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It defines how medical and physical qualifications are set for individuals entering and retaining positions involving arduous duties, including how standards determine fitness with or without reasonable accommodation. The manual outlines program roles, responsibilities, medical review and evaluation processes, and procedures for appeals and waivers, with guidance covering examinations, findings, confidentiality, and release, plus supporting appendices for definitions and medical standards.",{"@graph":63,"@context":112},[64,80,95],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/reference-manual-57a-medical-standards-program-april-2013/564592/",4,{"url":78,"name":59,"@type":81,"author":82,"headline":59,"publisher":85,"fileFormat":88,"inLanguage":57,"description":61,"dateModified":89,"datePublished":89,"encodingFormat":88,"isAccessibleForFree":90,"interactionStatistic":91},"DigitalDocument",{"name":83,"@type":84},"Ophelia","Person",{"url":68,"name":86,"@type":87},"DocShare","Organization","application/pdf","2026-10-12",true,{"@type":92,"interactionType":93,"userInteractionCount":4},"InteractionCounter",{"@type":94},"ViewAction",{"@type":96,"mainEntity":97},"FAQPage",[98,104,108],{"name":99,"@type":100,"acceptedAnswer":101},"What is the purpose of the Medical Standards Program in Reference Manual 57A?","Question",{"text":102,"@type":103},"It sets medical and physical qualifications for individuals entering and retaining positions with arduous duties. It also helps determine whether medical conditions prevent essential functions and assesses risk to safety and health with or without reasonable accommodation.","Answer",{"name":105,"@type":100,"acceptedAnswer":106},"Which positions are covered by the NPS medical standards under this manual?",{"text":107,"@type":103},"The manual applies to commissioned park rangers, criminal investigators, law enforcement coverage positions, wildland firefighters, structural firefighters, divers, and firearms instructors, based on their collateral responsibilities in position descriptions.",{"name":109,"@type":100,"acceptedAnswer":110},"How does the manual describe responsibilities for medical oversight?",{"text":111,"@type":103},"The Medical Standards Program Manager (MSPM) provides oversight for primary duty commissioned rangers and criminal investigators, and coordinates with the Department of the Interior Wildland Firefighter Medical Standards Program manager for wildland firefighter collateral duties.","https://schema.org",{"og:url":78,"og:type":114,"og:title":59,"og:site_name":86,"og:description":61},"article",{"robots":116,"canonical":78},"index,follow",{"doc_id":118,"site_id":56},564592,1791843065,{"code":4,"msg":5,"data":121},{"doc_id":118,"user_id":122,"nickname":83,"user_avatar":123,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":124,"file_id":125,"file_url":126,"file_type":127,"file_size":128,"view_count":4,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":129,"language":130,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":131,"faqs":132,"seo_title":133,"seo_description":61,"update_tm":119,"read_time":45},7971461741311,"https://ap-avatar.wpscdn.com/avatar/74000253aff267980c6?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779345379180704826","# Reference Manual 57AMedical StandardsProgram\n\nApril 2013  \nCameron H.ShollyAssociate Director,Visitor and Resource Protection  \ngeanFisher  \nMedical Standards Program Manager  \nTable of Contents  \nAcronyms and Abbreviations……………………………………………………………………………………………………………………………………i  \nChapter 1-General Medical Standards Program…………………………………………………………………………………1  \n1.1 Overview………………………………………………………………………………………………………………………………………………………………1  \n1.2 Positions Having Specific Medical Standards…………………………………………………………………………………1  \n1.3 Medical Review Officer……………………………………………………………………………………………………………………………………2  \n1.4 Reference Manual Administration, Distribution,and Maintenance………………………………………………………2  \nChapter 2-Basis for Medical Standards……………………………………………………………………………………………………3  \n2.1 Establishment of Medical Standards ………………………………………………………………………………………………………………3  \n2.2 Basis for Medical Standards……………………………………………………………………………………………………………………………4  \n2.3 Reference to Essential Functions and Work Condition-Charts………………………………………………………………7  \nChapter 3-Specific Medical Standards Program Guidance…………………………………………………………………8  \n3.1 Examinations…………………………………………………………………………………………………………………………………………………………8  \n3.2 Examination Process and Responsibilities …………………………………………………………………………………………………1  \n3.3 Medical Examination Findings………………………………………………………………………………………………………………………14  \n3.4 Management, Maintenance,Confidentiality,and Release ………………………………………………………………………16  \n3.5 Fitness for Duty,Return to Duty,and Independent Medical Evaluations for Law Enforcemen……18  \nChapter 4-Appeals and Waiver Review Panel Procedures……………………………………………………………21  \n4.1 First Level Appeals…………………………………………………………………………………………………………………………………………21  \n4.2 Initial Waiver Reques………………………………………………………………………………………………………………………………………2  \n4.3 Waiver Renewal Requests Process and Procedures …………………………………………………………………………………24  \n4.4 Waiver Review Panel………………………………………………………………………………………………………………………………………25  \n4.5 Waivers and Appeals for Wildland Firefighting,Structural Firefighting,and Diving……………………27  \nChapter 5-Medical Review Board………………………………………………………………………………………………………………28  \n5.1 Medical Review Board……………………………………………………………………………………………………………………………………28  \n5.2 Medical Review Board Process………………………………………………………………………………………………………………………31  \nAppendix A-Definitions………………………………………………………………………………………………………………………………………35  \nAppendix B-Medical Standards…………………………………………………………………………………………………………………37  \nAppendix C-Verification of Medical Status …………………………………………………………………………………………57  \nAppendix D-Initial Waiver Request…………………………………………………………………………………………………………58  \nAppendix E-Waiver Renewal Request……………………………………………………………………………………………………59  \n## Acronyms and Abbreviations\n\nBoardMedical Review Board  \nDOIDepartment of the Interior  \nDOI MSPDepartment of Interior Medical Standards Program(for Wildland Fire)  \nIMEIndependent Medical Evaluation  \nLEOLaw Enforcement Officer  \nLESESLaw Enforcement,Security,and Emergency Services  \nMROMedical Review Officer  \nMSPMMedical Standards Program Manager  \nSHROServicing Human Resource Office  \nWLFFWildland Firefighter  \nWRPWaiver Review Panel  \n## Chapter 1-General Medical Standards Program\n\n1.1 Overview  \n1.2 Positions Having Specific Medical Standards  \n1.3 Medical Review Officer  \n1.4 Reference Manual Administration,Distribution,and Maintenance  \n### 1.1 Overview\n\nThe Office of Personal Management(OPM)requires that agencies establish medical and physicalqualifications for individuals entering and retaining positions that primarily perform arduous duties.Director's Order(DO)\\#57A and Reference Manual(RM)57A.Medical Standards,establish medicalstandards.Under the National Park Service (NPS)Medical Standards Program,the Service applies thesemedical qualifications to select positions in which arduous duties are assigned,whether as a primary orcollateral duty.whether the emplovee encumbering a position is in a career,term.or temporaryappointment.  \nSpecific medical standards and the Medical Standards Program allow the Se","cbCaiaoxKLOUvBZo","https://ap.wps.com/l/cbCaiaoxKLOUvBZo","pdf",4713617,61,"English","# Acronyms and Abbreviations\n# Chapter 1 - General Medical Standards Program\n## 1.1 Overview\n## 1.2 Positions Having Specific Medical Standards\n## 1.3 Medical Review Officer\n## 1.4 Reference Manual Administration, Distribution, and Maintenance\n# Chapter 2 - Basis for Medical Standards\n## 2.1 Establishment of Medical Standards\n## 2.2 Basis for Medical Standards\n## 2.3 Reference to Essential Functions and Work Condition-Charts\n# Chapter 3 - Specific Medical Standards Program Guidance\n## 3.1 Examinations\n## 3.2 Examination Process and Responsibilities\n## 3.3 Medical Examination Findings\n## 3.4 Management, Maintenance, Confidentiality, and Release\n## 3.5 Fitness for Duty, Return to Duty, and Independent Medical Evaluations for Law Enforcemen","[{\"question\":\"What is the purpose of the Medical Standards Program in Reference Manual 57A?\",\"answer\":\"It sets medical and physical qualifications for individuals entering and retaining positions with arduous duties. It also helps determine whether medical conditions prevent essential functions and assesses risk to safety and health with or without reasonable accommodation.\"},{\"question\":\"Which positions are covered by the NPS medical standards under this manual?\",\"answer\":\"The manual applies to commissioned park rangers, criminal investigators, law enforcement coverage positions, wildland firefighters, structural firefighters, divers, and firearms instructors, based on their collateral responsibilities in position descriptions.\"},{\"question\":\"How does the manual describe responsibilities for medical oversight?\",\"answer\":\"The Medical Standards Program Manager (MSPM) provides oversight for primary duty commissioned rangers and criminal investigators, and coordinates with the Department of the Interior Wildland Firefighter Medical Standards Program manager for wildland firefighter collateral duties.\"}]","Reference Manual 57A - Medical Standards Program - April 2013 | PDF"]