Specialty Services

Medical Review Officer (MRO)


Dr. David Fletcher is a certified Medical Review Officer (MRO). He has been certified continuously since 1990 and last was certified in December 2018, by American Association of Medical Review Officers (AAMRO), which extends his certification status until December 2013.

The role and responsibility of the MRO is as follows:

  • Receive and review laboratory results generated by an employer’s drug testing program
  • Determine if there is a legitimate medical explanation for a laboratory-confirmed positive, adulterated, substituted and/or invalid drug test results
  • Contact the employee to discuss testing results and outline procedure for split-specimen testing
  • Inform an employer that even if an employee’s drug test has a valid medical explanation, such as prescription opioids, that the employer should perform a fitness-for-duty (FFD) evaluation because of safety concerns
  • Protect the confidentiality of the drug testing information
  • Ensure timely flow of results and other information to employer
  • Provide quality assurance (QA) to protect the integrity of the employer’s drug testing program

Dr. Fletcher has served as a MRO ever since the US Department of Transportation first developed this role in 1989 when the first Federal drug testing programs began, which required a licensed physician review and interpret drug test results.

Dr. Fletcher has served as an expert witness in multiple MRO-related cases where there has been a challenge to a drug test result or an assertion that an employee with a positive drug test was impaired. These cases often times are situations where an employee has been injured on the job and benefits were being challenged.

Dr. Fletcher has testified on behalf of employees with a positive test result asserting they were not impaired at the time of an accident when the specimen was collected. He has also testified in cases where an employer has relied on Dr. Fletcher’s expert opinion that an employee was impaired based on the interpretation of the drug testing results and other factors.


Any severe, life-threatening injury or illness should immediately report to the nearest hospital emergency room.

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