Medical Standards Frequently Asked Questions

The wildland firefighting medical standards and medical exam processes are very important and somewhat complex, but each process is incredibly valuable in enhancing the safety of our firefighting workforce. If you have any questions about any step in the medical exam process or the related policies please contact us here:


What are medical standards and who do they apply to?

The 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 and 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 qualification for arduous duty. The Work Capacity Test or “Pack Test” assesses physical capability to meet the fitness requirement. 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, aka the Pack Test.

How often are medical exams required?

All 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 qualifications 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 online portal.

You will need to fill out a questionnaire online in the examinee 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 might I be driving by one clinic to go to another clinic that is further?

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

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

You should receive notification 10 business days after the exam.

What happens in the event of a missed appointment?

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

  • Acuity-CHS Phone Number: (888) 636-8619
  • Acuity-CHS Customer Service Email:

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. Note: All costs for follow-up care are the responsibility of the individual and are not covered by the Government.

I was determined Not Qualified. What is the next step?

Please see the Medical Review & Waiver process section for additional information. You may need to provide additional documentation or you can contact your Fire Management Officer or Human Resources staff and they can help you with the risk mitigation/waiver process.

How can I request a copy of my exam?

You can request a copy of your exam at:

  • Acuity-CHS Phone Number: (888) 636-8619
  • Acuity-CHS Customer Service Email:

What is a Risk Mitigation/Waiver?

This document waives the standard with or without mitigating any risk associated with an individual’s condition(s).  A Risk Mitigation puts a plan in place to help fire fighters reduce the risks related to their medical conditions. The plan is developed with you, your Fire Management Officer, and the Human Resources staff.

What if I have a pre-existing Risk Mitigation/Waiver on file?

All existing information is sent to the reviewing medical officer, and they will determine if there are changes to your medical condition that could impact your Risk Mitigation/Waiver. If there are no changes, and the waiver is valid, you will be deemed Qualified w/ Risk Mitigation/Waiver. If there are changes in your condition(s) the reviewing medical officer will review your Risk Mitigation/Waiver and may request additional information or recommend changes in the existing mitigations. Any changes would then require additional review and acceptance by the agency and the individual.

I just received a Not Qualified letter and I want to start the Risk Mitigation/Waiver process.

Bring your letter to your Fire Management Office and Human Resources staff and they’ll help you with the process.

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

Collect additional medical information for submission to the Reviewing Medical Officer.

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/Waiver Process?

Your agency Management Officer, typically the local Line Officer, will make the final decision for all Risk Mitigation/Waivers.

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