Medical Standards Frequently Asked Questions

The Interior Department's Wildland Fire Medical Standards Program helps to reduce workplace injuries and improve the safety of our wildland fire workforce. 

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

If you have any questions about the medical exam process or related policies, please contact us at

You can find answers here to frequently asked questions about Interior's Wildland Fire Medical Standards Program.

If at any time you need one-on-one technical assistance or have questions that are not addressed here, please email medical standards customer service at

Frequently Asked Questions

What are medical standards and who do they apply to?

Medical standards apply only to arduous duty positions. They are authorized through 5 Code of Federal Regulations 339 with the intent to promote firefighter safety because of the arduous, hazardous nature of the job.

Are the medical standards the same as the work capacity or pack test?

No, these are two different programs. The Medical Standards Program assesses medical qualifications for arduous duty work. The work capacity test (commonly referred to as the pack test) assesses your physical ability to meet the fitness requirements of the position. It’s important to note that you will have to complete your medical qualification exam and receive a qualified determination BEFORE you can take your arduous work capacity test (pack test).

How often are medical exams required?

All those in positions considered arduous will take an initial comprehensive medical exam. Subsequent periodic exams are required every three years with an online self-certification in non-exam years.

What unique identification number do I use to input firefighters in the system?

An individual’s social security number is required for initial entry into the system. Once entered, this data will be hidden and the system will generate a new unique ID number for exam and qualification tracking.

Where do I go for my medical examination and how do I get paperwork?

Your local Fire Management Officer or human resources staff will request your exam through the Acuity MLINK Portal.

You will need to fill out a questionnaire online in the portal.  After all tasks are completed, you will be contacted with the date and time of the scheduled exam.

What do I need to bring to the exam?

Bring all supporting medical records that may be pertinent to your medical history and information about current conditions and medications you are taking.

Why do I have to drive by one clinic and go to another that is farther away?

Acuity-CHS will attempt to schedule your exam at the nearest clinic, but sometimes there may not be available appointments or the closer clinic does not conduct these exams.

What happens if I can't make my appointment?

Please contact the medical examination contractor, Acuity-CHS, and reschedule if you are unable to attend your appointment.

Phone: (888) 636-8619


How will I know the outcome of my exam?

The first letter you’ll receive is the official determination notice indicating your medical qualification.

The second letter will be from the health care contractor summarizing your overall health and may include suggestions for follow-up care. Please note that all costs for follow-up care are your responsibility and not covered by the Government.

How long does it take from the time of the exam until the qualification determination?

You should receive notification of your medication qualification determination 10 business days after the exam.

I received a not qualified determination. What can I do?

Visit our medical review and waiver webpage to learn how to participate in the risk mitigation and waiver process.

How can I request a copy of my exam?

You can request a copy of your exam by contacting the examination contractor, Acuity-CHS:

Phone: (888) 636-8619


What is a risk mitigation and waiver?

A waiver can waive the medical standard with or without mitigating any risk associated with your condition(s). A risk mitigation puts a plan in place to help you reduce the risks related to your medical condition(s). The plan is developed between with you, your Fire Management Officer, and your human resources staff.

What if I have a pre-existing risk mitigation and waiver on file?

All existing information is sent to the reviewing medical officer. They will determine if there are changes to your medical condition that could impact your risk mitigation or waiver.

If there are no changes, and the waiver is valid, you will be deemed qualified with risk mitigation/waiver.

If there are changes in your condition(s), the reviewing medical officer may request additional information or recommend changes in the existing mitigations. Any changes would then require additional review and acceptance by both you and the agency.

I just received a not qualified letter and I want to start the risk mitigation and waiver process. What should I do?

Bring your letter to your Fire Management Office and human resources staff. They will help you with the process.

I have additional medical information that may change my qualification. What should I do?

Collect documentation of the additional medical information.

Then call or email us at (888) 286-2521 or to request a review by the Reviewing Medical Officer.

Who makes the final decision in the risk mitigation and waiver process?

Your agency Management Officer, typically the local Line Officer, will make the final decision for all risk mitigation and waiver requests.

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