This article explains how drug screening works within Background Checks by ClearCompany. It covers scheduling, result timing, test types, common panels, Medical Review Officer (MRO) involvement, and how to interpret statuses and outcomes. Use this guide to understand what happens at each stage and how to manage results compliantly.
In this article:
Drug Screen Workflow
Screening And Confirmation Testing Levels
Common Drug Test Panels
Result Timing And Statuses
Medical Review Officer (MRO) review
DOT-specific considerations
F.A.Q.
Drug Screen Workflow
Once an applicant signs the required electronic authorization forms, the Background Checks team takes care of the rest. The following is the standard drug screening process:
- The Background Check team schedules the applicant at a clinic near their home address.
- The applicant receives an ePassport by email and text message with instructions for their visit.
- By default, applicants have three business days to complete the test and can walk in during clinic business hours.
- When results are ready, they are visible in the applicant’s profile in ClearCompany or in AllClear.
- Negative results should be back within 15-20 minutes, but any DOT or specimen that needs further testing can take an average of 1-5 business days.
Screening and Confirmation Testing Levels
Understanding screening vs. confirmation testing
In workplace drug testing, the industry standard is a two-step process, an initial screen on one portion of the specimen, followed by a confirmatory test on a second portion of the original specimen.
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Initial screening
- The lab performs an initial screen using immunoassay testing. This step separates negative specimens from those that need further review.
- If a specimen is below the cutoff level, it is reported as negative.
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Confirmation testing
- If the initial screen meets or exceeds the cutoff level, the specimen goes through confirmation testing.
- Confirmation testing uses advanced methods such as chromatography-mass spectrometry (GC/MS).
- This process specifically identifies and measures the drug or metabolite.
- A result is only reported as positive if the confirmed level meets or exceeds the confirmation cutoff.
Important
Confirmation testing can add several days to the turnaround time. This is required to protect accuracy and compliance. Each round can take up to 72 hours.
Common Drug Test Panels
5 Panel: The 5-panel is going to test for common “street” drugs like marijuana, cocaine, amphetamines, methamphetamines, and opiates.
Panel 1200
Marijuana
Cocaine
Amphetamines
Opiates
PCP
10-Panel: The 10-panel will test for the common drugs as well as common misused prescription drugs such as Oxycodone, PCP, barbiturates, Benzo, and methadone.
PANEL 3125 - 10P WITH THC* Standard Panel
Marijuana
Cocaine
Amphetamines (AMP)
Amphetamines (MET)
Opiates
Oxycodone
PCP
Barbiturates
Benzodiazepines
Methadone
PANEL 3477 - STANDARD 10 PANEL NO THC* Standard Panel
Cocaine
Amphetamines (AMP)
Amphetamines (MET)
Opiates
Oxycodone
PCP
Barbiturates
Benzodiazepines
Methadone
QUEST DOT PANEL
Marijuana Metabolite
Cocaine Metabolite
Amphetamine/Methamphetamine
Codeine/Morphine
6-Acetylmorphine
Hydrocodone/Hydromorphone
Oxycodone/Oxymorphone
Phencyclidine
MDMA/MDA
Breath alcohol testing (BAT)
Some testing packages include BAT (breath alcohol testing) alongside urine drug testing.
- Quant only BAT shows the exact alcohol level in the sample.
- Results show whether alcohol levels meet or exceed allowable limits.
- No additional substance screening is performed.
Most clients use BAT + urine drug testing as part of their Post Accident/Reasonable Suspicion testing packages.
Result Timing And Statuses
Drug test results move through several stages. Understanding these statuses can help set expectations and reduce confusion when results take longer than expected.
Typical turnaround times
- Negative results: Usually reported the same day.
- Non-negative results: If the reader or system flags a test as non-negative (for example, dilute, invalid, or other irregular findings), the sample is sent to the lab. Most lab results are returned 1–3 business days after the lab receives the specimen.
- Dilute results: A dilute result means the urine sample has a high water content. To help avoid dilute results, donors should avoid excessive hydration before testing.
- An invalid result means a scientifically supported negative result cannot be confirmed. This may be caused by: Abnormal ph, Unidentified substances, Medical or physiological factors, Adulterated or substituted results.
- Sent to Lab: The clinic has sent the specimen to the laboratory. The status updates to Received at lab once the lab checks the sample in.
- Received at Lab: The lab has received the specimen and is processing it. If this started as an instant test, this status means additional testing was required, so the sample was converted to a lab test.
- Extended processing time: If results take longer than 1–3 business days after arrival at the lab, the specimen is typically undergoing confirmatory testing. Confirmatory testing does not have a guaranteed timeframe, but it is usually completed within 1–5 business days.
- In Process With Medical Review Officer (MRO): All non-negative results are sent to the laboratory for confirmation and then reviewed by an independent Medical Review Officer (MRO) for final determination.-
- Privacy Note: Statuses such as Confirmatory testing or In MRO review are not visible in ClearCompany reporting or integrations. These steps remain confidential until final results are released to protect donor privacy, especially when prescription or positive results may be involved.
- Determination pending (DOT only): Used when a driver has a medical condition that requires additional information before certification. This status can remain for up to 45 days.
- Possible oxidant activity: Detected when oxidizing agents (such as nitrites or PCC) are found in the sample. Because these substances can interfere with test accuracy, the MRO typically recommends an immediate observed retest.
- Invalid result: An invalid result means a scientifically supported negative result cannot be confirmed due to factors such as abnormal pH, unidentified substances, or abnormal concentrations. An observed recollection is often recommended where permitted by law.
- Substituted result: A substituted specimen indicates the urine provided is inconsistent with human urine based on creatinine and specific gravity values. In some cases, substituted results may also be classified as a refusal, depending on donor behavior or admissions.
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Refusal: A refusal may be determined by the MRO for actions such as:
- Leaving the collection site before completion
- Failing to provide a specimen without a valid medical reason
- Admitting to tampering
- Refusing required observed collections
- Interfering with the collection process
- The MRO makes the final determination after reviewing all facts and medical explanations.
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Insufficient quantity: The sample provided is too small to complete the test.
- In some cases, some may also be labelled as insufficient quantity leaked in transit.
- Applicants have up to three hours to provide enough for testing through the shy bladder process.
- If a sufficient sample is not provided, the test may need to be canceled or rescheduled.
Why do some tests take longer?
A drug test may take longer when:
- The result is non-negative (for example, positive, dilute, invalid, or adulterated).
- The clinic sends an instant test to the lab for additional testing.
- The lab needs to complete multiple rounds of confirmation testing.
- The result requires review by the MRO.
Neither ClearCompany nor the lab can speed up this process. These steps are required by law to maintain the integrity of the results.
Medical Review Officer (MRO) review
All non-negative results are sent to an independent Medical Review Officer.
What the MRO does:
- Reviews lab results for accuracy.
- Contact the donor to verify prescriptions or medical explanations when needed.
- Makes the final determination before results are released.
- Return-to-duty and follow-up tests are reviewed by a Medical Review Officer (MRO) if the lab reports them as positive or invalid. The main difference is that RTD and follow-up urine collections are directly observed, as required by regulation.
- Marijuana and medical marijuana cards: Because marijuana is classified as a Schedule I drug under federal law, the MRO cannot overturn a THC positive result based on a medical marijuana card. If a donor reports medical marijuana use, the MRO will document and communicate that claim to the employer. The MRO does not verify medical marijuana cards.
- The MRO has 72 hours to reach the donor.
- The MRO typically makes three attempts.
- If the donor cannot be reached, the result may be reported as Positive – unable to contact donor.
If the donor later contacts the MRO and provides valid prescription information, the result may be updated.
- If the RX is deemed valid, it will update to negative.
- If the RX is deemed invalid, the result will be positive.
- If the donor does not call, the result will stay Positive Unable To Contact Donor.
Need help or next steps?
If you have questions about a specific result that is currently with the MRO, you can contact the MRO directly at:
- Donor line: 888-382-2084
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Employer line: 888-382-2281
- Important: The MRO communicates only with the Designated Employer Representative (DER) on file. Not all users with background check access are DERs. Clients must assign 1–3 DERs during setup or update them later.
- eScreen shares non-negative results only with the DER.
ClearCompany is committed to helping you navigate drug screening with clarity and confidence.
DOT-specific considerations
DOT-regulated tests follow stricter federal requirements.
- Missing or incorrect Chain of Custody Form (CCF) documentation can delay results for up to 30 days.
- In some cases, a test may be canceled due to a fatal flaw if documentation is not corrected in time.
- For unresolved abnormal results, guidance must come directly from the Department of Transportation.
- You can request a retest at a different clinic if you need results quickly. The client must approve this request.
- If the CCF issue is resolved within 30 days and you complete a retest, you will be charged for both tests.
- If the issue is a fatal flaw and is not resolved within 30 days, you will receive a credit for the first test.
F.A.Q.
Yes. Any non-negative result is sent to the lab for confirmation and then reviewed by the MRO before final reporting.
Only if the donor mentions it during the MRO interview, because marijuana is illegal under federal law, the MRO cannot overturn a THC positive based on a medical marijuana card. Any claim is shared with the employer for awareness, but is not verified.
These statuses are not shared due to donor privacy and compliance requirements. Results are released only when final.
To remove the THC/Marijuana from your drug screening panel, reach out to backgroundchecks@clearcompany.com with the request.
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