Confidentiality in the DOT Return-to-Duty Process

When you’re working with safety-sensitive employees under DOT regulations, confidentiality isn’t just a best practice—it’s the law. One of the most common areas of confusion? What information SAPs can share with employers, and what must stay between the SAP and the treatment provider.

Let’s clear it up.

When the Process Stops: No Info, No Progress

According to the latest updates in 49 CFR Part 40, if a SAP cannot obtain the necessary information from the treatment provider—because, for example, the employee revoked their release of information—the return-to-duty process cannot move forward.

That means:

1. No follow-up evaluation
2. No return-to-duty test
3. No return to safety-sensitive work

The process is paused until the SAP receives the required documentation.

What Employers Can See

SAPs are only authorized to share what’s included in their official SAP reports:

1. Initial evaluation report
2. Follow-up evaluation report

These reports include:

1. The employee’s name and ID
2. The reason for the assessment
3. Dates and format of evaluations
4. Treatment recommendations
5. Clinical determination of compliance
6. Follow-up testing plan

That’s it. No clinical records, no treatment updates, no discharge summaries.

What Employers Can’t See

Even if the employer asks for more, SAPs cannot share:

1. Treatment progress updates
2. Discharge plans
3. Positive drug tests during treatment
4. Anticipated return-to-duty dates

Why? Because this information is protected under DOT confidentiality rules and is not authorized for release to the employer.

Reassuring Treatment Providers

Sometimes treatment programs hesitate to share information with SAPs because they worry it might end up with the employer. It’s important to reassure them:

1. Clinical records are not shared with the employer
2. Only the SAP report is sent to the DER
3. Positive tests in treatment stay in treatment—they are part of the clinical process, not the employer’s business

This helps build trust and encourages open communication between SAPs and providers.

Final Thought: Stay in Your Lane, Stay Compliant

SAPs play a unique role in the DOT process. You’re not a case manager for the employer—you’re a clinical evaluator working within a federally regulated system. That means:

1. Protecting confidentiality
2. Following the rules of Part 40
3. Only sharing what’s allowed—and nothing more