Positive Test or Refusal? What To Do Next (Without Getting Stuck)

Fit for Duty / Drug & Alcohol Policy

By Logan Tannahill on October 7, 2025

“It’s rarely the test result that gets a company in trouble. It’s what happens in the next 10 minutes.”

When a worker tests positive or refuses to test, leaders feel pressure. Do you pull them from duty? Call HR? Start discipline? Ask health questions? One wrong move and you can created a mess, grievances, human-rights complaints, or a safety gap your lawyers now have to defend.

This article gives you the exact decision path to follow, mapped to our Positive Test / Refusal Management Flow Chart. Save it. Share it. Train to it. When everyone responds the same way, you protect people, protect privacy, and protect your company.

The Core Reframe: Positive ≠ Refusal

There are two different risk classes:

Positive test → Treat as a health/human rights scenario first. You have a Duty to Inquire and, if confirmed, a Duty to Accommodate to the point of undue hardship. Discipline comes after inquiry, not before.
Refusal to test → Treat as workplace misconduct unless the worker admits a potential health issue that triggers the Duty to Inquire path. No admission? It’s a conduct decision path.

Your flow chart draws these as two distinct color paths so the organization or leadership don’t guess. Use it.

What To Do in the Next 10 Minutes

If you have a Positive Test

Remove from safety-sensitive duty immediately. (Don’t let them drive themselves anywhere.)
Keep dignity + privacy. Share on a strict need-to-know basis.
Duty to Inquire. Use neutral, non-accusatory questions:
- “Are you feeling unwell or struggling with anything that could affect your ability to work safely?”
- “Is there anything medical we should know to support you right now?”
Initiate assessment (e.g., SAP/health professional). Put the worker on paid admin leave or a safe reassignment while the inquiry occurs.
Document facts (what you saw, timing, who was notified), not feelings or labels.

Outcome paths:

Health condition / dependency confirmed → consider accommodation and a Return-to-Duty (RTD) plan after treatment/clearance.
No protected health condition → progress on your conduct/discipline policy.

If you have a Refusal

Offer one chance to reconsider. Calmly explain that refusal has consequences under policy.
Document the refusal (who, when, where, witnesses).
Remove from safety-sensitive duty and notify HR/Management.
Ask one key question:
- “Is there a medical or personal health reason you’re refusing that we should be aware of?”
- If they admit a possible health issue → switch to the Duty to Inquire path.
- If no admission → proceed down the misconduct/discipline path.
Maintain privacy and keep the person in a supervised, safe location until directed by HR.

Mini-Checklists You Can Post at Every Site

Positive Test (5 Steps)

Remove from duty → safe transport.
Protect privacy → need-to-know only.
Duty to Inquire → neutral questions.
Start assessment → paid leave or safe reassignment.
Document facts → notify DER/HR.

Refusal (5 Steps)

Offer one reconsideration.
Document the refusal.
Remove from duty and notify HR.
Ask the “health reason” question once.
Route: admission = inquiry path; no admission = misconduct path.

Why This Flow Is Your Legal Shield

Human Rights compliance: You inquire before you punish. That’s the guardrail that prevents wrongful termination and discrimination claims.
Privacy & confidentiality: You share the minimum necessary details with the right people (DER/HR), and you store results separate from personnel files.
Consistency: Supervisors, HR, and Safety follow the same steps. Consistency beats “best intentions” in court and in culture.

Common Big-Dollar Mistakes (Don’t Do These)

Terminating before inquiry. You must ask the right questions and offer assessment first when there’s a positive or an admission.
Letting someone drive themselves after a positive/refusal. Safety risk + liability.
“Just go home.” That’s an informal refusal. Document, notify HR, follow the chart.
Oversharing details with line management. Keep it need-to-know.
Vague documentation. Write what happened (who/what/when/where), not interpretations.

Return-to-Duty Done Right

When a worker completes the recommended steps (treatment/education/monitoring as applicable) and is medically cleared:

RTD Agreement with clear expectations (testing cadence if applicable, follow-ups, support).
Accommodation if required and reasonable.
Re-onboarding to safety-sensitive duties with documented sign-offs.

This is how you reduce recidivism, rebuild trust, and close the loop defensibly.

Train the Habit

Make the right response automatic.

Cue → Routine → Result

Cue: Positive or refusal.
Routine: Follow the color-coded flow; run the 5-step checklist; notify DER/HR.
Result: Safety preserved. Dignity preserved. Liability minimized.

Post the one-page flow where supervisors can actually use it—in dispatch, foreman clipboards, safety boards, and your LMS. Then rehearse it.

Your Next Two Moves

Download: Positive Test / Refusal Management Flow Chart (print-ready, color-coded).
Book: DER & Supervisor Response Training so every leader knows the script, the paperwork, and the handoffs.

When the call comes, your team won’t guess. They’ll execute.

Final Thought: Culture is Built in the Pause

The next time this happens, your supervisor won’t get a rehearsal. No pause button. No time to guess.

You’ll either have a system or a story you can’t take back. Let’s build the system now.

Ready to Shift?

Want a Quick Win - Download our free Positive Test / Refusal to Test Management Flow Chart here, Or

Book your spot for The Reasonable Cause Supervisor Training or DER Training today. If this hit a little too close to home, that’s okay. We’re here to help you fix it, before it hits the fan.