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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 reduces 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 2025/2026 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, a 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 Health Screening Questionnaire (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 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 (also found in the Additional Forms and Documents section).

If using 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.

The medical clearance may also include the recommendation of additional follow-up appointments or testing. If you receive a follow-up recommendation, it is your responsibility to schedule and pay for the service unless you obtain prior, specific authorization from your agency.

Contact the eMedical Qualifications Program Helpdesk via email: SM.FS.mqp_emedical@usda.gov 

 

Your clearance will provide one of the following qualification determinations: 

  1. Medically Qualified: No further action is needed with your medical exam at this time. You are cleared to take the Work Capacity Test (WCT).

  2. Medically Qualified – With Waiver(s):  You are cleared to take the WCT. You will need to log into eMedical and review the conditions of your waiver. It may (or may not) require you to submit information about a medical condition to the medical officers annually. 

  3. Medically Qualified -- Temporary Restrictions: If you fail to meet the medical qualification standards due to a temporary medical condition you may bel allowed to take the WCT or continue performing work but ONLY under certain conditions. Talk to your supervisor.

  4. Not Medically Qualified – Information Needed: You cannot participate in the arduous WCT until you supply the required information requested from the medical officer and they clear you. Log into eMedical to find out what you need to provide.

  5. Not Medically Qualified: A waiver/accommodation would not allow you to perform your duties without endangering the health and safety of yourself and/or others. You can neither participate in the WCT, nor perform duties as a firefighter, unless the determination is reversed. 

     

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 Letter to Regional Foresters from Deputy Chief John Crockett about the medical clearance waiver.

Health Screening Questionnaire (HSQ) and OF-178 Process for employees taking the Moderate or Light WCT

HSQ User Guides for

Links

Waiver Guidance for

Waiver Mitigation

Templates for Medical Providers to Complete

Health Screening Questionnaire (HSQ) Coordinator Documents

Medical Provider Documents

Essential Functions and Work Conditions of a Wildland Firefighter, January 2023, (PDF, 141 KB)
Letter to the Medical Provider (Templet), July 2023, (PDF, 52 KB)
Obstetrician, Care Giver, Midwife Letter - Being Pregnant and Fighting Wildland Fire, November 2023, (PDF), (172 KB)

eMedical Medical Provider User Guide, July 2023, (PDF, 570 KB)

Work Capacity Test (WCT) Brochure, March 2002, (PDF, 193 KB)

Physician Documents: 

  • Optional Form 178 (OF-178) for Arduous, September 2009, (PDF, 912 KB) and Moderate, September 2009, (PDF, 912 KB) or Light Work Capacity Tests, September 2009, (PDF, 912 KB)

  • Medical Provider Guidance Sheet for the OF-178 (PDF, 76 KB)

Additional Forms and Documents

Additional eMedical Forms

Policy and Guidance

Policy and Guidance - Historical information

Training (User Guides available in AMP and HSQ / OF-178 Sections)

WCT Administrators

Questions? Suggestions? Help? Contact the eMedical Qualifications Program Helpdesk via email:

SM.FS.mqp_emedical@usda.gov