# Presentation: 173056

## Waiver/Accommodation Process5 CFR Part 339 – Medical Qualification Determinations

## Waiver/Accommodation Process

- Consists of an informal (local level) and formal (IMRB) review process
- Individualized case-by-case review/analysis of an individual’s medical non-clearance issue(s) against the risks associated with the essential functions and work conditions of a WLFF
- Interactive process between the SHRO, FMO and WLFF
- Timeframes are employee and management driven

##  Waiver/Accommodation applies to:

- Perm/CS/Term applicants and employees
- GS/WG Temporary seasonal hires
- AD/EFF (ONLY if determined to be mission critical by their Agency)

## Roles/responsibilities in the waiver/accommodation process

- Employee/Applicant  (AD/EFF if designated as a mission critical resource at the request of their agency)
- MSP Manager
- MSP Specialist
- FMO
- SHRO
- FFAST Representative(s)
- Regional/State Fire Operations Safety Manager
- IMRB Members

**Notes:**
The waiver/accommodation process is automatic for employees – they don’t meet the medical standard and the process begins.  However, the waiver/accommodation process is not automatic for an applicant and/or AD firefight, as the agency would need to request the process begin, along with their justification.

## Waiver/Accommodation Process Possible Results

- Waiver of the Standard(s)
- Waiver with Restriction(s)
- Waiver with Accommodation(s)
- No Waiver

## Waiver of the Standard(s)

- Waives the requirement to meet a medical standard or physical requirement (management assumes the liability) when there is sufficient supporting evidence that the individual can perform the essential functions of the position safely and efficiently, without hazard to themselves or others.

**Notes:**
No agency has waived monocular vision or hearing aid (“unilateral or profoundly deaf”), however, newer hearing aids can now detect the direction of sound.

## WAIVER WITH RESTRICTION(S)

- Waives the requirement to meet the medical standard or physical requirement (management assumes the liability) when there is sufficient supporting evidence that the individual can perform the essential functions of the position safely and efficiently, without hazard to themselves or others; AND
- Places specific restriction(s) on the individual on how they must perform their duties and/or prohibit(s) the performance of specific duties.

## Waiver or Waiver w/Restrictions Determinations at the Informal (local) Level

- The FMO and SHRO (with input from the WLFF)
- MSP Manager and FFAST representative (in consultation and review of information submitted by SHRO)

## WAIVER WITH ACCOMMODATION

- Qualified individual with a disability who meets the “major life activity” test under ADA/Rehab Act and can perform the _essential functions_ of the position in question without endangering the health and safety of the individual or others.
- “Reasonable accommodation” is 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 in question without endangering the health and safety of the individual or others.
- An agency may request supporting documentation about the disability and functional limitations.

## Waiver with Accommodation Determinations at the Informal (local) Level

- The FMO & SHRO (with employee/applicant input) follow the IMRB Guide on REASONABLE ACCOMMODATION to  make waiver with accommodation _**determinations**_.

## Confidentiality Agreement

- All individuals participating in the waiver/ accommodation review/determination process are required to sign a medical confidentiality agreement **prior to viewing** any of the WLFF’s medical non-clearance information
- Acknowledges the provision of the Privacy Act of 1974  (5 USC Sec. 553a) and requires a commitment to protect the privacy of every individual whose request is under review by:

## Confidentiality Agreement (cont.)

- Protecting all confidential information from inappropriate disclosure;
- Using only the information that is necessary and for the purpose for which the information was gathered and provided; and,
- Ensuring that all confidential information provided for review remains physically secure.

## Slide 13

## Vision Standard Automatic Waiver w/Restriction 

- Automatic waiver with restrictions for uncorrected vision worse than 20/100 in each eye, which is corrected with glasses to better than 20/40 in each eye (and no other medical non-clearance issues)
- Retains the safety emphasis of attaining corrected far visual acuity at 20/40 or better at all times under all environmental conditions
- Requires written documentation from the firefighter to the supervisor on how this restriction will be met at all times when engaged in arduous duty
- CHS posts determination in CAS “Cleared w/Restriction – Sufficient Pair(s) of Glasses”
- Waiver with Restriction memo provided to WLFF with the restriction they wear corrective lenses which returns their visual acuity in each eye to 20/40 or better at all times when engaged in arduous wildland firefighting

## Information/documentation individual should submit with their waiver/accommodation request

- Specify what they are requesting: waiver of the standard(s); waiver with restriction(s); or waiver with accommodation(s).
- History of work experience, qualifications, and training which demonstrates the ability to safely perform arduous duty given the medical non-clearance issue, including a history of collateral arduous duty assignments if applicable.
- History of performance abilities, including Incident Personnel Performance Ratings evaluation forms (NFES 1576), IQCS Record, etc.
- Current methods to mitigate the safety risks associated with the medical non-clearance issue.

## Information/documentation individual should submit with their waiver/accommodation request (cont.)

- Supporting documentation noting ability to safely perform arduous duty given the medical non-clearance issue.
- Any other documentation provided by the individual and/or others on their behalf regarding the individual’s ability to perform the essential duties of the WLFF arduous position without endangering the health and safety of the individual or others.
- Any additional medical information/documentation from a physician (history of the medical condition, findings from a current medical evaluation, treatment & responses to treatment, and the impact of the medical condition on the individual’s ability to perform the essential duties as an arduous WLFF).

## Examples and Tools

- Waiver/Accommodation Criteria/Process for Permanent/Career Seasonal/Term
- Waiver/Accommodation Criteria/Process for GS/WG Temporary Seasonal Hires
- Waiver/Accommodation Checklist
- Waiver/Accommodation Example

## Exercise

- 	Mr. WLFF is a 45 year old career seasonal Engine Operator who did not meet the Hearing Standard.  His CAS status is “Not Cleared.” CHS reported Mr. WLFF’s  audiogram results as:
- 	Hearing loss, with the following thresholds:
- 		_500_	_1000_	_2000_	_3000_
- Right ear	00	00	00	45
- Left ear		00	05	15	70
- 	Mr. WLFF also wrote on his Baseline exam that he has some ringing in his ears and sometimes has to ask to have information repeated.

## Exercise (cont.)

- SPO sent letter to WLFF and he responded, requesting a waiver with restrictions
- WLFF provided a statement and supporting statements from four others.
- WLFF provided a copy of his current resume and IQCS qualifications; his current performance rating and  3 years of fire performance ratings
**What steps should happen next?**
**Would you be supportive of a Waiver with Restrictions? Why or why not?**

## INTERAGENCY MEDICAL REVIEW BOARD (IMRB) 

- The IMRB membership consists of subject matter experts who represent key aspects of the WLFF program.  Members are designated on an ad hoc basis by the MSP Manager and include:
- MSP Manager (chairs the IRMB)
- Board Certified Physician with Federal Occupational Health
- Attorney from OPM Medical Qualification Programs and Policy
- DOI Occupational Health Programs Manager
- FS & DOI FFAST Representatives
- Agency and/or department safety officer
- Agency-appropriate SHRO
- Agency Employee Relations Specialist

## IMRB (cont.)

- Responsible for completing a high-level (formal) agency review of medical documentation on individuals who have not been medically cleared for WLFF arduous duty.
- Responsible for considering the significant factors (safety, mission accomplishment, personnel, program & medical elements) in all requested waiver/ accommodation requests and providing sound _**recommendation(s)**_ to the individual’s Agency Fire Director on the best course of action regarding a waiver/ accommodation.
- Agency Fire Director issues final waiver/ accommodation decision to individual.

## Employee Medical File (EMF), SF-665 CFR Part 293, subpart E

- Established to contain all of the occupational medical records maintained by the employing agency during the employee’s Federal service.
- Documents are maintained in accordance with the Privacy Act regulations in 5 CFR 293 and 297.
- Disclosure of an employee’s occupational medical records to agency officials will be granted only when the specific information sought is needed in the performance of official duties.

## Resources

- MSP Website: _[http://www.nifc.gov/medical_standards](http://www.nifc.gov/medical_standards)_
- DI-625
- FS-6100-13 for Militia & WLFF PD’s found at:  _http://fsweb.wo.fs.fed.us/hrm/employment/medical_standards/index.htm_