Skip to main content
U.S. flag

An official website of the United States government

Wildland Firefighter Medical Qualifications

Firefighters out on a fire.
Work Capacity Reasons

Wildland firefighting and other forms of field work, demand a high-level of mental and physical fitness, to safely perform arduous, 16-hour work shifts in difficult environmental conditions. These may be in, but not limited to hiking steep terrain, in extreme temperatures, at high/low altitudes, hauling heavy loads, and in smoky conditions. It is also possible to work in unforeseen fire and medical emergencies and react appropriately. When prolonged hard work is involved, mental and physical fitness is the most important factor in work capacity.

Wildand firefighters dig into roots to extinguish smoldering underground fire.
Work Capacity Levels

Work capacity is a composite of fitness, acclimatization, nutrition, skill, experience, motivation, and intelligence. Mental and physical fitness are the most important factors. All wildland firefighters, of various response capabilities, must meet minimum levels for arduous, moderate, and light fitness requirements for the type of duties they are assigned during a wildfire, prescribed fires, and/or all-risk incidents.

An all women wildland firefighting crew selfie
Keeping Everyone Safe

Some jobs, like wildland firefighting, require passing a job-related Work Capacity Test to meet minimum qualifications and standards. Such tests help ensure that prospective and returning employees have the capacity to perform work without undue fatigue and without the risk of becoming a hazard to themselves, coworkers, and adjoining resources.

New Arduous Firefighter Medical Standards in 2024 

Wildland firefighters perform rigorous tasks as a regular part of their job. To minimize the chance of injury or fatigue, they must maintain physical fitness. For the safety of each wildland firefighter and those working alongside them, those in fire positions considered arduous must meet certain medical standards.

The U.S. Forest Service’s Fire Medical Qualification Program helps to reduce workplace injuries by applying Federal Interagency Medical Standards to all employees that preform firefighting duties. 

This program is essential for the safety of our wildland firefighting workforce, and we make every attempt to streamline the medical standards process. This process ensures you are physically able to carry out the duties required of a wildland firefighter and can help you identify any emerging health issue and seek treatment before it becomes serious.

Medical Exam Process 

If you are a Forest Service wildland firefighter who performs arduous duties, you must complete a physical exam every three years. In between those three years, you must complete an annual self-certification check-up. Light and moderate duty positions use the Health Screening Questionnaire/OF-178 process. 

Periodic Exam (Completed every 3-years)

The periodic medical exam is required every three years from the date of your last exam. It must be completed prior to participating in the annual work capacity test. You will be required to complete a medical history form in eMedical and then will have the option to schedule your own exam with your medical provider or use a contracted scheduling system.  Your supervisor or Health Screening Questionnaire (HSQ) Coordinator will likely initiate this process for you. If you are approaching three years since your last in-person exam, we recommend contacting them to ensure the process is initiated at least 45 days prior to the work capacity test.  

Self-Certification (Completed Annually) 

A self-certification questionnaire and blood pressure check is required each year between your in-person exam. The self-certification for FS-5100-42 is not the same as the HSQ/OF-178. It can also be completed in the eMedical system. 

Physical Exam Process  

You will complete one of 2 processes in eMedical: the Arduous Medical Process (AMP) or the Health Screening Questionnaire 

  • Step 1: Initiate the process and complete the questionnaire in the eMedical system. 

    • If you are a firefighter with arduous duties, your supervisor or HSQ Coordinator will most likely initiate the eMedical process. You will know this has happened when you receive and email from the eMedical system asking you to complete the health screening questionnaire for the work capacity test. 

    • Login to eMedical and complete the form to move to the next step. 

    • If you haven’t seen this email, contact your supervisor. 

    • You can also initiate the process yourself by logging into eMedical and requesting a packet. Your HSQ Coordinator will direct you to the appropriate process. 

  • Step 2: Check your email for further instructions. 

    • If your Health Screening Questionnaire (HSQ) responses indicate the need for a physical exam, you will get another email from eMedical.  

    • For the HSQ process, you will get an email that tells you one of the following: 

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

      2. You need to supply additional information to the Forest Service medical officers  

      3. You need to go for an OF-178 Exam (proceed to Step 3) 

    • For the Arduous Medical Process, if you chose to use Acuity, the contracted provider, they will contact you by phone and/or email. If you chose to not use Acuity, you will receive an email from eMedical with instructions for getting your physical exam.  Proceed to Step 3 from here. 

    • Read your email carefully, it may contain instructions on how to proceed if further action is required from you! 

  • Step 3: Schedule the exam.

    • If your email indicates that you need to schedule your own exam, save and print this email! You will need to bring it to your exam. Contact your HSQ Coordinator to discuss how to arrange this exam and to obtain the necessary paperwork to bring with you. Your HSQ Coordinator should be cc’d on the email.  

    • They will ask you for more information about which provider you would like to use for the exam and what location. If you elect to have your exam done by the contracted provider (Acuity), Acuitythey will call, text and email you with further instructions for scheduling your exam.  

    • If using Acuity, they will send you an email with instructions to log into their Examinee Access System. You may have to create an account. Once you are logged in, they will ask you to fill out a few forms and upload a copy of your Part A and B from eMedical. You can download that pdf from eMedical. Finally, you can select your availability for an appointment on their calendar. They should follow-up with appointment time.  

You must bring the following items to your exam: 

  • A valid ID with your legal name.

  • A copy of the email from eMedical with the access code.

  • Documentation of any medical conditions not previously provided.

  • Documentation of any medications you are taking.

  • Any information from your medical provider regarding procedures or surgeries that indicates you are fully recovered and can perform the essential functions of an arduous duty firefighter.

Remember, if you are in pay status, 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. 

  • Step 4: Determination. 

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

    • The medical clearance may also include recommend 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.

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. 

Forms and Reference Documentation

Arduous Medical Process—AMP (for those taking the Arduous WCT)

AMP User Guides for

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

HSQ User Guides for


Waiver Guidance for


Waiver Mitigation

Templates for Medical Providers to Complete

HSQ Coordinator Documents

Medical Provider Documents

Essential Functions and Work Conditions of a Wildland Firefighter (PDF, 141 KB)

Flowchart (PDF, 130 KB)
Letter to the Medical Provider (Template) (PDF, 52 KB)
OB Letter - Being Pregnant and Fighting Wildland Fire, (November 2023), (PDF), (172 KB)

User Guide (PDF, 570 KB)

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

Physician Documents: 

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: