The sap process

What to Expect

The SAP conducts an initial face-to-face clinical evaluation, including standardized testing.  DOT’s rule requires treatment and/or education recommendations in every case.  The SAP must send an initial evaluation report to the Designated Employer Representative (DER).

The SAP can assist the employee in contacting the treatment provider and arranging for services;

The SAP maintains regular contact with the treatment provider to monitor the employee’s treatment progress and confirm the suitability of the treatment plan;

The SAP will conduct a face-to-face follow-up clinical evaluation to determine if the employee has complied with the SAP’s recommendations and to measure the success of treatment.  Suppose the employee has complied with the SAP’s recommendation. In that case, the SAP sends a follow-up report to the DER, including SAP’s proposals for a program of aftercare and follow-up testing.

Per DOT Regulations, Follow-up and Return to Duty testing are observed.



Initial session with a licensed clinician. During this session, your therapist assesses various areas using a bio-psychosocial interview.

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The interview is an assessment of questions that determines psychological, biological, and social factors that could be contributing to a person’s problem or problems. We will collect information on family, medical, mental health, relationships, education, employment, and legal. At the end of the evaluation, we will make recommendations.

These recommendations can be for no treatment, individual treatment, family/couples treatment, referral to another level of care, referral for a specific treatment modality, referral for medical follow-up, and/or referral for further assessment.


After the assessment, we will recommend an appropriate treatment and/or education program for you to complete.

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This may include:

  • Outpatient treatment
  • Inpatient treatment programs or addiction rehabilitation programs
  • Individual therapy programs like cognitive behavioral therapy or psychotherapy
  • Group therapy programs
  • Other education programs relating to drug or alcohol abuse

The cost of treatment can range from $50-300

Return to Duty

After your follow-up evaluation, the SAP will determine if you comply with the outlined program.

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If you did, you would be eligible to submit a return to duty drug or alcohol test. If you return a negative result, you can then resume safety-sensitive work.


Lastly, the SAP submits a Periodic Follow-up Testing Plan to a specific person at your company (or the company that ordered the test).

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Periodic Follow-up Tests are observed DOT Drug and Alcohol tests that employees who have previously violated the DOT’s Drug and Alcohol testing regulations are now subject to. There will be a minimum of 6 tests in the first 12 months for a maximum of 5 years.

FastTrack Enrollment – SAP Evaluation Services


Scheduling of the initial evaluation


(2) Face-to-face substance abuse evaluations with a DOT-qualified SAP


Recommendations for education or treatment (as per the requirement of the DOT)


(2) SAP reports (initial and follow-up)


Recommendations for submitting to a return-to-duty test

Frequently Asked Questions

My employer told me I need to contact an SAP (Substance Abuse Professional). How do I do this?

DOT Regulation 49 CFR Part 40 Subpart O requires your employer or a service agent of the employer to provide a list of DOT-qualified SAPs (40.287). When you contact SRS, a list of DOT-qualified SAPs will be provided.

Do employers have to terminate an employee for testing positive?

The decision to terminate an employee who tested positive is left up to the organization and its internal policies. There are no federal regulations requiring the termination of a safety-sensitive employee.


Can employees go to a local substance abuse treatment center and be evaluated by a substance abuse counselor?

 Not all Substance Abuse Counselors meet the qualifications of the Department of Transportation.

How long is an SAP program?

The time required to complete the DOT return-to-duty program is determined by the SAP and is based on the individual’s need for either treatment or education.

Is the employer responsible for payment of the SAP program?

The DOT does not require the employer to incur the cost of the SAP program. This decision is left up to employers and employees and may be governed by existing management-labor agreements.

Can I see another SAP if we disagree with the recommendations of an SAP?

No, DOT regulations strictly prohibit second opinions. The employee must comply with the recommendations of the original SAP.

Can my employee return to safety-sensitive work after getting recommendations from an SAP?

No, the employee must show compliance with the recommendations and be seen by the SAP for a follow-up evaluation.

Who decides when the employee is ready to return to work?

Only the SAP can determine if the employee is eligible to submit to a return-to-duty test. As the employer, it is a personnel decision that you have the discretion to make, subject to collective-bargaining agreements or other legal requirements.

What are the employer’s responsibilities regarding follow-up testing?

The employee is responsible for conducting follow-up testing as prescribed within the SAP’s follow-up report.


May an employer have a policy of declining to hire applicants who have a negative dilute test result on a pre-employment drug test?

The Department’s rules do not require an employer to hire anyone. That decision is an employer’s. While 40.197(b) authorizes an employer to obtain one additional test following a dilute negative result (in pre-employment or other testing situations), a negative dilute test result is a valid negative test for DOT’s purposes.


Because a negative test result is a negative test for DOT program purposes, the employer is authorized to have the applicant begin performing safety-sensitive functions. If the employer declines to hire the applicant in this situation, the employer’s decision is based solely on its policy. The employer cannot claim its action is required or authorized by DOT rules.

What happens to me when I have a positive test or refuse to test (i.e., adulterate, substitute my urine specimen, or decline to be tested)?

DOT – If you are a safety-sensitive employee mandated by the DOT, you are not permitted to perform safety-sensitive duties until you have seen a DOT-qualified Substance Abuse Professional (SAP) and completed the return-to-duty process. Working in a safety-sensitive position before finishing the return-to-duty process violates the DOT regulation 49 CFR Part 40 and could result in fines being assessed.

Will I lose my job if I test positive or refuse a test?

These decisions are solely the employer’s, which may be based on the company policy and/or any collective bargaining agreements.

Will I lose my job if I test positive or refuse a test?

These decisions are solely the employer’s, which may be based on the company policy and/or any collective bargaining agreements.

What if I don’t complete an SAP program?

You will not be eligible to perform safety-sensitive duties for any employer or as an owner-operator until you have complied with the DOT’s Part 40 regulated SAP program.

Can I find an SAP on my own?

Yes, you can; however, the requirements under Subpart O have to be met.

What are the drug & alcohol testing rules, and where do I find them?

DOT – The Federal Aviation Administration [FAA], the Federal Motor Carrier Safety Administration [FMCSA], the Federal Railroad Administration [FRA], the Federal Transit Administration [FTA], the Pipeline and Hazardous Materials Safety Administration [PHMSA]) and the United States Coast Guard [USCG] each have industry-specific regulations, which cover approximately 12.1 million transportation employees who perform safety-sensitive functions. These regulations spell out who is subject to testing, when and in what circumstances. These regulations can be found on the DOT website,

Will my results follow me to other employers?

Your drug and alcohol testing history will follow you to your new employer. By law, employers must provide certain records of your DOT and/or NRC drug and alcohol testing history to your new employer.

Who decides when I can return to work?

It is up to the SAP to recommend a return-to-duty test; however, the employer decides when or if you are eligible for return to duty.

Can an employee perform safety-sensitive duties before completing the SAP process?

No, the employee must show compliance with the recommendations and be seen by the SAP for a follow-up evaluation. During the follow-up evaluation, the SAP will determine if the employee is eligible to be considered for return to duty.

Will I be able to continue to drive my vehicle with a DOT testing violation?

A violation will only prohibit you from operating a vehicle over 26,001 lbs. or a commercial vehicle with more than 15 passengers and a driver.

How many referrals can I expect?

The number of referrals is dependent upon intake from your area. It varies greatly depending on geographic location and testing schedules.