What Is A Refusal?
What Is A Refusal?

What Is A Refusal?

Blog and Opinions Red Slashes May 27, 2022
By: Kendra Lawrysyn

What is a Refusal? 

What is a refusal result for a drug test? Drug testing can conclude in a variety of results depending on several factors including concentration cut-off levels and a donor’s ability to follow established guidelines. Check out below to learn what classifies as an official refusal result.

Workplace drug and alcohol policies set the stage for successful fit-for-duty programs. This is a key feature of a health and safety program for safety-sensitive positions. Drug and alcohol testing mitigate the risks of injury and property damage. This helps companies establish a strong safety culture.

The results of these tests often have serious and action-taking consequences. Review the chart below to see the difference between the results.

Result  Negative  Negative with Safety Advisory  Positive  Refusal  Cancelled
Concentration Cut off Level  < , = , >   = , >  ~
Reviewed by MRO  No  Yes  Yes  Sometimes  Yes
Brief Explanation   Occurs when the sample a donor has provided has substance concentration levels below CannAmm’s cut-off levels.  Occurs when the sample a donor has provided has substance concentration levels below, at, or above CannAmm’s cut-off levels; however, after being reviewed by an MRO the official result is negative and there is a safety advisory.  Occurs when the sample a donor has provided has substance concentration levels at or above CannAmm’s cut-off levels. All non-negative results are reviewed by an MRO who determines if a sample will have a positive result or a negative result with a safety advisory. Occurs when donors refuse, are unable, or fail to provide an appropriate sample or follow established guidelines. See below for more details.  Occurs when a legitimate medical reason is established, an MRO can report the result to the DER as cancelled
Additional Notes   Donor is compliant  A safety advisory indicates a medical clearance is required before performing safety-sensitive duties in accordance with the job description. * Donor is non-compliant  A refusal can be considered a positive result under U.S. DOT rules and regulations  Cannot be relied upon to determine compliance or noncompliance


What is a refusal and is it an official result? A refusal result can occur based on any of the following:

  • Refusal to complete and sign the required steps on the chain of custody form
  • Refusal to provide a sample
  • Inability to provide an adequate amount of specimen and there is no adequate medical explanation for the failure
  • Failure to cooperate with the testing process in any way that prevents the completion of the test
  • Failure to arrive at the testing site within a reasonable amount of time as determined by the employer
  • Failure to remain at the testing site until the testing process is complete
  • Failure to undergo a medical examination or evaluation, as directed by the employer as part of the insufficient breath procedures (Shy Bladder)
  • Failure to permit to a monitored or observed collection
  • Decline to take an additional drug test the employer or collector had directed
  • For an observed collection, fail to follow the instruction to raise and lower clothing and turn around
  • Possess or wear a prosthetic or another device that could be used to interfere with the collection process
  • Admit to the collector to having adulterated or substituted the specimen
  • Adulterate or substitute a urine specimen
  • Admit to the MRO to having adulterated or substituted the specimen

A refusal test result is considered an official test result. Consequences that follow this depend on the rules and regulations of the regulatory program, the organization’s health and safety policy, as well as the DER of the donor.

Our team at CannAmm is proud to provide our clients with accurate and defensible results. When results matter, reach out to our team of experts for your occupational testing services. Connect with CannAmm today.

* The Canadian Model 6.0 –

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