SAP Evaluations

To schedule a SAP Evaluation, call Dr. Fitzgerald directly at  (312) 834-3491.

Updated June 3, 2023: I am currently accepting appointments for DOT SAP violation evaluations at the HInsdale office or remotely. Please call for availability.

SAP Evaluations May Be In Person or Remote:  The Department of Transportation, in May 2020, modified their requirement that all SAP evaluations must be conducted in person. In June, 2023, DOT made permanent the option of conducting remote evaluations. The decision about this is left up to the SAP.

For DOT (including Federal Railroad Administration, Federal Transit Administration, and Federal Motor Carriers Safety Administration) regulated employees), my services are being provided both in-person (at my Hinsdale office) OR via tele-health. I am at the Hinsdale office on Tuesdays, Fridays, and Saturdays only. Tele-health assessments can be scheduled on other weekdays.

A part of the SAP evaluation has always been a screening assessment called the SASSI-4, so for tele-health assessments, you will be sent the link for that assessment prior to the appointment It will need to be completed before the session. Payment also needs to be made before the session (by Square). For office appointments, the SASSI will be pencil-and-paper, and payment must be brought to the session if not already made by Square.

Please call Paul at (312) 834-3491 to schedule a SAP evaluation or Drug and Alcohol Counselor evaluation (for self-identified employees).

Please note that the fee for SAP or DAC evaluations remains at $475, payable at the time of the first evaluation. The DOT Return-to-Duty process requires that the employee complete either treatment or education services before the SAP’s return-to-duty evaluation. These services are not covered by the $475 fee and must be provided by someone who has no financial connection with the SAP.

Since the COVID-19 pandemic, education services, and some treatment services, have been provided virtually. I will attempt to locate services that are readily available and affordable. However, you need to know that I will recommend in-person treatment whenever available, and my recommendations will always be geared to prevent future prohibited behavior, whatever plan will do that best, from my assessment. DOT has said that they do not approve of an over-reliance on “canned” online education, for example.

Employees who perform safety-sensitive duties under US Department of Transportation (DOT) rules (such as truck drivers) must have an evaluation by a qualified Substance Abuse Professional when they are in violation of DOT rules (for a positive test or a refusal to test). The SAP Return-to-duty process must be completed and compliance and progress must be verified by the SAP before the employee can return to safety-sensitive duties with any DOT-regulated employer. The employer is not required to offer the employee continued employment, but the employer is responsible for informing other future employers that there has been a violation and whether the RTD process has been completed.

I am qualified as a SAP under DOT regulations (49 CFR Part 40) and can perform these evaluations, which involve specialized assessment and compliance reports, along with the required follow-up ( return to duty) assessment.   The fixed fee for this process in my practice is $475.00, payable at the time of the initial appointment, using PayPal, or (when in person evaluations resume) in cash, with a cashier’s check, or a money order made out to me. This fee is not billable to health insurance. Employers may choose to pay for SAP evaluations. I can only work with those arrangements if the employer contacts me directly.

TRUCK DRIVERS: You are required to designate a SAP in the FMCSA Clearinghouse website, and the SAP must accept the designation. Once designated, only the employee (driver) can change the designated SAP. Once the assessment has been done, you may not choose a different SAP. I am required to enter the date of the assessment and the date of the follow-up evaluation in the Clearinghouse. Because of all this, please do not designate me as your SAP until we have talked and you are sure that we will be meeting for the assessment. I will not accept the role of SAP until we have worked out a date and payment is being made. I understand that drivers often have to wait until they can get the money for the SAP services. But, often, drivers may decide to get a different kind of job and I never hear from them again, which leaves me with unfinished cases in FMCSA’s eyes.

Please note that truck driving schools are considered DOT employers, and the drug test for driving school is considered a pre-employment test by DOT.

After the SAP evaluation, DOT rules require the employee to complete the course of treatment or education recommended by the SAP. The $475 SAP fee does not include the cost of these recommended services. Education (when no treatment for substance use is indicated) is not covered by insurance. Treatment for substance use disorders may be covered by insurance. I am required to base my recommendations on the clinical assessment, although I will attempt to consider cost, location, scheduling availability, and insurance coverage in determining my recommendations.

Safety-sensitive employees often ask me how long the return-to-duty process will take. Not only is this question impossible to answer prior to the evaluation, I would be explicitly violating the DOT rules if I were to give any estimate of the time frame. DOT says:

It has come to the attention of the U.S. Department of Transportation (DOT) that some Substance Abuse Professionals (SAP) are providing Return-to-Duty (RTD) timelines to employees who have violated the DOT drug and/or alcohol regulations before conducting the required initial evaluation and SAP assessment of the employee.Doing so directly contravenes 49 CFR Part 40 and potentially compromises public safety.  It also undermines the SAP’s role in evaluating each individual employee and directing that employee to get the specific help the employee needs.

DOT has become very emphatic that an employee’s plan of treatment or education prescribed by the SAP must be individualized, based on the assessment, in such a way that the likelihood of future improper drug or alcohol use is minimized. The SAP has a great deal of flexibility in what kinds of services are recommended, but the employee must be able to demonstrate learning and/or progress in addressing any issues found in the assessment with regard to substance use or other emotional, behavioral, or attitude issues that may be relevant to the violation.

Ordinarily, a counselor works to meet the needs of the clients seeking services. Employee Assistance Professionals are also helping to serve the needs of the organization, especially when an employee is formally referred due to some sort of job performance issue. The SAP has a third responsibility that overrides the other two: serving the public safety. The rules were written this way so that people with substance abuse problems can get the help they need to turn things around, without fearing the loss of their livelihood. Once they complete the SAP’s recommendations, they may be considered for return to safety-sensitive duty. (However, employers are not obligated to keep them as employees and may choose to terminate their employment even if they are compliant with the SAP process). Employees who are in violation are required to be kept from any safety sensitive duty (with any DOT-regulated employer) until the SAP’s recommendations have been completed and a return-to-duty assessment has been conducted. That assessment must be face to face, and I will ask for evidence from the provider regarding the level of participation and compliance with my recommended services.

The employer and the SAP are responsible for making sure that the employee is not allowed to return to safety-sensitive duty until he or she has followed all the recommendations. Many people with substance abuse problems are very reluctant to admit that they have a problem. Part of the challenge for the SAP is to assess whether the violation was simply a lapse in judgment or a sign of a problem with alcohol or drug use. For me, compassion for the employee is tempered by an awareness of my responsibility as a SAP.

SAPs have been advised by DOT’s Office of Alcohol and Drug Compliance to treat a confirmed positive drug test as a violation, and as a sign that the safety-sensitive employee has used a prohibited substance, a serious matter for public safety. SAPs are not allowed to accept an employee’s assertion that the test was not valid or that some other problem may have led to false positive results. That is a matter for the Medical Review Officer to question, and any employee who comes to me with a positive drug test will have already been questioned by the MRO who will have established that there was a bona fide positive test.

Likewise, alcohol violations (including positive breath tests and/or “actual knowledge” of alcohol misuse, including a DUI in a commercial motor vehicle) must be treated as evidence that a misuse of alcohol has occurred. Please note that a DUI citation in a CMV is still a DOT violation even if the DUI charges are later dismissed or lowered.

Therefore I will proceed on the assumption that the employee has engaged in conduct that they know is prohibited. This is quite often a sign of a substance use problem. My task is to assign appropriate assistance (treatment and/or education) that will (as much as possible and when combined with a rigorous schedule of unannounced follow-up testing) minimize the chances that the employee will use alcohol or drugs in the future and thus compromise public safety. A “one-time lapse in judgment” is still considered to be a sign of a substance use problem, which means I must assign a form of assistance that is appropriate. Employees may think that if they minimize their problems they will “get off: with “just going to a class.” My advice is to be honest and get the help that is needed – which will be to the employee’s and their family’s advantage in the long run.

The provider of treatment (who must not have any financial connection with the SAP) needs to stay in communication with the SAP, in order to be able to say with some certainty that any substance abuse problem has been successfully dealt with. This usually means completion of treatment and starting aftercare. This can take time, and employees are often very anxious to return to work. However, the SAP must do everything possible to insure that no employee is allowed to work until the psychological or behavioral issues that have led to the rule violation have been fully addressed in treatment; because future misuse of substances would be likely to result in the employee being impaired or unfit for duty. This could place the employee and the public at risk.

For all these reasons, SAPs must undergo extensive training in addition to their professional training in mental health and substance abuse. Initial training on the DOT process and the challenges facing SAPs is followed by a written exam. Afterward, an additional twelve hours of SAP-specific training is required in each three-year period. Rules do change – for example, since 2009, all return to duty and follow-up drug tests must be observed collections. (This was started due to some people’s attempts to use prosthetic devices to sneak in another person’s urine to the collection site).

The professionals who do SAP evaluations generally do this work because they value the importance of public safety, and also value the importance of helping people who may have problems get the help they need and maintain their livelihood. It takes a toughness of attitude and a knack for sensing when someone may be struggling to control a problem to which they don’t want to admit, but which they really need to accept help to deal with. In spite of their key role in the enforcement of drug and alcohol regulations, SAPs (as counselors) really do want to see people get help when they have problems with substance use and abuse.

I would encourage all employees in DOT safety-sensitive positions to become familiar with the regulations at the DOT website, to be sure that there is no misunderstanding about the testing requirements in particular. Any lack of co-operation with the testing or collection process may be considered a refusal to test, and has the same implications as a positive test. An invalid (potentially adulterated or dilute) specimen requires the employee to submit to a repeat collection. There are very few false positives (in spite of popular myths), and the SAP may ask the medical review officer (MRO) for additional information regarding test results. Alcohol and drug tests are conducted randomly, as well as pre-employment and for reasonable suspicion or after an accident. Follow-up tests (after a violation) are unannounced but are not random tests, because the same employee may be tested randomly while also being tested on follow-up.


Cannabis is still a Schedule 1 drug by Federal law, in spite of medical and recreational cannabis being legal at the state level in some states. DOT has made it clear that they have no intention of changing the status of THC as a prohibited substance. There is no such thing as a “prescription” for cannabis or THC because it is illegal at the Federal level. A medical marijuana card will not be a reason for a Medical Review Officer to reverse a drug test result that is positive for THC. Further, there are no drugs or supplements that can “remove” THC metabolites from the body. They can remain in the body for many weeks after use. And drinking a great deal of water will only result in a dilute specimen that will need to be repeated. In fact, I have seen a number of people whose urine was both dilute AND positive for THC! DOT says a positive dilute is still a positive.

Although we have been assured by DOT that their testing procedures for THC will not result in a positive test from “secondhand smoke,”  please note that concentrated THC products sold in dispensaries have created a new risk that was not present with smokable marijuana in the past. These forms of THC (primarily for vaping) are concentrated enough that it may be possible for a family member who uses these products to unintentionally expose another family member to enough THC on surfaces or skin  to cause a positive test. Likewise, edibles are sometimes unintentionally consumed by safety-sensitive employees who share a home with a person who uses these edible forms of THC. For all these reasons, safety-sensitive employees are strongly encouraged to maintain a drug-free home.

Cannabidiol (CBD) is also made from the cannabis plant and is currently legal, but there is no quality control to back up the claims of the seller that it is free of THC (or low enough in THC not to cause problems). In fact, chronic use of CBD may cause a positive test for THC even at a very low concentration of THC, because THC builds up in the fatty tissues of the body over time. For this reason, DOT-regulated safety-sensitive employees should avoid CBD products (including balms and ointments) altogether. “Full-Spectrum” products often contain THC in amounts large enough to trigger a positive test.

Employers with US DOT safety-sensitive employees are required to have drug and alcohol testing and removal-from-duty policies that are compliant with DOT regulations. Supervisors must receive training, and safety-sensitive employees must be tested for drugs and/or alcohol according to the modal rules. Any employee who violates the rules must stand down and be referred to a Substance Abuse Professional for an evaluation and recommended services before returning to duty. I am available to perform these evaluations and coordinate the return-to-duty process. I can offer to schedule employees within three working days at my Hinsdale office location (or virtually during the COVID-19 emergency). I have developed relationships with numerous local treatment programs and make recommendations designed to help assure that employees gain understanding, take responsibility, and refrain from further prohibited conduct. I use the SASSI and other measures to assess for substance abuse and mental health problems. I send reports promptly to the DER, and maintain close communication with treatment providers.

I am also available to provide training for supervisors on DOT regulations, and to consult on policy development and compliance. I have worked with trucking companies, railroad maintenance firms, public utilities, and municipalities on DOT violation situations over the past ten years. You may refer employees with confidence that their return-to-duty process will be handled responsibly and professionally to help protect the employer – whether the employee demonstrates compliance or not.

Some employers choose to pay for employees’ SAP evaluations, and others leave the cost to the employee’s responsibility. I will work with either arrangement.

If you have an employee who reports a problem with substance abuse and seeks assistance, and do not have an EAP program, I will provide EAP services that meet DOT regulations, so that employee can seek help prior to being tested. Again, the cost for these EAP services may be borne by the employer or the employee, at a reasonable per-session fee.

Dr. Fitzgerald’s Qualifications for Performing DOT SAP Services:

  • Qualifying Credentials: Licensed Psychologist (Illinois), Certified Employee Assistance Professional (EAPA, National) and Master Addiction Counselor (NAADAC, National)
  • Original SAP Training and Examination: NAADAC – January 20, 2005
  • Update Training Record (DOT Rules require 12 hours of SAP update training within each three-year period after initial examination, not necessarily every three years):

3-Year Period Start and End Dates

Date of SAP Training for that Period

Providing Organization and Hours




Blair Consulting (14 Hrs)

Lee Mauk



Blair Consulting (14 Hrs)

Tamara Cagney



SAPList U (12 Hrs)




SAPList U (12 Hrs)




EAPA (14 Hrs)

Tamara Cagney



EAPA (14 Hrs)

Tamara Cagney


Due by 2026





Copies of Certificates are available on request. Please e-mail [email protected] if you need a copy.

CC BY-ND 4.0 SAP Evaluations by Fitzgerald Counseling is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.