Medical Clearances matches an individual medical needs with posts capable of providing adequate medical or education services. If an employee wishes to contest a decision, they may contact the Medical Review Panel (MRP) at MEDMRP@state.gov and a review will be convened by a three-physician panel. Insure the patients name and date of birth is at the top of each page of the exam form. An official website of the United States Government, Office of the U.S. Contacting your assignments officer in Human Resources for your agency. This exam is recommended but not mandatory. Sign in to the editor using your credentials or click on Create free account to examine the tool's functionality. All persons must undergo a full physical exam for their first medical clearance. CONUS based individuals who do TDY travel to ESCAPE posts for 30 or more consecutive days have a medical clearance valid for two years from the date of issuance. Include the Medical Records coversheet. Confidential Medical Information. Tips for Your Separation Medical Examination. Yes / No 2. Contractors and DOD Civilians should contact their sponsors human resources. a. Include the Medical Records coversheet. DOS Medical Guidelines and DOD Medical Deployment Requirements. EFMs, age 18 and over, must provide their own email address for privacy reasons. Coordinator for the Arctic Region, Bureaus and Offices Reporting Directly to the Secretary, Office of the Coordinator for Cyber Issues, Office of the U.S. What medical conditions does FAA consider disqualifying? Under Status of Employee check or write in the appropriate designation (Employee, contractor, EFM, TDY, etc). There are often no blood banks or limited medical supplies and medications available locally. Reason to Update a Medical Clearance While In-Service. Individuals with no health issues should be notified after review that they have a Worldwide Available (Class 1) clearance. The individual, parent or guardian should complete the first two pages of each form. Foreign Service Officers are required to serve much of their career overseas. Since youll be serving overseas as a Foreign Service Specialist after successfully completing the FAIT Fellowship program, youll need to be able to obtain and maintain a worldwide (Class One) medical clearance. 3901 et seq., requires all Foreign Service employees to serve a substantial portion of their careers overseas, and limits the number of years Foreign Service employees can spend in continuous domestic service. Conduct which clearly shows poor judgment and or lack of discretion which may reasonably affect an individual or the agencys ability to carry out its responsibilities or mission. Those individuals will remain in a pending status. Your CDO or agency HR will send your list to MED Clearances. The in-service clearance process is simplified by the use of a DS-3057: Medical Clearance Update (MCU) form. https://careers.state.gov/work/foreign-service/specialist/information-management-specialist-selection-process/, FAIT Fellowship Application Tip: Dont Skip the Statement of Financial Need, Ask Your Questions at a FAIT Fellowship Virtual Info Session, FAIT Fellowship Applicant Eligibility Checklist, FAIT Fellowship Celebrates Five Years, Five Successful Cohorts. Other agency employees, contractors or their family members may begin one year prior to their overseas assignment or training. You can also download a PDF document with this information on the Resources page. The following information is designed to assist as you navigate the MED Post Approval process for those with a Post Specific clearance. Exam Clinic Option: Appointments for separation or retirement examinations are available at Department of State Exam Clinic. Although qualified students who travel on educational travel orders are eligible for care abroad under the Medical Program up to their 23rd birthday (16 FAM122.2, subparagraph a(2)), their separation examination must be completed within 90 days of their 21st birthday (16 FAM 122.2, subparagraph a(1)). The medical clearance process is designed to identify medical, mental health, or educational issues before departing for an overseas assignment. For more detailed information see Post Specific (Class 2) Clearance Guidance. The Suitability Review Panel has the authority to terminate your candidacy. The Committee reserves the right to seek MEDs opinion when it deems such opinion is necessary for proper adjudication of the request, consistent with the Health Insurance Portability and Accountability Act (HIPAA) and implementing regulations at 45 C.F.R. Document rationale for Post Approvals and/or Disapprovals. A TDY medical clearance is valid for 2 years from the date it was issued. Do NOT submit to Medical Clearances. The separation (or retirement) physical examination is for employees and eligible family members (EFMs) leaving the Foreign Service. and Foreign Commercial Service/Foreign Agricultural Service/Animal and Plant Health Inspection Service/USAGM), (Applies to all U.S. Government Employees and Eligible Family Members Participating in the Department of State Medical Program). Persons who are CONUS based doing frequent TDYs to ESCAPE post/s must complete the below documents every two years. DOD deployment requirements are generally stricter than DOS medical clearance guidelines. Where a particular physical or mental health condition, or extraordinary stress are the basis or for the request. Medical Clearance Questions. For information on how to schedule an appointment with the Exam Clinic, contact. The purpose of this SOP is to establish procedures and criteria for considering requests for waivers of the requirement for overseas service, (1) after six years of continuous domestic assignments, and (2) after eight years of continuous domestic assignments. Tips for Submitting Your Medical Clearance Application. Misconduct in prior employment, including marginal performance or inability to interact effectively with others. Other conditions are less restrictive and others are more restrictive in terms of the number of posts with resource. Do not travel to your next overseas assignment without a valid medical. The medical clearance exam may be completed for you and your family members by a licensed medical provider of your choice.If done overseas insure that the all sections, labs and reports are in English. Fellows should be aware that these posts are neither few in number nor confined to a specific geographic region. Page 2 must be signed and dated. Medical Clearance Notices will be sent to your e-mail address you place on your form. All blanks need to be filled in. Examples of chronic conditions that must meet stricter DOD requirements to be deployed to an ESCAPE include but are not limited to; tighter control of seizures, asthma, headaches and mental health issues; injectable or refrigerated medications; cardiovascular risk factors and excessive weight (BMI >35). EFMs, age 18 and over, must provide their own email address for privacy reasons. Via email in PDF format to MEDMR@state.gov (preferred) Employees and Contractors have the right to appeal any Post-Approval decision. b. Post-Specific (Class 2): Issued to an individual with a medical condition that would pose a significant risk to the health or safety of the individual or others if the individual were assigned to work at one or more posts abroad. Your CDO or Agency HR will notify you of posts you have been medically cleared for your next assignment. Given the representational nature of employment in the Foreign Service, employees must observe proper standards at all times. List your prescription medications, hospitalizations, and medical conditions since your last clearance. Worldwide Available (Class 1): Issued to applicants, employees and eligible family members who have no identifiable medical conditions that would limit assignment abroad. If you are TDY indicate if you are CONUS or overseas based, all possible ESCAPE posts you may travel to, and the estimated duration of your TDY stay. If a new post potentially arises, they should contact their Clearance Consultant for approval for that post. Because everyone is medically cleared to be in the United States, individuals whose next tour is a domestic assignment do not require a medical clearance unless they will be doing TDY travel of 30 or more consecutive days during their domestic tour. Show details How it works Open the ds1843 and follow the instructions Easily sign the 1843 form with your finger Send filled & signed ds 1843 pdf or save Rate the rent increase form 4.7 Satisfied 135 votes Criminal, dishonest, or disgraceful conduct. Reasons for a Separation or Retirement Exam. The separation (or retirement) physical examination is for employees and eligible family members (EFMs) leaving the Foreign Service. A medical clearance is valid until your scheduled home leave or end-of-tour whichever is sooner. A medical clearance is valid until your scheduled home leave or end-of-tour whichever is sooner. A DS-3057: Medical Clearance Update (MCU) is the preferred method of renewing a medical clearance. . A waiver request should be sent to an employees CDO, who will forward it to the Five/Eight Committee. The list is not inclusive, but rather reflects the conditions that most commonly arise. A Post Specific (Class 2) Medical Clearance means you (or your EFM) have (or has) an on-going medical, mental health, or educational issue where the medical capabilities needed may not be available at every post in the world. Get involved! Please be sure that the name, DOB, and email address are all printed clearly. ESCAPE posts comprise a subset of High-Threat, High Risk (HTHR) posts. Certain conditions may require that the employee stay in the United States for longer than 6 years. These individuals must receive a Worldwide Available (Class 1 Clearance) based on their pre-employment medical exam. Please send inquiries only to this email address. Individuals assigned to an ESCAPE post has a medical clearance valid for one year. Unsigned forms will not be accepted by Medical Records. Examples include, but are not limited to, the need to spend time with otherwise healthy children to assist their readjustment to new living circumstances; to complete an adoption; or to assist in the career or personal needs of a non-tandem spouse. However, for some individuals with on-going medical, mental health or educational issues adequate medical resources may not be available in all countries. Often children are under one parents orders for their current assignment and need to be switched to the other parent for an onward assignment. From one overseas assignment to another overseas assignment, From a domestic assignment to a new overseas assignment, On TDY overseas for more than 30 consecutive days, Language or extended CONUS training for the assigned post after language training, Linked assignment for both current and linked assignment, Complete an MCU for each member of the family.For adults or children with a. Waivers of these DOD requirements may be granted in select cases. Many waiver requests are based on confidential medical or mental health information regarding the requesting employee and/or members of the employees family. It is your clearance. Post Approval Process for Foreign Service Officers, Limited Non-Career Assignment, Foreign Service Fellows or their Eligible Family Members with a Post Specific (Class 2) Clearance. Provide a current phone number and valid mailing address that can be used even if you are between posts on home leave or personal travel. Your CDO or Agency HR will notify you of posts you have been medically cleared for your next assignment. The Office of Medical Clearances is responsible for ensuring the U.S. government personnel receive adequate medical evaluation and clearance prior to their assignments abroad. Please check the signature area. How Long Will the In-Service Clearance Process Take? There are several extra steps involved in bidding on overseas jobs if you or one of your Eligible Family Members (EFM) has a Post Specific (Class 2) Medical Clearance. For information on how to schedule an appointment with the Exam Clinic, contact MEDASEC@state.gov or 202-663-1779. Failure to have all family members medical clearance in order may delay your travel orders. How Long is an ESCAPE Post Clearance Valid? Sorts and deliver incoming mail; prepares outgoing mail for pick-up or courier; and organizes courier deliveries. Obtaining reports from specialists, hospitals, therapists, and schools is time consuming. Foreign Service Officers Candidates, Foreign Service Fellows, and some first-time Limited Non-Career Appointees under the 5 Foreign Services Agencies must be able to serve at any post in the world for their first tour. The following in-service employees, contractors and EFMs are required to update their medical clearance: Persons assigned to the United States and not traveling overseas do not require a medical clearance. Medical Clearances reviews the submitted documentation and retains a copy in your permanent medical file. Under the guidance of the California Department of Health Care Services, the Medi-Cal program aims to provide health care services to about 13 million Medi-Cal beneficiaries. Shreds security and medical sensitive materials as directed including medical reports and old chronological files. You can begin up to one year prior to departure from your current post. Separating FSOs intending on becoming a Retirement Annuitant (REA/WAE) should use their separation exam as their first-time WAE/REA physical. Employees and their EFMs of one of the 5 Foreign Service Agencies must complete a: Employees, LE Staff, Contractors, and EFMs who are Non-Foreign Service Personnel must complete a: Persons holding a current valid ESCAPE medical clearance and are extending their tour at an ESCAPE post must complete the below documents annually. Submit your completed forms and other medical reports to Medical Records: Send via email to MEDMR@state.gov (preferred) standards. Clearly print the persons name on each page submitted to Medical Records. f. Incomplete/Cancellation (Class 8): Issued to an individual whose pre-employment medical evaluation is incomplete and the application has been inactive for more than 90 days. Additional countries can be submitted after the first 15 have been reviewed. Sending forms and reports to the wrong email address results in confusion. Individuals who currently have a Post Specific (Class 2) medical clearance or have a new significant medical, mental health or educational issue will need to supply supporting documentation of their condition and treatment plan. Who Should Use a Medical Clearance Update Form? Medical, Mental Health or Educational reports do not need to be submitted with your initial medical clearance forms but be aware that Medical Clearances may require reports from providers, medical facilities, or schools for anyone with significant past medical, mental health, or special educational needs. It is your clearance. Add the DS-3057 Medical Clearance Update for redacting. The military provides emergency medical support for the Department of State in Afghanistan, Libya, Peshawar, Somalia, Syria, and Yemen. Page 2 must be signed and dated. If you have questions, please send us an email at FAITFellowship@twc.edu. For further questions or information, please contact MEDClearances@state.gov or call 202-663-1519. The employee and/or EFM should complete the separation exam within 90 days of retiring or separating from the Foreign Service. Some countries have inadequate infrastructures such as a poor or negligible public health care system, poor sanitation, unreliable electricity and a lack of potable water. Many Embassy or Consulate Health Units will complete a pre-employment or pre-assignment medical clearance. Send all medical forms and reports to MEDMR@state.gov. Requests for a 6/8 waiver where neither the employee nor a family member has any special physical or mental health condition that would require the Bureau of Medical Services (MEDs) expertise may be considered by the Committee without MED input. Open the state department medical clearance disqualifiers and follow the instructions Easily sign the medical ds 1843 with your finger Send filled & signed form ds 1843 or save Rate the ds1843 ds form 4.7 Satisfied 139 votes Quick guide on how to complete ds form 1843 Forget about scanning and printing out forms. Trafficking in or abuse of narcotics or controlled substances. Via email in a PDF format to MEDMR@state.gov (preferred) Worldwide Availability Requirement for Foreign Service Officer Candidates, Fellows, and some First-Time Limited Non-Career Appointees. Class 7 is not valid for travel to an assignment abroad. Class 8 clearances will also be issued to an employee or eligible family member who is in pending status (Class 7) and who has not completed the evaluation within the allotted 90 days. If you or your family members have on-going medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. Fellows will receive decisions on their medical clearances from the State Department. Employees or eligible family members with a Class 5 medical clearance may not be assigned outside the United States. Once youve completed the background investigation and medical examination, a State Department Suitability Review Panel will examine your file (minus any privileged medical information) to determine your suitability for employment with the Foreign Service. The name of the examinee (employee, contractor, LES or EFM) and DOB must appear at the top of each page 2, 3, & 4. Or fax to 202-647-0292 (less preferred) Candidates are required to pass a medical examination, which is in accordance with P.O.S.T. You should list any posts you may travel to. Documented medical conditions precluding medical clearance. Via email in a PDF format to MEDMR@state.gov (preferred) Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and Explanation of Benefits to Medical Claims at MEDClaims@state.gov. (Applies to all U.S. Government Employees and Eligible Family Members Participating in the Department of State Medical Program). Candidates who hold dual citizenship, have had extensive travel, education, residence and/or employment overseas, or who have foreign contacts, a foreign-born spouse, immediate family members, or relatives who are not citizens of the United States, should be aware that the clearance process will take longer to complete. Brea Police Department 1 Civic Center Circle Plaza Level Brea, CA 92821 Main Line: 714-990-7625 Non-Emergency: 714-990-7911 Fax: 714-990-7950 Emergency: 911 Please read and follow the instructions in Medical Clearance Guidance for Deploying to ESCAPE Posts. Complete a DS-1622: Medical History and Examination for Foreign Service for Children Age 11 and Younger form. Foreign Service Officer Candidates and EFMs of one of the 5 Foreign Affairs Agencies1, Limited Non-Career Appointees, Contractors, Civil Service, Locally Employed Staff, Personnel from Non-Foreign Service Government Agencies, and EFMs. A MED Clearances Nurse Consultant assigned to you will follow this process: Review the list of posts submitted by the CDO or agency HR. Consult the Medical Capabilities database and alternatively consult with post directly. There are numerous posts where conditions appear similar to that of the U.S. but which also suffer from some of these restrictive characteristics. The medical clearance exam may be completed for you and your family members by a licensed medical provider of your choice. While a medical clearance is not required for TDY travel of less than 30 days, persons with health concerns should avoid to travel to localities where medical care is inadequate to meet their needs. Do NOT include any personal medical information in this communication. This includes those retiring/separating from the Foreign Service, moving to the private sector, Civil Service or another agency, divorcing from a Foreign Service Spouse and Eligible Family Members turning 21 years of age. 1. Provide explanations in section IIA on page 2 or on a separate sheet of paper. Medical Clearance Process for ESCAPE Posts. Complete a DS-3057: Medical Clearance Update (MCU) form. During peak seasons MED Medical Records may take 10 business days to upload and index medical documents. You can determine you or your family members medical clearance status by: An official website of the United States Government, DS-6570: Pre-Deployment Physical Exam Acknowledgement Form, DS-1843: Medical History and Examination Form, DS 1843: Medical History and Examination Form, DS-6570: Pre-Deployment Physical Exam Self-Acknowledgement Form, DS 1843: Medical History and Examination Form Over 12 Years of Age, DS-1622: Medical History and Examination for Children Age 11 and Younger, Office of the U.S. ESCAPE posts have limited medical capabilities and personal security risks. Please print your email legibly. Employees subject to the six or eight-year rule must work with their CDOs if they wish to request a waiver of the rule. All direct hire employees, Locally Employed Staff, contractors, and Eligible Family Members who will be posted to a designated ESCAPE posts for 30 or more consecutive days are required to obtain a more comprehensive medical clearance than other posts. Institutional Contractors must include a 3308.5: Institutional Contractor ICASS Verification Form. Applications are . confidential security clearance disqualifiers include careful examinations of the following: allegiance to the united states; foreign influence; foreign preference; sexual behavior; personal conduct; financial considerations; alcohol consumption; drug involvement; emotional, mental, and personality disorders; criminal conduct; security These are DOD medical standards. Medical Clearances will not clear an individual to go to a post that does not have adequate resources for that person. Individuals extending at an ESCAPE post have a medical clearance valid for one year from the date of issuance. is entered. Medical Clearances must see reports from your specialists regarding the status of your health or educational issues. (Uniform State/USAID/U.S. The medical clearance process is designed to identify medical, mental health, or educational issues before departing for an overseas assignment. Welcome to the Medi-Cal Provider Home. The employee and/or EFM should complete the separation exam within 90 days of retiring or separating from the Foreign Service. Employees, Contractors and EFM shave the right to appeal any medical clearance classification decision. The healthcare provider should review all yes answers on page 2 and provide relevant comments. Because everyone is "medically cleared" to be in the United States, individuals whose next tour is a domestic assignment do not require a medical clearance unless they will be doing TDY travel of 30 or more consecutive days during their domestic tour. Global AIDS Coordinator and Global Health Diplomacy, Special Presidential Envoy for Hostage Affairs, Special Representative for Afghanistan Reconciliation, Special Representative for Syria Engagement, U.S. Security Coordinator for Israel and the Palestinian Authority, Under Secretary for Arms Control and International Security, Bureau of Arms Control, Verification and Compliance, Bureau of International Security and Nonproliferation, Under Secretary for Civilian Security, Democracy, and Human Rights, Bureau of Conflict and Stabilization Operations, Bureau of Democracy, Human Rights, and Labor, Bureau of International Narcotics and Law Enforcement Affairs, Bureau of Population, Refugees, and Migration, Office of International Religious Freedom, Office of the Special Envoy To Monitor and Combat Anti-Semitism, Office of the U.S. Special Coordinator for Tibetan Issues, Office to Monitor and Combat Trafficking in Persons, Under Secretary for Economic Growth, Energy, and the Environment, Bureau of Oceans and International Environmental and Scientific Affairs, Office of the Science and Technology Adviser, Bureau of Information Resource Management, Bureau of the Comptroller and Global Financial Services, Office of Emergencies in the Diplomatic and Consular Service, Office of Management Strategy and Solutions, Bureau of International Organization Affairs, Bureau of South and Central Asian Affairs, Under Secretary for Public Diplomacy and Public Affairs, DS-1843 Medical History and Examination for Foreign Service, DS-6570: Pre-Deployment Physical Exam Acknowledgement Form, DS-6561: Pre-assignment for Overseas Duty for Non-Foreign Service Personnel, DS-1843: Medical History and Examination for Foreign Service, DS-6570: Pre-Deployment Physical Exam Self-Acknowledgement Form, Medical Clearance Guidance for Deploying to ESCAPE Posts, DS-1843 Medical History and Examination for Foreign Service or Individuals Age 12 or Older, DS-1622 Medical History and Examination for Foreign Service for Children Age 11 and Younger, DS-1843: Medical History and Examination for Foreign Service or Individuals Age 12 and Older, DS-1622: Medical History and Examination for Foreign Service for Children Age 11 and Younger. 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