Short Answer

A DOT SAP cannot be pressured, or agree, to change an evaluation to produce a different outcome, and no one else may alter the SAP's evaluation either, apart from the original SAP modifying it based on new information. 49 CFR § 40.295 49 CFR § 40.297 A SAP also cannot refer an employee to the SAP's own practice or to a program in which the SAP has a financial interest, outside specific exceptions. 49 CFR § 40.299(b) A SAP cannot conduct an evaluation outside the geographic area covered by the SAP's professional credential. 49 CFR § 40.297(c)

Detailed Explanation

Cannot Participate in Second Opinion Shopping

Neither an employee nor an employer may seek a second SAP evaluation to obtain a different recommendation than the one already given. If an employee improperly obtains a second evaluation anyway, the employer may not rely on it. 49 CFR § 40.295 A SAP asked to perform such a second evaluation solely to change an outcome is being asked to act outside what the regulation permits.

Cannot Alter Another SAP's Evaluation

No one, including an employer, employee, managed care organization, or service agent, may change a SAP's evaluation or recommendations, or seek another evaluation to make the recommendation more or less stringent. 49 CFR § 40.297(a) The only exception is the original SAP modifying the recommendation based on new or additional information, such as information from the employee's treatment program. 49 CFR § 40.297(b)

Cannot Refer Based on Financial Self-Interest

To avoid conflicts of interest, a SAP must not refer an employee to the SAP's own private practice or to a person or organization from which the SAP receives payment or holds a financial interest. 49 CFR § 40.299(b) This rule has four specific exceptions covered in a related article on SAP ethical responsibilities, involving public agencies, the employer's own contracted provider, insurance coverage constraints, and sole source availability in the general commuting area. 49 CFR § 40.299(c)

Cannot Practice Outside Licensed Jurisdiction

A SAP must not perform evaluations outside the geographic area covered by their professional license or credential. If a SAP does so, the employee is not automatically required to get a second evaluation just because of that jurisdictional problem, but the SAP has still acted outside the regulation's bounds. 49 CFR § 40.297(c)

Remote Evaluation Has Limits

A SAP may only conduct an evaluation remotely, using real time audio-visual technology, if the SAP's own license actually permits it and the technology meets confidentiality and quality standards. 49 CFR § 40.291(a) A SAP is not free to conduct remote evaluations by any means whenever convenient; the license basis and quality standards are conditions on that flexibility, not an open ended allowance.

Applicable Regulations

• 49 CFR § 40.295, prohibiting second opinion shopping
• 49 CFR § 40.297, prohibiting alteration of a SAP's evaluation and limiting cross jurisdiction evaluations
• 49 CFR § 40.299, prohibiting conflict of interest referrals except for specific listed exceptions

Professional Observation

In my experience, most of these boundaries exist for good reason: they prevent the SAP evaluation from becoming something that can be negotiated, shopped around, or quietly influenced by whichever party has more bargaining power in a given situation. Knowing these limits in advance can help both employees and employers recognize when something in the process looks off.

Common Misconceptions

Misconception

An employer can ask a SAP to reconsider a recommendation it thinks is too lenient or too strict.

Reality

No one, including the employer, has authority to change a SAP's evaluation. Only the original SAP can modify it, and only based on new information. 49 CFR § 40.297

Why the Confusion Occurs

Employers sometimes assume that because they are paying for or coordinating the process, they retain some say over the clinical outcome. The regulation deliberately separates that administrative role from the clinical evaluation itself.

Frequently Asked Questions

What should I do if I believe a SAP crossed one of these lines?

Raise the concern with your DER, the applicable DOT agency, or the SAP's professional licensing board, depending on the nature of the issue.

Does this mean a SAP can never update a recommendation?

No. The same SAP who did the original evaluation can still modify the recommendation if new or additional clinical information becomes available. 49 CFR § 40.297(b)

Related Articles

• Can I Change DOT SAPs?
• What Ethical Responsibilities Does a DOT SAP Have?
• Why Are SAP Recommendations Individualized?

Primary Authorities/Sources

• 49 CFR § 40.295, second SAP evaluations
• 49 CFR § 40.297, authority to change a SAP's evaluation
• 49 CFR § 40.299, conflict of interest in referrals

Concerned About Something in Your SAP Process?

If something about your SAP evaluation does not seem right, a second, qualified perspective on the regulation itself can help you understand your options.

Schedule an Initial SAP Assessment