Drug tests

The goals of onsite oral fluid drug tests are to expedite hiring and reduce the costs and risks of drug use in the workplace.

Checkr partners with Premier Biotech to offer onsite oral fluid drug tests. You administer the OralTox rapid oral fluid drug test where you choose, instead of at a third-party clinic. 

This article has the sections below: 

• Initial setup
• Substances tested
• Collection process
• Results
• Candidate experience

Initial setup

To add onsite drug testing to your account, contact Checkr. You can order your first test about 10-12 business days after you add onsite oral fluid drug test to your account. 

1. Confirm that you have received the OralTox drug test collection kits.
2. On your phone or device, download the OT Scan app from the Google Play store or the Apple App Store.
3. Email clients@checkr.com to add users to the OT Scan app.

Before the end of each day, log in to the OT Scan app and check for pending results in Menu > Results. 

Substances tested

Checkr offers panels that can test between 4 and all 10 of the substances below:

• Amphetamines
• Barbiturates
• Benzodiazepines
• Cocaine
• Marijuana 
• Methadone
• Methamphetamine
• Opiates 
• Oxycodone
• Phencyclidine (PCP)

Collection process

Premier Biotech's website has a video overview of the collection and test process.

The sample collection process follows the sequence below:

1. You send an invitation to the candidate.
2. The candidate submits their personally identifiable information (PII).
3. The candidate travels to your chosen location.
4. On your phone or device, sign in to the OT Scan app. Open the order for the candidate. Collect the candidate's signature, and scan the collection kit.
   The app calls the candidate the donor. 
5. Give the collection kit to the candidate to swab their mouth. Then, seal the collection kit and wait 10 minutes for the test to complete.
6. You scan the results, and the OT Scan app shows a result of inconclusive, invalid, or negative. Proceed based on the test result:

• • Inconclusive: Inconclusive results require additional review. Use the steps below:

1. 1. 1. 1. Scan the barcode for the FedEx package.
         2. Ask the candidate to initial the security seal.
         3. In the OT Scan app, complete the chain of custody form.
         4. Prepare the collection kit for shipping. 
         5. In the OT Scan app, enter the candidate's phone number.
         6. Ship the collection kit to the lab using FedEx. After the lab tests the sample and a medical review officer (MRO) reviews it, Checkr shows the result.

• • Invalid: Invalid results can happen if there were errors in the collection. Use the steps below:

1. 1. 1. 1. Tap Done to return to the home screen.
         2. Retrieve the order for the same candidate.
         3. Collect a new sample with a new collection kit.

• • Negative: Negative results mean that the sample contains none of the tested substances. You can discard the specimen. Checkr immediately shows negative results on the candidate’s report.

The OT Scan app might not promptly send the result to Checkr for a reason below:

• Delay between logging in to the app and starting a test
• Delay between tests
• Network connection issue

Medical review officer (MRO) process for onsite oral fluid drug tests

When the lab can't verify inconclusive results, a medical review officer must review the results. Inconclusive results appear after the lab tests the sample and an MRO reviews it. MRO review extends the average turnaround time up to 10 business days.

Checkr partners with Premier Biotech’s MRO, Dr. Khella, for this review. The process includes the steps below:  

1. The MRO reviews the inconclusive result with the candidate. 
2. The MRO determines whether the candidate takes prescription medication that would show evidence of the tested substance. If needed, the MRO verifies the prescription with the pharmacy.
3. If the MRO needs to contact the candidate, they make 3 attempts within 1 business day.
   If the MRO can't contact the candidate during this time, results remain pending for an additional 72 business hours to give the candidate time to call back.
   If the candidate doesn't respond, the result appears in the final report as “Positive-UTCD” (Unable To Contact Donor).

If you need to contact Dr. Khella at Industrial Medical Testing, LLC, call 888-808-4676.

Results

To find the results of a drug test, open the candidate’s report and click Health test. For more details, you can download the Health test PDF from the Report information section of the candidate's report.

Checkr receives results as negative or positive:

• Negative indicates that the test showed no evidence of the tested substance.
• Positive indicates that the test showed evidence of one or more of tested substances.

Checkr can't expedite reports for onsite oral fluid drug tests. Checkr also can't change a test's result. If a candidate wants to dispute oral fluid drug test results, they can contact the MRO directly at 888-808-4676.

Contact Checkr about the topics below:

• Report status questions
• OT Scan app questions, including adding and deleting users
• OralTox collection kit orders using this form that you email Checkr
• Technical issues

Candidate experience

After receiving the invitation, the candidate does the steps below:

1. Enter personal information.
2. Acknowledge receipt of applicable forms and notifications, including those below:
• Summary of Your Rights Under the Fair Credit Reporting Act (FCRA)
• Acknowledgment and authorization for a background check
• Other state and required disclosures as applicable
3. Travel to the test location.
4. In the OT Scan app, sign the consent form.
5. Use the collection kit to provide an oral fluid sample.
6. Sign in to the Checkr Candidate Portal to find the test result.

The goal of clinic-based drug tests is to reduce the costs and risks of drug use in the workplace. 

Checkr partners with eScreen to offer clinic-based drug test options. To add drug test to your account, contact Checkr. You can order your first test about 7-10 business days after you add drug tests to your account.

This article has the sections below:

• Substances tested
• Collection process
• Results
• Candidate experience

Substances tested

The most common panels include the tests below:

	5-panel	9-panel	10-panel
Tests	Amphetamines Cocaine Marijuana Opiates (Basic) Phencyclidine (PCP)	Amphetamines Cocaine Marijuana Opiates (Basic) Phencyclidine (PCP) Barbiturates Benzodiazepines Propoxyphene Methadone	Amphetamines Cocaine Marijuana Opiates (Basic) Phencyclidine (PCP) Barbiturates Benzodiazepines Propoxyphene Methadone Methaqualone

If you need a more specific panel, contact Checkr. 

Collection process

The sample collection process follows the workflow below:

1. You send an invitation to the candidate.
2. The candidate selects a test location and receives their test pass.
3. The candidate contacts the clinic to schedule their appointment.
4. The candidate completes their appointment before the pass expires. If you need to, you can update the clinic location for the candidate or send an updated pass from their report in the Checkr Dashboard.
5. After the test, the clinic submits a sample to the lab. The lab processes the sample and submits the results to eScreen. A certified medical review officer (MRO) reviews the results.
6. Final results appear on the Checkr Dashboard for your review.

Medical review officer (MRO) process for non-DOT drug tests

An eScreen medical review officer reviews drug test results. Non-negative results (such as pending results or inconclusive results) require additional followup with the candidate. The process includes the steps below:

1. The MRO reviews the result with the candidate. 
2. The MRO determines whether the candidate takes prescription medications that would show evidence of the tested substance. If needed, the MRO verifies that prescription with the pharmacy. 
3. If the MRO needs to contact the candidate, they make 3 attempts within 1 business day.
   If the MRO can't contact the candidate during this time, results don’t change for an additional 72 business hours to give the candidate time to respond.
   If the candidate doesn't respond, the result appears in the final report as “Positive-UTCD” (Unable To Contact Donor).

This process is specific to non-DOT (Department of Transportation) drug tests. Help me understand MRO reviewed results of a drug test.

Results

Checkr usually shows results within 3 days of the candidate completing the appointment. MRO review extends the average turnaround time up to 10 business days. 

To prevent delays, work with your candidate to ensure:

• The candidate calls the clinic to confirm the appointment. 
• The candidate downloads the test pass and brings it to the appointment. Completing the test requires the test pass. The clinic can't help with lost or misplaced passes. 
• The MRO follow-up happens promptly.

To review results, open the candidate’s report and click Health test. For more details, you can also download the Health test PDF from the Report information section of the candidate's report.

Checkr receives results as negative or positive:

• Negative indicates that the test showed no evidence of the tested substance.
• Positive indicates that the test showed evidence of one or more of the tested substances.

Get help

Checkr can't expedite reports for drug tests. Checkr also can't change a test's result. If a candidate wants to dispute drug test results, they can contact the MRO directly at 888-382-2281. 

For more information, refer to What if the candidate challenges the results of their drug test?

Visit Checkr’s Drug and Occupational Health FAQs for answers to common questions. 

Contact Checkr about the topics below:

• How to find a clinic near the candidate
• Report status questions

Candidate experience

After receiving the invitation, the candidate does the steps below:

1. Enter personal information.
2. Acknowledge receipt of applicable forms and notifications, including those below:
• Summary of Your Rights Under the Fair Credit Reporting Act (FCRA)
• Acknowledgment and authorization for a background check
• Other state and required disclosures as applicable
3. Consent to the test. 
4. Select a test location. 
5. Confirm the appointment with the clinic, and schedule the test before the listed date.
6. Download and print the pass.
7. Bring the pass to the clinic for the test. 

Checkr’s Health test product is designed to assign a 1:1 match for drug testing clinics based on the product selected. The only exception is for the 5-panel, which Checkr will convert to an eCup+. 

Related article: 

• Checkr Health: Drug tests

Question

When would a candidate need additional paperwork outside of the screening pass to complete their screening?

Answer

Candidates must complete additional paperwork (a custody control form) if they select a paper-based clinic during the apply flow. This paperwork will be mailed to the address they provide during the apply flow. 

For more information about the screening process when using paper-based clinics, please refer to Screenings using paper-based clinics.

Question

Why did the clinic refuse service to my candidate? 

Answer

Possible reasons that a clinic may refuse service to a candidate include: 

• The candidate did not provide the required paperwork
• The screening pass has expired
• The candidate did not schedule an appointment

For more information about required paperwork for drug and occupational health screenings, please refer to Screenings using paper-based clinics.

Question

How long does it take to get the results of a drug test?

Answer

Drug test results are usually available within 2 to 10 business days after the test is complete. However, the turnaround time for the following scenarios may be longer than the expected 2 to 10 business days:

• Drug test specimens that need to be shipped to the lab for additional testing; 
• Tests performed using paper-based clinics; or
• Test results that require MRO follow-up (see below). 

Medical Review Officer review

All drug tests are passed through a Medical Review Officer (MRO) for review. If MRO follow-up is needed, the MRO will attempt to call the candidate 3 times within 1 business day. If they are unable to reach the candidate during those attempts, the results will remain Pending for an additional 72 hours to allow the candidate time to return the call. To prevent delays in the results, ensure that the candidate performs any MRO follow-up promptly.

Once the test window has closed the pass will expire. To send an updated test pass:

1. Open the Candidate’s report in the Checkr Dashboard.
2. Navigate to the Health test appointment section.
3. Select Email Candidate > Send updated test pass.

After an updated test pass is shared:

• The same clinic previously used will be applied to the new passport
• The expiration date of the test pass will be updated according to the account/package setting

Please note that reports suspend within 48-72 hours of the pass expiring. If a report has been suspended due to a pass expiring, sending an updated test pass will push the report out of a suspended status and into a pending status.

If a candidate had NOT scheduled at their chosen clinic, the customer can still resend the test invitation by selecting Email Candidate > Re-send test invitation within the Health test appointment section.

Related articles:

• How do I extend the deadline on an active drug test pass?
• What if a candidate needs to change the location for their drug test appointment?

Candidates can now change the location of their scheduled drug/health test directly in the Candidate Portal:

1. Navigate to the Health test information section
2. Select Change Location

Related articles:

• How do I extend the deadline on an active drug test pass?
• How do I send my candidate an updated drug test pass?

The most commonly ordered 5-panel drugs include: 

1. Amphetamines
2. Cannabinoids (THC)
3. Cocaine
4. Opiates 
5. Phencyclidine (PCP)

You can also review Checkr’s most common panels (PDF attached) for a broader list of test types.

Question

I cannot find a clinic located in the zip code I searched.

Answer

If the customer (or candidate) is searching a zip code and no locations are returned, that likely means that there are no clinics available in a 60-mile radius that perform the required test. There may be “Out of Network” clinics that are not enabled in the customer account settings available. These clinics are typically more expensive and require customer agreement in place before leveraging these additional locations. If you need to inquire further about available clinics in a particular zip code please contact Checkr Customer Support and we will assist in running a zip code search to identify if alternative locations may be available to your candidate.

Question

Can Checkr expedite a drug test? 

Answer

No, Checkr is unable to expedite the test process as Checkr is not involved in the collection or processing of a sample. Once eScreen submits the results to Checkr, the test results will become available immediately.

 

Find an outline of the test process as follows:  

When no electronic clinics exist within a candidate’s zip code or there are limited clinics in the area, the candidate will be given the option to select a paper-based clinic. If candidates see the phrase "Paperwork will be mailed to you" under the clinic name, this indicates that it is a paper-based clinic.

When a candidate selects a paper-based clinic, a message will appear asking the candidate “Are you sure?” with additional information explaining the extended turnaround times. This messaging will also appear on the candidate’s report within the Checkr Dashboard. To proceed with the selected clinic, the candidate will select “Add Address” and enter their address on the following page. After adding their address, the candidate will complete the remaining pages of the apply flow.  

When the apply flow is completed, the expiration date of the test pass is automatically pushed to 30 days instead of the customer-set default. 

Once the candidate has completed the apply flow, our lab provider will send the required paperwork (a custody control form) via FedEx to the address provided by the candidate.

 

Viewing this information in the Checkr Dashboard

To see if a paper-based clinic was selected, navigate to the Health test appointment section of the candidate's report. If the phrase 'Paperwork will be mailed' appears under the clinic name then a paper-based clinic was selected.

Question

Can Checkr upload drug or health test results shared by the candidate?

Answer

Checkr cannot directly upload drug test or occupational health test documentation nor manually update a candidate’s test. However, if your candidate received paperwork after completing their test, and provided it to you, Checkr can send that paperwork to eScreen. eScreen will then determine if the paperwork can be used to update a candidate’s test. 

Updates may happen at any point during the test process, including after the test is “complete.”

To update an active test pass:

1. Open the Candidate’s report in the Checkr Dashboard
2. Navigate to the Health test appointment section
3. Select Add more time

There are no limitations to how much time can be added to active test passes or how often they can be updated. Customers should use the Add More Time button in conjunction with their internal hiring policies and expectations for completing a drug/health test. 

If the pass has expired, the Add more time button will disappear and the customer should send an updated test pass or re-send a test invitation. 

Related articles:

• How do I send my candidate an updated drug test pass?
• What if a candidate needs to change the location for their drug test appointment?

Question

We received an invoice for a drug test that did not come from Checkr. What should we do?

Answer

Submit the invoice to Checkr Customer Support. Checkr will follow up with eScreen to correct the mistake.

How does legal marijuana affect drug testing in the workplace?

It is up to the customer to decide whether or not to test for marijuana in states where it has been legalized. Checkr, via our eScreen partnership, will provide an MRO note where a marijuana test is positive and the candidate noted that they have a valid prescription. 

The result will still be released as a positive regardless of the prescription. The MRO does not validate marijuana prescriptions. It is the customer’s responsibility to make a determination on qualification, hiring, or termination of a candidate based on positive/negative test results and local law. 

Today there is no central US repository for legal marijuana prescriptions and CRAs cannot access the local state databases. Customers should consult with their legal counsel to determine specific needs and obligations. 

 

Does Checkr offer a drug screening panel that excludes THC?

Yes, contact Checkr Customer Support to add this screening option to your account.

 

Question

A drug test came back canceled.  Why would that happen and will the customer be charged?

Answer

Two common reasons a drug test may be canceled:

1. An error occurred on our side. For example, the specimen was lost in transit or spilled, etc. There will be no charge for the test. The candidate will need to go back to the clinic and take a new test. You will create a new order for the candidate to begin this process.

Here is an example of a canceled test that was due to a human error at the collection site and a mix-up of the Specimen ID number.  This drug test would not be billed to the customer:

1. The test was canceled due to something that looks like an adulterated specimen, or an error on the candidate’s part. For example, the temperature of the specimen at the time of collection was not within an acceptable range, etc. These tests will result in a charge and a “Consider” status on the report. If you’d like to give the candidate a second chance to retake their drug test, you can do so by ordering a new report. 

Here is an example of a canceled test that was due to something abnormal with the specimen.  This drug test would be billed to the customer:

Question

What are the different types of drug tests?

Answer

Urine is the most common specimen for drug screening. Each drug test consists of a “panel” of various drugs to be tested at certain thresholds. 

Businesses rely on laboratory-based urine testing for its cost-effectiveness, capacity to screen for a variety of different illicit drugs, and ability to withstand most legal challenges. Other specimens include saliva, hair and blood draws. 

Contact Checkr Customer Support for screening options. Checkr partners with eScreen to offer a comprehensive and customizable selection of drug tests to suit each company’s needs.

Also see What is the standard panel of drugs tested for during pre-employment screening?

Question

Help me understand MRO reviewed results of a drug test.

 

Answer

Checkr’s partner eScreen works with a certified Medical Review Officer for the review of all testing. The Medical Review Officer (MRO) is a licensed physician with special certification to receive, review and evaluate drug-testing laboratory results.  

 

The Medical Review Officer (MRO) process is when a non-negative result comes back from the lab. The MRO will:

• Review the result with the candidate to determine if they have any prescriptions which would account for the positive drug analyte. 
• Verify the prescription with the pharmacy. 
• If it aligns with the positive drug, the result will be released as a Negative. 
• If it does not align with the positive drug, the result will be released as a Positive.

*Note: The MRO is NOT verifying the level of the drug compared to the prescription. Only if the drug positive matches the prescription. Results can be delayed if the candidate does not respond to the MRO in a timely fashion.

 

Use the following guide to interpret MRO results:

MRO Reviewed Result	Result Meaning	Next Steps
Positive UTCD	If the candidate has a positive analyte from the lab result, the MRO will contact the candidate before releasing the results to Checkr to see if they have a prescription for that substance. If they are unable to connect with the candidate, they will release the results to the report to “Positive UTCD” (Positive Unable To Contact Donor) due to the candidate still testing positive for a substance without a prescription verification confirmation.	Take the drug test at face value or send another invitation to the candidate. If a new invitation is sent, the candidate must go to a clinic and provide another urine collection.
Negative-dilute	Urine from the donor has been diluted either by drinking excessive amounts of water or by adding water directly to the sample after voiding, in an effort to reduce the concentration of drug metabolites in it.	Send another invitation to the candidate. Once sent, the candidate must go to a clinic and provide another urine collection.
Substituted	The candidate provided a sample that was either not urine or not their own urine at the time of collection.	Send another invitation to the candidate. Once sent, the candidate must deposit another sample.
Abnormal PH	Urine samples always have their PH level tested. If the PH does not fall within the normal range, it will be reported invalid.	Send another invitation to the candidate. Once sent, the candidate must go to a clinic and provide another urine collection.
GC/MS (Immunoassay) Interference	Interference with the initial stage of testing, preventing a result. result of medication that the donor has been taking, an attempt to adulterate, or neither.	Send another invitation to the candidate. Once sent, the candidate must go to a clinic and provide another urine collection.
Test Cancelled	Results cannot be determined. Can be due to a myriad of reasons. Please look at the notes section for more details.	Send another invitation to the candidate. Once sent, the candidate must go to a clinic and provide another urine collection.
Positive	Upon review of the positive lab result, the MRO will contact the candidate to review their prescriptions.  If no prescription validates the positive drug, the result will be released to the employer as a positive.	Take the result at face value.

As a reminder, this does not constitute and is not intended to be construed as legal advice. Please consult your legal counsel regarding your compliance obligations and best practices.

Question

What are adulterants? Can labs screen them?

Answer

Adulterants are substances added to a specimen to produce a false negative that donors can consume through over-the-counter products. An adulterated specimen may contain a substance that is not normally found in human urine. Labs do screen for adulterants, but may encounter difficulty with identifying the drugs the donor was trying to conceal.

Also see Help me understand MRO reviewed results of a drug screening.

Question

What is a dilute specimen?

Answer

• A specimen that contains too much water as a result of the donor drinking too much water or adding water to their sample
• A specimen with creatinine (a natural byproduct of physical activity) and specific gravity (density) values that are considered abnormally low for human urine
• A dilute specimen can bear results of either Positive-Dilute or Negative-Dilute

Also see Help me understand MRO reviewed results of a drug screening? or the attached document for further explanation of a negative dilute result: Neg-Dilute Information.pdf. 

 

Question

What does a "substituted" result mean and why is it treated as a non-negative result?

Answer

A substituted result means the lab has found the that sample is not consistent with human urine. See Help me understand MRO reviewed results of a drug screening for more details.

Question

What if the candidate challenges the results of their drug test?

 

Answer

Checkr cannot help candidates update their drug test results. Checkr’s partner eScreen works with a certified Medical Review Officer for the review of all tests. The Medical Review Officer (MRO) is a licensed physician with special certification to receive, review and evaluate drug-testing laboratory results.  

Candidates may proactively ask questions or contest their results by contacting the Medical Review Officer (MRO):

• Hours: Monday-Friday 7:00AM-7:00PM CST
• MRO Services: 888-382-2281

Candidates may also reference Health Checks for more information

Question

What’s the difference between DOT and Non-Regulated drug tests?

Answer

DOT (Regulated):

• Regulated by the Federal Government
• Strict Guidelines (DOT Rule, CFR Part 40 describes required procedures for conducting workplace drug and alcohol testing)
• Urine specimen only – cannot be altered
• DOT lab test (Standard 5 panel expanded for MDMA and 6-AM) – cannot be altered
• Alcohol testing may be required
• Under the DOT, each agency must conduct random drug screening on all employees working in a safety-sensitive position. Checkr does not offer random drug screening solutions natively in our app today, but has network partners you may leverage.

Non-Regulated:

• Not regulated by any federal government agency
• The customer has freedom to customize their drug screening program for any type of screen that suits your policy.
• Variety of specimens (urine, hair, saliva, blood)
• The Customer is able to select their panel

Question

A Positive drug test was changed to a Negative drug test after the result was already posted in the Checkr Dashboard. Why would this happen?

Answer

Checkr is required by law to accept supporting documentation from the Candidate which provides a medical explanation of a Positive result. There are no time constraints on when documentation will be accepted. When supporting documentation is received, results will be updated accordingly and Checkr will contact the Customer to inform them of the change. Please consult your legal counsel regarding your compliance obligations and best practices.

 

Question

Does Checkr offer drug tests for candidates outside the United States?

 

Answer

No, Checkr does not offer drug tests outside the United States at this time. 

Question

What is a SAMHSA Certified Lab?

Answer

SAMHSA is the Substance Abuse and Mental Health Services Administration. They are an agency of The Department of Health and Human Services (DHHS) that regulates and inspects federally accredited drug-testing laboratories. A SAMHSA Certified Lab is any United States laboratory certified by DHHS under the National Laboratory Certification Program that meets the minimum standards of Subpart C of the HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs; or, in the case of foreign laboratories, a laboratory approved for participation by DOT under this part.

Checkr’s partner eScreen leverages SAMHSA-certified labs for all testing. A list of SAMHSA certified labs can be found here: http://www.samhsa.gov/sites/default/files/workplace/certified-lab-list-july-2015.pdf