> INTERAGENCY WILDLAND FIREFIGHTER MEDICAL QUALIFICATIONS STANDARDS
> WAIVER/ACCOMMODATION PROCESS

5 CFR Part 339 Medical Qualification Determinations requires agencies to
"...waive a medical standard or physical requirement ... when there is
sufficient evidence that an applicant or employee, with or without
reasonable accommodation, can perform the essential duties of the
position without endangering the health and safety of the individual or
others." The Rehabilitation Act of 1973, as amended, prohibits
employment discrimination against people with disabilities and requires
employers to provide "reasonable accommodation" to employees with
disabilities.

However, a waiver, waiver with restriction(s), or waiver with
accommodation(s) is not automatic, and may not be afforded though local
management or the firefighter may appear to have presented relevant
employment history. Granting a waiver, waiver with restriction(s), or
waiver with accommodation(s) confirms that the medically disqualified
firefighter can perform the full range of functions including those
functions which may be rarely if every required to perform. The ability
to perform the full range of functions quantifies the Agency's
expectation that the firefighter can perform the full range of duties at
any time and at any place, maintaining continuity of operations at all
times. Acute or chronic, permanent or ongoing, medical concerns not
meeting the Interagency medical qualification standards preclude the
Agency from utilizing all available resources to accomplish the mission.

Until management reaches an informed, individualized, fact based, case
by case decision and the waiver/accommodation process ends, the
firefighter is restricted from continuing or participating in arduous
duty. This restriction is mandatory as the requirements of the job may
aggravate, exacerbate, accelerate, or permanently worse the disease
process which affects the safety of the individual. The probability of
sudden incapacitation or inability to mitigate the hazards inherent with
the medical concern, pose a danger to self and threaten the safety of
others.

The Interagency Wildland Firefighter Medical Qualification Standards
Program (MSP) developed a two level waiver/accommodation process based
on 5 CFR Part 339. The purpose of a two level waiver/accommodation
process is to provide the applicant/incumbent the opportunity to request
a higher level review should the results of their 1^st^ level
waiver/accommodation request be nonconcurrence or a decision of No
Waiver. Additional information on the MSP and waiver/accommodation
process is found at: <http://www.nifc.gov/medical_standards/index.htm>

**The Waiver/Accommodation process provides the applicant/incumbent\* an
opportunity to request a:**

***Waiver -*** (waives the requirement to meet a medical standard) when
there is sufficient evidence that the applicant/incumbent can perform
the essential functions of the job safely and efficiently, without
endangering the health and safety of the individual or others.); or,

***Waiver with Restriction(s)*** - same definition as a **w*aiver***;
however a waiver with restriction(s) also place specific restriction(s)
on the applicant/incumbent when performing arduous duties and/or
prohibit(s) the performance of a specific duty/duties); or,

***Waiver with Accommodation(s)*** - (applicant/incumbent who meets the
definition of a qualified individual with a disability can request
"reasonable accommodation"). Reasonable accommodation is defined as any
change or adjustment to a job or work environment that permits a
qualified individual with a disability to perform the essential
functions of the position without endangering the health and safety of
the individual or others.

*\* And an AD/EFF **IF** their Agency makes a determination the position
they would occupy is "mission critical".*

NOTE: Applicant/incumbent should carefully consider whether to request a
waiver, a waiver with restriction(s), or a waiver with accommodation(s)
as 5CFR339 does not allow an opportunity to change from one type of
request to another once the DRAFT waiver, waiver with restriction(s), or
waiver with accommodation(s) memo is forwarded for a decision at the
1^st^ level of the waiver/accommodation process. *For example, an
applicant submits a request for a waiver with restriction at the 1^st^
level and received a nonconcurrence decision; the applicants request at
the 2^nd^ level must also be for a waiver with restriction(s).*

**Waiver/Accommodation Process - (1st level)**

1)  Comprehensive Health Services (CHS) Central Medical Consultant (CMC)
    determines the applicant/incumbent does not meet a medical standard;
    sends the non-clearance letter to the MSP Staff.

2)  MSP Staff obtains signed confidentiality agreement from the SHRO/FMO
    contacts listed on the CHS non-clearance letter. *(Note: If
    confidentiality agreement is already on file MSP Staff moves to next
    step.)*

3)  MSP Staff sends email to SHRO (cc to FMO); includes copy of CHS
    non-clearance letter and information on notifying
    applicant/incumbent of opportunity to request waiver/accommodation.

4)  SHRO prepares the non-clearance notification/opportunity to request
    waiver/accommodation memo and sends to applicant/incumbent (cc to
    FMO).

5)  Applicant/incumbent receives memo and notifies SHRO (within 5 days
    for GS/WG temporary or 30 days for Perm/CS/Term) they are requesting
    a waiver, a waiver with restriction(s), or a waiver with
    accommodation(s). Applicant/incumbent provides SHRO with supporting
    documentation on their current mitigation methods,
    qualifications/experience/training/performance, supporting
    statements, etc. *IF applicant/incumbent decides not to request
    waiver/accommodation they notify SHRO, SHRO notifies MSP Staff, and
    the waiver/accommodation process terminates.*

6)  SHRO/FMO review/analyze applicant/incumbent request for a waiver,
    waiver with restriction(s), or waiver with accommodation(s) and the
    supporting documentation. If request/information is sufficient
    SHRO/FMO develops a DRAFT waiver/accommodation memo with input from
    the applicant/incumbent. *If insufficient, SHRO/FMO request
    additional information/supporting documentation from
    applicant/incumbent. If SHRO/FMO does not support the request for
    waiver/accommodation, "No Waiver," the SHRO will forward their
    decision to the MSP Fire Management Specialist (DRAFT memo not sent
    to MSP Fire Management Specialist). SHRO notifies
    applicant/incumbent in writing of opportunity to appeal to the IMRB
    (2^nd^ level).*

7)  SHRO forwards DRAFT waiver/accommodation memo (***via email***) to
    MSP Fire Management Specialist.

8)  MSP Fire Management Specialist coordinates the review and
    concurrence/nonconcurrence decision with the designated Agency
    representative.

9)  MSP Fire Management Specialist sends decision via email to SHRO
    (concurrence on DRAFT as written, concurrence on DRAFT with proposed
    revision(s), or non-concurrence).

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a)  If concurrence of DRAFT as written; SHRO finalizes memo and obtains
    signatures (SHRO and applicant/incumbent);

b)  If concurrence on DRAFT with proposed revision(s); SHRO
    shares/discusses revision(s) with FMO and applicant/incumbent. If
    FMO and applicant/incumbent accept revision(s), SHRO finalizes memo
    and obtains signatures (SHRO and applicant/incumbent). If FMO and
    applicant/incumbent don't accept revision(s), move to step *9) c)*;

c)  If nonconcurrence of DRAFT as written, SHRO notifies
    applicant/incumbent in writing (*Denial of Waiver/Accommodation
    memo),* with a cc to FMO and MSP Manager. ***See 2nd level
    waiver/accommodation process (IMRB) for additional information.***

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10) SHRO faxes copy of signed waiver/accommodation memo to MSP Staff,
    files original in applicant/incumbent Official Personnel Folder as a
    condition of employment.

11) MSP Staff sends email to CHS (cc to SHRO) to change
    applicant/incumbent clearance in CAS.

12) CHS changes applicant/incumbent clearance in CAS.

Interagency Medical Review Board (IMRB)

> The IMRB is scheduled by the Federal Fire and Aviation Safety Team
> (FFAST) to meet three times per fiscal year (the 1st Wednesday in
> October, February, & June). The IMRB is responsible for completing a
> higher-level agency review for an applicant/incumbent who received a
> nonconcurrence or No Waiver decision at the 1^st^ level of the
> waiver/accommodation process.
>
> The IMRB is responsible for considering all information provide by the
> applicant/incumbent in addition to following an established criteria
> that considers the following:

1)  medical disqualification issue(s);

2)  qualifications, experience, and training;

3)  significant threshold shifts;

4)  stability of medical disqualification issue;

5)  conditions of employment;

6)  physical limitation(s);

7)  body stature and PPE; and/or

8)  ADA determinations.

> After the review, the IMRB provides a sound
> **[recommendation(s)]{.underline}** to the applicant's/employee's
> Agency management. Agency management (determined by Agency) issues the
> final waiver/accommodation decision memo to applicant/incumbent.
>
> The IMRB is made up of voting members and non-voting subject matter
> experts as follows:

-   IMRB Chair -- MSP Manager (Non-voting)

-   FFFAST Representatives or alternate (Voting)

-   DOI Occupational Safety & Health Program Fire Management Specialist
    (Voting)

-   IMRB Independent Medical Evaluation (IME) from Federal Occupational
    Health physician (Non-voting subject matter expert)

-   OPM Attorney (Non-voting subject matter expert on medical
    qualification determinations)

-   NIFC Employee Relations Specialist/FS Agency Representative
    (Non-voting subject matter expert in employee relations)

-   National/Regional SHRO (Non-voting subject matter expert)

-   Union Representative (Non-voting observer when requested by WLFF
    included in a bargaining unit)

-   MSP Fire Management Specialist (Non-voting)

-   Recorder -- MSP Deputy Program Manager (Non-voting)

IMRB Process - (2nd level waiver/accommodation process)

1)  If nonconcurrence of DRAFT memo as written or No Waiver decision at
    the 1^st^ level by FMO/SHRO, the SHRO notifies applicant/incumbent
    in writing (*Denial of Waiver/Accommodation memo),* with a cc to FMO
    and MSP Manager.

2)  Applicant/incumbent notifies MSP Manager (within 5 days for GS/WG
    temporary or 30 days for Perm/CS/Term) requesting a higher level
    review by the IMRB and provides any additional supporting
    documentation on their
    qualifications/experience/training/performance, current mitigation
    methods, supporting information/statements, etc. *IF
    applicant/incumbent decides to not request a higher level review (or
    an extension) during the given timeframes, the SHRO notifies the MSP
    Manager, and the waiver/accommodation process is terminated.*

3)  MSP Staff schedules applicant/incumbent request for an IMRB.

4)  MSP Staff obtains a copy of the applicant/incumbent medical file
    from CHS.

5)  MSP Staff obtains a copy of the applicant/incumbent 1st level
    waiver/accommodation file from the SHRO.

6)  MSP Staff copies all information and sends a copy of the entire IMRB
    file to the IME physician.

7)  IME physician reviews file and prepares an independent medical
    review on the medical disqualification issue(s) for presentation at
    the IMRB.

8)  MSP Staff copies all information in the IMRB file and sends a copy
    to the appropriate Agency FFAST Representative and IMRB ER and SHRO
    subject matter experts.

9)  IMRB reviews case and votes to concur/not concur with the
    applicant/incumbent request for waiver/accommodation.

10) MSP Staff finalizes IMRB case review notes and sends to the
    appropriate Agency IMRB SHRO subject matter expert.

11) Agency IMRB SHRO subject matter expert advises/assists Agency
    management official with preparation of IMRB decision memo.

12) IMRB decision memo issued to applicant/incumbent with copy to their
    next level supervisor and the MSP Manager.