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Fire and Aviation Management Medical Qualifications Program

Image shows three wildland firefighters on a ridgeline with the sun setting behind them and the sky is orange with smoke from the Eaton wildfire.

Wildland firefighting and other forms of field work demand a high level of fitness to safely perform arduous, day-long work in difficult environmental conditions, including steep terrain, extreme temperatures, altitude, and smoke, and to meet unforeseen emergencies. When prolonged hard work is involved, fitness is the most important factor in work capacity.

Photo: Wildland Firefighters on the Mill Creek Fire Station, CA. January 14, 2025. USDA Forest Service photo by Jhovanni Solano.

The Fire Medical Qualifications Program of the US Forest Service establishes and maintains a process to decide if a wildland firefighter or wildland fire support staff member meets the health and physical requirements of the fire qualifications, they wish to function in.

The anchor point for the medical qualifications program is the Federal Interagency Wildland Firefighter Medical Standards for arduous positions or the current medical standard of care for light and moderate positions.

The program involves a review of an individual’s medical history, current health status through medical documentation, and sometimes a physical examination. Following these steps, the medical qualifications program issues a medical determination for each responder. The process may help you identify an emerging health issue so that you may seek treatment before it becomes serious.

The medical qualifications program does not actively seek ways to disqualify responders. It attempts to reduce the likelihood and severity of medical emergencies occurring during an ongoing incident by supporting a capable workforce.

Follow the steps below to navigate through the Medical Qualifications Program:

  • If you have access to ConnectHR, you can initiate the process by logging into eMedical, requesting a packet, and notify your HSQ Coordinator.

  • If you don’t have access to ConnectHR, an HSQ Coordinator will initiate the eMedical process for you.

Carefully read the eMedical email for instructions.

  • You may have been cleared to take the WCT (this is the end of the process!)

  • Your packet may need further review by a Forest Service medical officer.

  • You may need to go for an OF-178 Exam.

  • A waiver and mitigations are a medical accommodation for a medical condition that does not meet either the Federal Interagency Wildland Firefighter Medical Standards for arduous or the current medical standard of care for light and moderate.

  • Essentially, a waiver is your proof for being medically cleared. The waiver will also have the mitigation requirements you need to fulfill in order to keep the waiver valid.

    See below for more information on this critical element.

  • After your HSQ or OF-178 is sent to the Forest Service Medical Officer, you may get an email for a Request for Information. This request for additional medical information or documentation regarding a medical diagnosis or a potential medical condition as medical signs and/or symptoms noted.

  • It is your responsibility to obtain, pay for, and supply this information or grant access to this information to the Forest Service medical officer per 5 CFR 339.304(c).

  • If you go to your personal medical provider and are in pay status or have a tentative selection notice, the government will reimburse you for all costs associated with the exam as well as travel using the Request for Reimbursement form FS6500-229, (PDF, 207 KB) also found in the Forms and Reference Documents for Employees section.

  • If using the contractor, Acuity, they will take care of all payments for the exam.

  • A Forest Service Medical Officer will review the results of your exam and will issue a level of medical clearance.

  • Your medical provider does not make the final determination if you are medically qualified.

Update Effective April 2025

Based on our ongoing assessments and feedback from employees and NFFE, the Arduous Medical Process implementation will remain paused, and effective immediately all IQCS cardholders will use the updated Health Screening Questionnaire (HSQ), which closely resembles the pre-2023 version.

Additional details are provided in the May 28, 2025, the Letter to Regional Foresters from Deputy Chief John Crockett (PDF, 197 KB) about the medical clearance process.

Medical Qualifications Program

The U.S. Forest Service’s Fire Medical Qualification Program is essential for the safety of our wildland firefighting workforce, and we make every attempt to streamline the medical screening process. For many medical conditions, you will be asked to provide additional information for clarification and waiver consideration. If you receive a “Not Medically Qualified – Information Needed,” you cannot participate in the WCT nor perform the duties of your fire position. You were sent a request for information via eMedical where additional information detailed is needed to complete your medical review. The Washington Office Fire and Aviation Management program remains committed to ensure our wildland fire workforce is both mentally and physically healthy and available to engage in wildland fire response activities. An important component of preventative care is establishing a relationship with a medical provider, and we recognize that should happen outside of agency exam requirements. There are many resources to help our wildland fire workforce personally manage their health with a physical training program, healthy diet and using insurance’s health benefits like annual exams.

For Information about payment for exams, see the FAQs.

For Acuity's customer service: usdausfsacuity@chsmedical.com or call 855-462-1634

Federal Interagency Wildland Firefighter Medical Standards

The Federal Interagency Wildland Firefighter Medical Standards establishes the medical qualifications needed to perform the work of a wildland firefighter with arduous duties. These standards are an effort to mitigate the potential hazard of medical conditions that may impact personnel or their coworkers on the job. The body systems covered in the medical standards are: 

CardiacHematopoietic System
Chest and Respiratory SystemImmune System and Allergic Disorders
DermatologyMusculoskeletal System
Endocrine and Metabolic SystemProsthetics, Transplants and Implants
Gastrointestinal SystemMedication
Genitourinary SystemPsychiatric
Head, Nose, Mouth, Throat and NeckVision
HearingVascular

A waiver with or without mitigation(s) is a form of medical accommodation, granted only by a FS medical officer, that allows the firefighter to perform their job functions safely and efficiently as possible with a medical condition that is static and stable. In plain speak, a waiver is your “ticket” for being medically cleared and the mitigations are the requirements you need to fulfill in order to keep the ticket (waiver). A waiver for a medical condition can only be considered when enough information is obtained to show the condition is static and stable. If a request for information has been sent to an employee, the medical review to consider a waiver will begin when additional medical documentation is provided to address the medical condition in question. 

These mitigations may have a yearly requirement to supply information to the Medical Officer. Some may ask for evidence that a condition continues to be static and stable, others may have a requirement to notify the Medical Officer if there are any changes to their medical condition. There are many different waivers available, and the most important thing is to read your waiver to understand its requirements. 

TIP: The medical officer and your primary medical provider care about the same thing. A proactive step is to schedule your yearly medical exam or one of your multiple medical exams with your personal medical provider(s) a month before you normally start your medical clearance process so that you can proactively discuss the waiver with your provider and obtain necessary documents.

 

Links to Logon to eMedical

 

GUIDANCE

FORMS AND DOCUMENTS

GUIDANCE

FORMS AND REFERENCE DOCUMENTATION

FORMS TO PRINT/TAKE TO PERSONAL MEDICAL PROVIDER FOR OF-178 OR PREGNANCY

FORMS AND REFERENCE DOCUMENTATION TO COMPLETE THE OF-178

SPECIFIC MEDICAL CONDITION TEMPLATES TO COMPLETE WAIVER MITIGATIONS

Questions? Help? 

Contact the Medical Qualifications Program Helpdesk via email:

SM.FS.mqp_emedical@usda.gov