable presumption” and fail to validate within their medical opinion that a claimants’ injury was caused or attributable in part to the verifiable presence of drugs. So in the end, nothing is a guarantee since the integrity of those in this process can also be suspect at times. Regardless of the imperfections it is common sense for employers in today’s drug infested climate to drug test at every opportunity since doing so raises the bar of expectations for all employees by saying – the employer will provide to the best of their ability a safe and drug free work environment for every employee.

The Written Drug & Alcohol program of Insured Solutions has been used for years. It is simple, effective and right to the point. It covers all of the relevant elements including that of containing a specific policy statement.

Below is a page by page analysis of this written program. (Appendix A)

PAGE ONE OF FOUR ESTABLISHES: (page 12 this file)

  1. The purpose of the program (PREFACE) – thereby setting forth a zero tolerance position of the employer. Employee safety is and remains the number one objective of a drug and alcohol program.
  2. Substance abuse policy statement – outlines the four main elements of policy violations along with supervisory direction, and the Company goal of having a written program aimed at giving specific direction while removing any system designed ambiguity on the subject of legally presumed employee privacy.

In contrast to a simple Policy Statement, an effectively written program is comprehensive providing mechanical-direction as it defines the critical areas of testing, what to do for an alcohol screen, what to do on providing employee transportation for a failed test in the workplace, and what to do if someone refuses to submit to a drug test. These fine points must be spelled out ahead of time.

PAGE TWO OF FOUR ESTABLISHES: (page 13 this file)

  1. Confidentiality – test results will be kept confidential and not shared or commented on at any time.
  2. Positive Test Results – The employer has to inform the employee in writing within 5 days of learning of the failed test. Notification to the employee is sent by Certified mail to include consequences and directions. A first time failed test should incorporate an “indefinite suspension without pay” directing the employee to obtain treatment through local public services where they live. A second failure should result in termination.
  3. General Procedures – This defines the impairment observation process and how it is to be handled by supervisors and management including consultation with the employee. It also spells out the possibility of having to call a taxi, providing company transportation or for calling the police rather than allowing an employee to drive off the property.
  4. Pre-Employment Drug Testing – Allows for a variety of testing methods at the point of hire.


Employee Testing –

  1. Defines “cause or suspicion” testing that spells out six specific areas supervisors need to be aware of when requesting an employee be drug tested.
  2. Post Accident testing
  3. Follow-up testing as may be prescribed by a provider or treatment center
  4. A physical exam test
  5. The company option to include Random Testing
  6. Confirmed positive test results regarding an employee’ request for a second test on the same sample – formally prohibiting the option of having a second or new sample.
  7. Suspicions of specimen tampering (where urine tests are conducted)

PAGE FOUR OF FOUR ESTABLISHES: (page 15 this file)

  1. Alcohol Abuse – Spelling out the policy as it relates to working conditions, and defining “under the influence”.
  2. Refusal of a Substance Abuse Policy Test – consequences of an employee meeting the definition of triggering a drug test but refusing to permit or consent to the test. Here the Insured Solutions response is always that of an “immediate and indefinite suspension without pay” directing the employee to seek treatment where they live (see the sample letter to be sent by certified mail following this scenario). If this REFUSAL follows a reported injury – DO NOT terminate for a first offense regardless of how tempting it may be or that it may appear to be justified. See Appendix A page 19 – the failed or refused drug test letter outlining the action to be taken and using an immediate indefinite suspension without pay. If the failed test is not involving an alleged injury refer to your HR staff and employee handbook. But, stick to your Handbook definitions at all times.

EMPLOYEE AND JOB APPLICANT SIGN OFF FORMS to file: (pages 16 & 17 this file)

Employee Sign Off forms – The below forms within the Drug and Alcohol Program materials are required to be signed/dated by every current employee:


If the employer has never had a written Drug Program and Testing Consent forms are not in file then all existing employees must be given a 60 day advance notice (after signing/dating these forms) before you can submit them to any form of Random or unannounced type testing. However, new hires can be tested from day one as defined by the written Drug and Alcohol Program provided they sign/date these Employee forms (2) at the time of hire. NOTE: Where no written Drug Program has existed the initial “testing notification” time of 60 days must be granted before unexpected testing can occur. However no future 60-day notification is necessary once the initial 60-day notice has passed.

JOB APPLICANT DRUG & ALCOHOL TESTING CONSENT FORM (Page 18 this file) – Include this with your application forms to serve notice of your written program, to negate an expectation of privacy and to obtain a written consent to test. NOTE: If an applicant is formally hired they must then sign/date the EMPLOYEE ACKNOWLEDGEMENT and EMPLOYEE DRUG & ALCOHOL TESTING CONSENT forms since their status has changed.

RE: DRUG TEST RESULTS NOTIFICATION (page 19 of this file) – This sample letter should be sent certified mail to the employee’ address of record when failing or refusing to submit to a drug test as is stated on page two under Positive Test Results. This letter sets forth the suspension and drug treatment process including how they can return to their job if all conditions are met. Find APPENDIX A – page 19 of this file.


The subject of employers adopting a “state certified” Drug and Alcohol Program” arises at times due to the “premium credit” (%) enticement some states offer. Insured Solutions does not require or prefer that a program be Certified since it forces on the employer extensive paperwork along with the added expense attendant to maintaining certification. We welcome Certification Certificates but do not require them.

NOTE: your written premium for coverage incorporates the presence of a written drug program thus any readjustment or credit has already been factored into your rate.

A certified program includes and requires every element of testing including:

  • Pre-hire testing
  • Post accident testing
  • Random testing
  • Cause of suspicion testing.

When certified – Employers are required to conduct all forms of testing including Pre-hire, Post-accident and Cause or suspicion. Moreover the detailed paperwork is also required in the event you are audited by the state. This audit is usually triggered if the carrier suspects you are not compliant with the Certification mandates, and only your paperwork will exonerate you from losing your credit and being assessed additional (penalty) fees. Also note that you are required to have your program up and running one year ahead of being given the premium credit (%). The credit is granted in arrears, not in advance.


The drugs in the workplace issue has been a tug-of-war for years especially in very employee friendly states such that legislatures and higher courts have basically decided employee privacy supersedes employee safety and this concept is promulgated using the “expectation of privacy” definition. This means the employer must remove this “expectation” as much as possible.

A written and visibly promoted Drug and Alcohol program is aimed directly at sending a message that drugs and alcohol are not welcome within the workplace. This clear and distinctive message helps quash an otherwise legally accepted yet tacitly implied expectation of employee privacy, which more and more states are adamant about imposing on employers. These states are always looking for ways to tolerate the use and abuse of drugs and to force the ever growing cost of offering full employee benefits associated with Workers Compensation onto the backs of employers. This is a popular under the table “share the wealth” approach that keeps tax payers off the hook where perhaps valid costly medical and income benefits are needed but the employee is both unwilling and unable to pay.

The tug of war between tax payers and business on how to pay for costly medical care coupled with how to redistribute cash through-out the economic system is well served via legislative action written and imposed by the Work Comp courts within each state.

At Insured Solutions the steps we take to better manage Workers compensation are always behavior based. Make no mistake about it, the drug/alcohol issue is in fact a “behavior” problem that requires a long range perspective if an employer is to survive the “force of law”.


Drug testing can take on several forms. Many companies prefer to use a laboratory sending the employee out for a test however this is costly and takes time especially when hiring becomes a timing issue. We prefer saliva drug test kits which you can find online at reasonable prices ($10). These kits have become very sophisticated and are far more accurate than a decade ago. Manufacturers offer several test levels (panels) however the simple 5-panel should suffice. Some advantages of saliva kit tests are:

  1. They catch an applicant and/or existing employee off guard since no restroom is needed thus no games can be played with the sample.
  2. They take less than 15 minutes for a reading.
  3. Only the applicant and/or employee touch the container – thus no urine to handle.
  4. They can’t be circumvented with dilution or the excuse of “I just can’t pee right now”.
  5. There is no mandate to protect non-existent rights for an “applicant” because they are not entitled to special privileges, unlike employees who are protected and granted privileges or assurances. Any applicant questioning a kit test result is free to visit a lab of their choosing and at their expense pay for a new test returning the lab result to the prospective employer who can and should accept it at face value the results if it contradicts the earlier kit test and refund the cost of the lab test.
  6. Kits can be left out as a visual reminder to all of how seriously this subject is taken.

Below are workplace situations where these kits are both cost and time effective:

  1. Job Applicants – during the applicant screening phase the employer can:
    1. Pay for the kit test ($10 each ordered online) and require the saliva test be done in the office at the interview desk (not in a bathroom). This test gives a response in 12-15 minutes using a simple chart. If the applicant test is clean the employer can go ahead with the other prescreening steps attendant to the hiring process. If the applicant fails the test then he can be rejected or have the same sample tested at his/her lab, and if it is found to be drug free the employer can gladly pay for the test, and continue the screening process provided the job remains open.
  2. The Employer can request the applicant submit a $10 cash deposit before the interview process advising the applicant their deposit is refundable only if they pass the drug test. Then as stated, if the applicant passes the test refund the $10, but if not, keep the $10 to replace the cost of the kit.
  3. The employer can use the drug test “ploy” meaning they inform the applicant that during the first seven days of employment they will be requested to undergo a drug test without prior notice as to the day and time. However, the employer will not actually perform the drug test on the applicant (forgetting it entirely). This vocalized intent to test is key setting up a – fear of being discovered and then terminated – for those applicants who know they have a problem. This step allows the employers to filter out applicants without incurring any additional costs by performing a drug test on each applicant. To test – you must give notice. To give notice of a test but then choose – NOT to test – is your prerogative.
  4. Existing employees:
    1. Refusal of Doctors Care – perfect to save time while catching the employee off guard yet again…a behavior issue as will be tacitly viewed by other employees.
    2. Random testing – perfect to save time and money making this form of testing more attractive and if failed…a chain of custody lab test must follow.
    3. Cause or Suspicion situations – perfect again to save time and affect behavior.

NOTE: The key is that employees have rights thus any failed kit test requires a lab test be done quickly either using the same sample or if the lab insists, a new sample (you can relent here to get the chain of custody) . Only the results of a lab test can dictate what disciplinary actions are taken for existing employees.

As the employer you choose the testing option that best suits your need to screen depending on your company operations, your claim problems and your overall history with drug related issues.


This can be a touchy subject unless employers understand that when it comes to EMPLOYEE SAFETY, there is in reality no such thing as a touchy subject. The degree of danger in a workplace or for a given job description should dictate the level of discussion or emphasis given to the use of prescription drugs. A proper “New Hire/Transfer Employee” safety check list should identify prescription drugs being taken, and all employees should be reminded of their obligation to report prescription drug use to their supervisor NOTING THE DRUG STORE INFORMATION PAGE, WHEN IT SPECIFIES THE INDIVIDUAL TAKING THE DRUG…


This type of warning usually involves certain narcotic drugs that can dramatically affect an employees’ ability to work safely especially if their job description involves a alternative risk of injury such as working around dangerous machinery/equipment, working above or below the ground or where mental focus is imperative. The employer cannot prevent injuries in dangerous work environments unless they know a drug is being taken thus employees MUST know they have a duty to report the taking of these drugs to their supervisor for their own safety.

It is also important to learn how the employee is getting to work since the NOT DRIVE part of this warning is just that…DO NOT DRIVE. The employer becomes the surrogate parent in this situation and needs to find a resolution to this medical and safety dilemma on several fronts.

  1. Getting to and from work – What arrangements are being made for safety?
  2. Driving on the job in a company or personal vehicle on company business – Prohibited under any and all circumstances…no exceptions even if job descriptions must be changed. Employer liability here is enormous and should not be taken lightly.

Remember in the end – EMPLOYEE (and public) SAFETY IS ALWAYS NUMBER ONE.

See APPENDIX B for a sample of this policy.


Yes, a written Drug program will provide definition for illegal drugs and legal drugs used illegally. (item 3 on page one of the written drug program). However a comprehensive written program should also address Over-the-Counter Drugs. OTC can be a legitimate safety concern thus we offer a separate one-page Over-the-Counter policy (poster version) on this often overlooked subject. An OTC sample policy is also shown on APPENDIX B – page 20 at the end of this file.

Over-the-Counter Drugs alone or in combination can be problematic for those sensitive to drowsiness (antihistamines) and/or may create other mentally distractive reactions thus making certain work environments much more dangerous. Employers should have some basic safety driven policies for OTC drugs used by employees, the first of which is to be aware of them.

If an employee reaction to OTC does create a safety concern – however innocuous it may seem on the surface – the employer should take action like modifying a Job description or moving the employee to less hazardous job duties depending on the extent and duration of the reaction versus the degree of danger based on the work being performed. A frank discussion with the employee is called for and pragmatism should dictate how this conflict is resolved always keeping employee, co-worker and public SAFETY the number one goal.

Workers Compensation insurance is “no fault” meaning the employer needs to take pre-emptive action to avoid alternative risk work situations that can lead to serious injuries. Removing any real or implied expectation of privacy on the drug issue in general can be critical to this end.


CRITICAL COMMENT: As noted earlier – a written Drug & Alcohol Program is used to facilitate denial of an employee claim should the employee test positive (non-negative) when backed by a “lab verified chain of custody” test. The use of saliva kits can be convenient and cost saving however employees have rights requiring a “chain of custody” test before any disciplinary decision can be made. A “chain of custody” test may or may not involve a saliva test sample depending on the lab being used (most labs prefer urine testing). Employee rights MUST be guarded so do not discipline anyone without having a lab certified test result regardless of the sampling method chosen.

In contrast, Job Applicants do not have the same rights as employees so a saliva or similar kit test should work fine with no mandatory “lab based chain of custody” follow up, unless the applicant insists that one be done, and if so it is always best to allow for such keeping in mind that this applicant has just shown their hand in the screening process, and not after you have hired them. When it comes to screening and hiring hindsight is a lousy teacher when it comes to the drug and alcohol subject.

DOT drug program and its special but not superior position for CDL drivers

The DOT respecting CDL drivers has its own specifically written Drug and Alcohol Program guidelines however these apply to driver positions involving motor vehicle accidents where property damage and/or driver hospitalization is involved. The DOT testing mandates are not applicable for driver injuries such as jumping out of the cab injuring a knee, ankle, leg or back; not for lifting or strain claims: not for slip/trip/fall claims: or not for any type of reportable Work Comp claim absent a serious over the road accident or hospitalization of the employee.

Insured Solutions can provide you a DOT specific Drug and Alcohol Program including the specific driver sign off forms, however for Work Comp purposes a driver reporting any type of injury, or refusing to see a doctor when out of town or local, SHOULD ALWAYS BE SUBJECT to the non-DOT written drug program guidelines.

In the end – drivers can be subject to BOTH the DOT and the standard Company drug programs, and the testing required can involve two tiers or types…without exception. Call our office (877-213-1999 x 205) if you have any questions or need further clarification on this subject.

In summary

Here are a few truths about this very important subject.

  1. Employers not having a written drug program and/or not conducting actual testing will attract those who have been tested by other employers, failed and sent out the door. These people are still looking for a way to get on someone’s payroll, and they will do so unless their next prospective employer tests them for drugs. The odds of these hiring-problems waiting to damage your bottom line rises exponentially without drug testing .
  2. A written drug program covers your back side on the “burden of proof” standard. Yes, this is a tough one to handle unless you have it spelled out and you adhere to its tenants.
  3. A written drug program is how you begin addressing the “expectation of privacy” vulnerability imposed on you as the employer. Your intentions are always suspect and discounted in the eyes of the Work Comp system unless you go on offense leaving no doubt that within your workplace…drugs are not and will not be tolerated.
  4. A written drug program helps support a rebuttable presumption defense where a failed or non-negative test is verified pursuant to written guidelines while using an approved lab backed by a chain-of-custody test thus allowing for denial of the claim. This denial shifts the burden to the claimant, which historically is not easy to overcome.
  5. Having a written drug program enhances an employers’ ability to further satisfy the General Duty Clause found in 29 CFR 1910 standard (OSHA) by further assuring employees of being in a workplace free from recognizable hazards, including drug induced co-workers whose inattention to safety policies often cause accidents.

The Drug and Alcohol Programs created and customized by Insured Solutions have been in use for many years. However, you should have your own HR and/or attorney review them to suit your specific needs and/or concerns. Insured Solutions can provide all necessary guidance and coaching on how to implement the program of your choice. If questions arise please contact our office at 877-213-1999 X 205 (Risk Manager).


APPENDIX A – Written Drug and Alcohol Program sample (it can be edited)

APPENDIX B – Prescription and OTC Drug policy sample





(COMPANY NAME) (Hereafter referred to as The Company) has developed a policy regarding the use of illegal drugs, the illegal use of legal drugs, and the abuse of alcohol that we believe best serves to protect the health, safety and welfare of all employees. Our policy formally and clearly states that the use of illegal drugs, the illegal use of legal prescription drugs, or the abuse of alcohol will not be tolerated. As a means of maintaining our policy, we have implemented pre-employment and active employee drug testing.

An employee whose conduct violates The Company’s Substance Abuse Policy will be disciplined up to and including termination.

Substance Abuse Policy Statement

The Company is committed to providing a safe work environment and to fostering both the well-being and the health of its employees. This commitment is jeopardized when any Company employee illegally uses drugs on the job, comes to work under their influence, possesses, distributes, or sells drugs in the workplace, or abuses alcohol on the job. Therefore, The Company has established the following policy:

  1. It is a violation of the company policy for any employee to use, possess, sell, trade, offer for sale or, to buy illegal drugs or otherwise engage in the illegal use of drugs on the job.
  2. It is a violation of the company policy for anyone to report to work under the influence of illegal drugs, or alcohol.
  3. It is a violation of the company policy for anyone to use prescription drugs illegally. However, nothing in this policy precludes the appropriate use of legally prescribed medicines. Any employee legally taking such drugs is required to notify their supervisor immediately.
  4. Violations of this policy are subject to disciplinary action up to and including termination.

It is the responsibility of the company’s managers and supervisors to counsel employees and implement corrective actions whenever they see a change in performance or behavior that suggests an employee has a drug problem. Although diagnosing personal problems is not the manager(s) or supervisor(s) job, they should encourage such employees to seek help and advise them about available resources for getting help. Everyone shares in the responsibility for maintaining a safe work environment and co-workers as well, should encourage anyone who has a drug problem to seek help.

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The goal of this policy is to balance our respect for individuals with the need to maintain a safe, productive, and drug-free environment. The intent of this policy is to send a clear message that the illegal use of drugs and the abuse of alcohol are incompatible with employment at The Company.


The confidentiality of any information received by the employer through this substance abuse testing program shall be maintained, except as otherwise provided by law.

Positive Test Results

The Company will notify employees or job applicants in writing, within five (5) days of receipt of a confirmed positive test result from the laboratory. The written notification of confirmed positive test results will also address the consequences of such results, and the options available to the employee or applicant.

An applicant or employee who tested positive for the presence of drugs or alcohol may contest or explain the results to The Company within five (5) working days after notification of the test results. Anyone wishing to contest or explain the results must state their desire to do so in writing, dated and signed by the employee and delivered to The Company within five (5) working days after receipt of the written notification.

General Procedures

An employee reporting for work visibly impaired will be deemed unable to properly perform their required duties, and will not be allowed to work. If possible, the employee’s manager or supervisor will first seek another manager or supervisor’s opinion to confirm the employee’s status. Next, the manager or supervisor will consult privately with the employee to determine the cause of the observation, including whether substance abuse has occurred. If in the opinion of the manager or supervisor the employee is considered impaired, and if possible, the employee will be sent home or to a medical facility. If these are not possible, the employee will be sent home by taxi or other safe transportation alternative – depending on the determination of the observed impairment – and accompanied by the manager, the supervisor, or another employee if necessary. A drug test may be in order and if so, one will be requested.

An impaired employee will not be allowed to drive. In cases where no person is available to transport an impaired employee and that employee insists on driving, the police will be called.

Pre-employment Drug Testing

All job applicants who are considered for employment and complete the interview process at The Company will undergo testing for the presence of illegal drugs as a condition of employment. Any applicant with a confirmed positive test will be denied employment.

Applicants will be required to submit voluntarily to either an oral saliva kit test on site, a urinalysis kit test on site, and/or if elected an off site urinalysis lab test at a facility chosen by The Company, and by signing a “Consent agreement” applicant will release The Company from any and all liability attendant to the testing methodology chosen by The Company. If the office, physician, official, or lab personnel have reasonable suspicion to believe that the job applicant has tampered with the specimen, the applicant will not be considered for employment.

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The Company will not discriminate against applicants for employment because of a past history of drug abuse.

It is the current abuse of drugs, which prevents the employee from performing their job properly that The Company will not tolerate.

Individuals (applicants) who have failed a pre-employment test may initiate another inquiry with the company after a period of not shorter than six (6) months; but they must present themselves drug-free as demonstrated by urinalysis or other test(s) as selected by The Company.

Employee Testing

The Company has adopted testing practices to identify employees who use illegal drugs on or off the job, or who abuse alcohol on the job. It shall be a condition of employment for all employees to submit to drug testing under the following circumstances:

  1. When there is “reasonable suspicion” to believe that an employee is using illegal drugs or abusing alcohol. “Reasonable suspicion” is based on a belief that an employee is using or by objectively articulated fact(s) and/or reasonable inference(s) drawn from the fact(s), has used drugs or alcohol in violation of the employer’s policy drawn from their specific light of experience. Among other things, such facts and inferences may be based upon, but not be limited to, the following.

A. Observable phenomena while at work such as direct observation of substance abuse or of the physical symptoms or manifestations of being impaired due to substance abuse.

B. Abnormal conduct or erratic behavior is observed while at work, or a significant deterioration in work performance is detected. C. A report of substance abuse provided by a reliable and credible source.

D. Evidence that an individual has tampered with any substance abuse test during his or her employment with the current employer.

E. Information that an employee has caused or contributed to an accident while at work.

F. Evidence that an employee has used, possessed, sold, solicited, or transferred drugs while working or while on the employer’s premises, or while operating the employer’s vehicle, machinery or equipment.

  1. When an employee has caused or contributed to an on-the-job injury that has resulted in lost work time, which means any period of time during which an employee stops performing the normal duties of employment and leaves the place of employment to seek care from a licensed medical provider. An employee will be sent for a substance abuse test if they are involved in an on–the-job accident where any type of personal injury or, any form of damage to company property occurs.
  2. As part of a follow-up program of treatment for drug abuse.
  3. When a substance abuse test is conducted as part of a routinely scheduled employee fitness-for-duty medical examination that is part of the employer’s established policy or that is scheduled routinely for all members of an employment classification or group.
  4. When the company elects to conduct their own internal random drug testing activity being on a predetermined percentage of the workforce. Those chosen for testing will be selected in a nondiscriminatory manner as deemed acceptable or impartial to all company employees.

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Employees with a confirmed positive test result may at their option and expense have a second confirmation test made on the same specimen. An employee however will not be allowed to submit another specimen for testing.

If the physician, official, or lab personnel have reasonable suspicion to believe that the employee has tampered with the specimen, the employee is subject to disciplinary action up to and including termination.

Alcohol Abuse

Company policy shall be understood to exist as follows, an employee who is under the influence of alcoholic beverages at any time while:

  1. On company business or,
  2. At any time during the hours between the beginning and ending of the employee’s work day whether on duty or not or,
  3. Whether on Company business or property or not,

Shall be guilty of misconduct and is subject to disciplinary action up to and including termination.

An employee shall be determined to be under the influence of alcohol if…

  1. The employee’s normal faculties are impaired due to the consumption of alcohol, or
  2. The employee’s blood alcohol level as a result of the test is found to be .08 or higher or as currently defined by the state as being sufficiently elevated to the point where it is unlawful for the employee to operate a motor vehicle.

Refusal of a Substance Abuse Policy Test

Failure of the employee to submit to a Company required substance abuse test is considered an act of misconduct and the employee shall as a result of this refusal be subject to disciplinary action up to and including termination.

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(Hereafter referred to as The Company)

Substance Abuse Policy

I do hereby certify that I have received and read The Company‘s Substance Abuse and Drug & Alcohol policy, and have had these policies explained to me.

I understand that I may be required to submit to a drug test under the following circumstances:

  • When there is reasonable suspicion that I am using illegal drugs.
  • When I have been involved in an on-the-job accident where personal injury or property damage occurs, or when a significant loss of company funds or property occurs.
  • When returning to work after completing a drug abuse rehabilitation program.
  • When a substance abuse test is conducted as part of a routinely scheduled employee fitness-for-duty medical examination that is part of the employer’s established policy, or that is scheduled routinely for all member of an employment classification or group.
  • As required by Federal, State or other regulatory agencies, other types of testing required for certain employees, such as testing of company drivers and individuals in safety sensitive positions as required by D.O.T. regulations.
  • When the company elects to conduct internal random testing, which is done in a non-discriminating and impartial way as determined by both my co-workers and management.

I also understand that failure to comply with a drug test request, tampering with urine or other samples, or a positive test result may lead to my termination of employment.

Nothing in this consent form is to be construed or interpreted as a contract between the parties.

Name – please printDate



(Hereafter referred to as The Company )

Employee Drug & Alcohol Testing Consent Form

I hereby consent to submit to urinalysis and/or other tests as shall be determined by The Company, for the purpose of determining the drug content thereof.

I agree that individuals certified by the National Institute on Drug Abuse (NIDA), the College of American Pathologists (CAP), the State Department of Human Resources, or a qualified person certified or employed by a practicing collection company may collect specimens for these tests to be performed. Moreover, I agree the collector of specimens may conduct their own tests, or they may forward them to a NIDA or CAP Certified, testing laboratory for analysis.

I further agree to and, hereby authorize the release of, the results of said tests to The Company.

I understand that it is the current use of illegal drugs that shall strictly prohibit me from being employed at The Company.

I further agree to Hold Harmless in every respect The Company and their agents, including specimen collection companies, designated testing laboratories as well as their duly authorized representatives, from any liability arising in whole or in part out of the collection of specimens, the testing of specimens, and the use of the information from said testing all being conducted in connection with The Company’s consideration of my continued employment.

I further agree that a reproduced copy of this Drug & Alcohol Testing Consent Form shall have the same force and effect as the original.

I have carefully read the foregoing and fully understand its content. I acknowledge that my signing of this Drug and Alcohol Testing Consent Form is a voluntary act on my part and that I have not been coerced into signing this document by anyone.


Printed Name: ___________________________________S.S.#:__________________________



Printed Name:____________________________________



(Hereafter referred to as The Company )

Job Applicant Drug & Alcohol Testing Consent Form

I hereby consent to submit to urinalysis and/or other tests as shall be determined by The Company in the selection process of applicants for employment, for the purpose of determining the drug content thereof.

I agree that individuals certified by the National Institute on Drug Abuse (NIDA), the College of American Pathologists (CAP), the State Department of Human Resources, or a qualified person certified or employed by a practicing collection company may collect specimens for these tests to be performed. Moreover, I agree the collector of specimens may conduct their own tests, or they may forward them to a NIDA or CAP Certified, testing laboratory for analysis.

I further agree to and, hereby authorize the release of, the results of said tests to The Company.

I understand that it is the current use of illegal drugs that shall strictly prohibit me from being employed at The Company.

I further agree to Hold Harmless in every respect The Company and their agents, including specimen collection companies, designated testing laboratories as well as their duly authorized representatives, from any liability arising in whole or in part out of the collection of specimens, the testing of specimens, and the use of the information from said testing all being conducted in connection with The Company’s consideration of my continued employment.

I further agree that a reproduced copy of this Drug & Alcohol Testing Consent Form shall have the same force and effect as the original.

Job Applicant Statement of Acceptance

I have carefully read the foregoing and fully understand its content. I acknowledge that my signing of this Drug & Alcohol Testing and Consent Form is a voluntary act on my part and that I have not been coerced into signing this document by anyone.

Job Applicant:

Printed Name:_______________________________________S.S.#:______________________



Printed Name:_________________________________________




Re: Drug test results notification

Employee Name


City State Zip

Dear ______________________:

Your recent drug test results at our approved testing lab have been received and reveal a non-negative test for drugs. You may ask about the specifics if you contact our office.

Pursuant to our company policy this is your written notification to which you have 5 days to respond in writing should you have an issue with the results. A second test can be run on the same sample if you so desire.

As you know this company has a zero-tolerance policy on drugs in the workplace and as a result of your test results the following actions are being taken:

You are immediately suspended without pay. Moreover, you are advised to promptly seek drug treatment and its attendant counseling from the county or treatment center provided in your area of residence. Upon completion of your treatment you are to bring to our office a copy of your certificate to verify you have completed the treatment program. Upon producing this notice of completion you will be retested for drugs at your expense and if you pass the new drug test your employment can or may be reinstated provided it remains available. If the same position is not available perhaps other employment positions may be suitable, which can be discussed at the appropriate time.

Please reply within 5 days to our office so your decision can be formally documented for our file. We regret this action however this decision is final and adheres to existing company drug policy.



(HR Department)

Cc: ____________________________________________________

Carrier Name Adjuster




Employees who need to use prescription or nonprescription legal drugs while at work MUST report this medical requirement to the Human Resources Department if such use might be seen or deemed as impairing or hindering the employee’s ability to perform their job safely and effectively.

Depending on circumstances meaning if the drug based on its warning instructions or due to employee reaction, induces or causes sleepiness, disorientation or the display of any other form of physical or mental instability management reserves the right and has the obligation to take one of the following affected employee actions:

  1. Reassignment to another job
  2. Prohibition of performing certain tasks or specifically where safety is a concern
  3. Prohibition from performing any job or task on the premises

Management with this policy is trying to balance employee rights with employee safety including fellow employees who could be put in danger due to the legal use of prescription or other forms of OTC type legal drugs.

This obligation by the Company is not taken lightly, and is only being adopted to provide the safest possible workplace for all of its valued employees.


Please report any observed unsafe behavior regarding the above to your supervisor. You too have an obligation to provide for a safe workplace and to report any irregular or unsafe behavior to management so responsible action can be taken.