# Da Refusal Vs Diluted Result

> Use this skill when interpreting a drug test result that comes back as 'diluted negative,' 'diluted positive,' 'refusal,' or 'adulterated.' Covers what constitutes a refusal vs. retest vs. confirmed positive.

- Skill: `x3allamerican/da-refusal-vs-diluted-result` (Agent Skill)
- Install (CLI): `npx skillmds add x3allamerican/da-refusal-vs-diluted-result`
- Raw SKILL.md: https://api.skillmd.com/api/skills/x3allamerican/da-refusal-vs-diluted-result/raw
- Safety review: pending (external: skill-scanner PASS, skillspector PASS)
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Coding & Dev Tools
- Author: x3allamerican (https://skillmd.com/u/x3allamerican)
- Updated: 2026-08-19
- Page: https://skillmd.com/skills/x3allamerican/da-refusal-vs-diluted-result

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# Refusal vs Diluted Result — What's a Refusal?

A drug test result has more shades than 'positive' or 'negative.' Specific terms have specific consequences under Part 40.

## Negative
Test came back with no detected substances. No action required beyond recordkeeping.

## Negative-Dilute
Specimen had a low creatinine and dilute specific gravity. Per § 40.197:
- If diluted with creatinine ≥ 5 mg/dL: result stands as **negative** (proceed normally)
- If diluted with creatinine ≥ 2 mg/dL but < 5 mg/dL: MRO directs **immediate recollection observed** under § 40.67
- If diluted with creatinine < 2 mg/dL: treated as **refusal** (substitution)

The MRO makes this call. Carrier follows the MRO's direction.

## Positive
Test came back with confirmed drug presence above cutoff. MRO interviewed driver; no legitimate medical explanation accepted (driver may have a verified prescription, e.g., for amphetamines). Result is a **violation** → reported to Clearinghouse, driver removed from safety-sensitive duty, SAP process begins.

## Positive-Dilute
Test came back positive with dilution. Treated as a regular positive (proceed with violation processing).

## Adulterated
Specimen contained a chemical not normally found in urine, or pH outside normal range. Per § 40.93:
- Adulteration is a **refusal**
- MRO confirms; reported to Clearinghouse
- Driver removed from safety-sensitive duty

## Substituted
Specimen was not actually urine (e.g., water, synthetic urine). Per § 40.93:
- Substitution is a **refusal**
- MRO confirms; reported to Clearinghouse

## Cancellation
Test result is invalid for procedural reasons (chain-of-custody break, lab error). Per § 40.205:
- MRO cancels the test
- Driver may need re-collection
- Cancellation is NOT a violation

## Critical: refusal triggers
Per § 40.191, the following are refusals:
- Failure to appear for testing
- Failure to provide a specimen
- Failure to remain at collection site
- Failure to provide observed collection when required
- Adulteration or substitution
- Failure to undergo evaluation after positive
- Failure to participate in SAP process

A refusal is treated the **same** as a positive test for FMCSA purposes.

## CFR citations
- **49 CFR § 40.181**
- **49 CFR § 40.185**
- **49 CFR § 40.197**

## How Compass surfaces this
This skill is searchable in the Compass Ask interface and runs against the carrier's actual fleet data when invoked from within the relevant tracker. It is read-only — no actions are taken without explicit user approval.


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## Built by X3 Compass

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X3 Compass turns these skills into a complete operational platform: driver qualification files, drug & alcohol consortium, MVR pulls, hours-of-service tracking, hazmat shipping, IFTA filing, FMCSA audit prep, and DataQ dispute drafting — all CFR-cited, all in one place.

*This skill is published under the X3 Compass open skills initiative. Contributions welcome at https://github.com/x3fleetsafety/skills*