Short Answer

Before an evaluation begins, an employee generally has some flexibility to select a different qualified SAP. Once a SAP has completed an evaluation, however, the employee cannot seek a second SAP evaluation simply to get a different recommendation, and no one, including the employee, the employer, or any managed care provider, may alter what the original SAP decided. 49 CFR § 40.295 49 CFR § 40.297

Detailed Explanation

The Rule Against Second Opinion Shopping

Once an employee has completed a SAP evaluation, neither the employee nor the employer may seek a second evaluation in hopes of getting a different or more favorable recommendation. If an employee improperly obtains a second evaluation anyway, the employer is not permitted to rely on it for any purpose. 49 CFR § 40.295

This rule exists because the SAP evaluation is meant to be a single, individualized clinical judgment. Allowing employees or employers to shop for a more convenient outcome would undermine the purpose of the evaluation entirely.

No One Can Alter the SAP's Evaluation

No one, not the employer, not the employee, not a managed care organization, and not a service agent, has authority to change a SAP's evaluation or recommendations, or to seek another SAP evaluation aimed at making the recommendation more or less stringent. 49 CFR § 40.297

There is one narrow exception: the same SAP who conducted the initial evaluation may modify the recommendation if new or additional information becomes available, for example information from an education or treatment program the employee attended. 49 CFR § 40.297

When a SAP Practices Outside Their Jurisdiction

A SAP must not perform evaluations outside the geographic area covered by their professional license or credential. If this happens, the employee is not automatically required to obtain a second evaluation simply because of that jurisdictional problem. 49 CFR § 40.297

Changing SAPs Before an Evaluation Is Complete

The restrictions above apply once a SAP evaluation has been completed. Before that point, for example if an employee cannot reach a listed SAP or needs to reschedule with a different qualified provider, selecting a different SAP is a scheduling and access question rather than a second opinion question. Confirm with your DER how your employer wants that handled.

Applicable Regulations

• 49 CFR § 40.295, prohibiting employees and employers from seeking a second SAP evaluation for a different outcome
• 49 CFR § 40.297, prohibiting anyone from altering a SAP's evaluation except the original SAP acting on new information

Professional Observation

One issue I often see is an employee assuming that disagreeing with a SAP's recommendation is grounds for starting over with someone new. It generally isn't. If new, relevant clinical information comes to light during treatment, the right path is usually to bring that information back to the same SAP, since that SAP retains the authority to revisit the recommendation.

Common Misconceptions

Misconception

If an employee disagrees with a SAP's recommendation, a second SAP can be consulted for a different opinion.

Reality

The regulation specifically prohibits seeking a second evaluation to obtain a different recommendation, and an employer cannot rely on such a second evaluation even if the employee obtains one anyway. 49 CFR § 40.295

Why the Confusion Occurs

Seeking a second medical opinion is common and often encouraged in general healthcare. The DOT SAP process is intentionally structured differently, to prevent evaluation shopping.

Frequently Asked Questions

What if I believe my SAP's recommendation was clinically wrong?

Bring your concern and any new information directly to that SAP first, since only the original SAP has authority to modify the recommendation based on new information. If you believe a SAP acted outside professional or ethical standards, that is a separate concern you can raise with the applicable licensing board.

Can my employer request a different SAP evaluation if they think the recommendation is too lenient?

No. Employers are equally bound by the prohibition on seeking a second evaluation to change the outcome. 49 CFR § 40.295

Related Articles

• How Do I Choose a DOT SAP?
• What Is a DOT SAP Not Allowed to Do?
• Why Are SAP Recommendations Individualized?
• What Ethical Responsibilities Does a DOT SAP Have?

Primary Authorities/Sources

• 49 CFR § 40.295, second SAP evaluations
• 49 CFR § 40.297, authority to change a SAP's evaluation

Questions About Your SAP Evaluation?

If you have concerns about your current SAP relationship or need clarification on next steps, speak with a DOT qualified SAP before taking action on your own.

Schedule an Initial SAP Assessment