16 FAM 210 MEDICAL CLEARANCE

UNCLASSIFIED (U)

16 FAM 200
procedures for MEDICAL EXAMINATION AND CLEARANCE

16 FAM 210

MEDICAL clearance

(CT:MED-50; 06-09-2023)
(Office of Origin: MED)

16 FAM 211 MEDICAL CLEARANCE classifications

16 FAM 211.1 Medical Clearances

(CT:MED-41; 03-07-2019)
(Uniform State/USAID/U.S. 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)

All employees and eligible family member(s) who are posted abroad require a medical clearance or a waiver to receive benefits under State’s Medical Program (MED). Benefits include, but are not limited to, post health unit access, medical evacuation travel, and secondary payer coverage for hospitalizations.

16 FAM 211.2 Clearance Classifications

(CT:MED-50; 06-09-2023)
(Uniform State/USAID/U.S. 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)

a. Worldwide available (Class 1): Issued to applicants, employees and eligible family members who have no identifiable medical conditions that would limit assignment abroad.

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. The Bureau of Medical Services (MED) determines approval for assignment to a specific post based on the criteria above.

c. Domestic only (Class 5): Issued to all who have a medical condition which is incapacitating or for which specialized medical care is best obtained in the United States. Employees or eligible family members with a Class 5 medical clearance may not be assigned outside the United States.

d. Temporary travel (Class 6): Issued only to an eligible family member who is not medically cleared to reside at the employee’s assigned post but is authorized to visit that post for a period of time not to exceed 120 days per calendar year.

e. Pending (Class 7): Issued to individuals awaiting completion of the evaluation of a medical condition within 90 days. Class 7 is not valid for travel to an assignment abroad. If the examination/evaluation is not completed within 90 days, the individual will be issued a Class 8 clearance and will not be eligible for the Medical Program abroad.

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. 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.

g. Separation (Class 9): Issued to employees and eligible family members following separation from State’s Medical Program. This includes eligible family members who have reached age 21, or persons leaving the program through legal separation or divorce. 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)).

h. Deceased (Class 10): Issued to employees or eligible family members at notification of death.

16 FAM 212 pre-employment medical Clearance for foreign service candidates

a. All Foreign Service candidates who have received conditional offers of employment must undergo a pre-employment medical examination and have the results of the examination forwarded to Medical Clearances. The files of applicants with incomplete pre-employment medical examinations extending past 90 days will be closed. The examination must be documented on Form DS-1843, Medical History and Examination for Foreign Service (for Individuals Age 12 and Older).

b. The purpose of the pre-employment medical examination is to identify any physical or mental health condition that could affect assignment abroad.

c. If additional evaluations are needed to make the pre-employment clearance decision, MED will issue Form DS-616, Authorization for Medical Tests/Consultations.

d. MED will notify the candidate of his or her medical clearance.

e. A completed pre-employment medical clearance is valid for 5 years from the date of issuance. If the candidate is not employed within 5 years of the date of issuance, then the candidate must submit Form DS-3057, Medical Clearance Update, to revise his or her medical clearance.

f. The candidate must submit Form DS-3057, Medical Clearance Update, if there is any significant change in the candidate’s medical condition at any time. Such changes include but are not limited to a hospitalization or urgent outpatient treatment; a change of or initiation of regularly taken medications; or the need for regular, frequent follow-up.

16 FAM 213 MEDICAL CLEARANCE FOR Eligible Family Members OF NEWLY HIRED fOREIGN sERVICE eMPLOYEES

a. Each eligible family member who will accompany an employee assigned abroad must undergo a pre-assignment medical examination prior to proceeding abroad for the first time. Medical examiners must use Form DS-1843, Medical History and Examination for Foreign Service (for Individuals Age 12 and Older), and Form DS-1622, Medical History and Examination for Foreign Service (for Children 11 Years and Under).

b. Each agency must verify an eligible family member’s medical clearance status before issuing travel orders. An employee or eligible family member with a post-specific (Class 2) medical clearance must obtain post approval from MED. Failure to obtain post approval before traveling abroad may result in the individual being denied participation in the Medical Program and access to health units abroad.

c. If additional evaluations are needed to make the pre-employment clearance decision, MED will issue Form DS-616, Authorization for Medical Tests/Consultations.

16 FAM 214 INSERVICE AND pre-Assignment MEDICAL CLEARANCES FOR Employees and Eligible Family Members

a. Employees and eligible family members of all ICASS participating agencies who are assigned abroad for the first time must undergo a full medical clearance examination. (Form DS-3057, Medical Clearance Update, may not be used in this case.)

b. A worldwide available (Class 1) medical clearance is valid for the length of the tour or upon eligibility for home leave, whichever is shorter, unless there is a significant change in the individual’s medical condition. A new medical clearance can be obtained following a medical examination or submission of Form DS-3057, Medical Clearance Update.

c. A post-specific (Class 2) medical clearance is valid only for the length of the tour. An individual with a post-specific medical clearance transferring directly to, or performing a TDY of 30 days or longer at, another post must obtain post approval from MED prior to the transfer.

d. If additional evaluations are needed to make the clearance decision, MED will issue a Form DS-616, Authorization for Medical Tests/Consultations. Family members 12 and over, use Form DS-1843, Medical History and Examination for Foreign Service (for Individuals Age 12 and Older), and those 11 years and under use Form DS-1622, Medical History and Examination for Foreign Service (for Children 11 Years and Under). WAE employees are not issued either Form DS-616 or Form DS-3069, Authorization for Medical Examination.

e. An employee or eligible family member with a post-specific (Class 2) medical clearance must obtain post approval from MED. If an employee or eligible family member (EFM) arrives at post without a medical clearance, post management will notify the individual that he or she is ineligible for participation in the Medical Program abroad.

f. Employees and eligible family members must also renew their medical clearances prior to bidding on their next assignment abroad or prior to entry into long-term language training in preparation for assignment abroad.

g. An employee serving in a domestic assignment who performs temporary duty abroad for 30 or more consecutive days must have a valid medical clearance and must renew it every 2 years or earlier if there is a significant change in the individual's medical condition. An individual with a post-specific (Class 2) medical clearance performing a TDY of 30 consecutive days or longer must obtain a post approval from MED prior to each TDY assignment.

16 FAM 215 APPEAL OF MEDICAL cLEARANCE DECISION

(CT:MED-49; 04-11-2023)
(Uniform State/USAID/U.S. 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)

a. An applicant, employee, or eligible family member may submit a written appeal of a clearance decision to the Chief Medical Officer or their designee.

b. The Chief Medical Officer or designee will convene a three-clinician panel to review the request.  For mental health cases, the panel will consist of two Regional Medical Officer – Psychiatrists and one clinician (Regional Medical Officer or Medical Provider). For other medical cases, the panel will consist of two Regional Medical Officers and one Medical Provider. The panel’s recommendation will be presented to the Chief Medical Officer for a final review and determination of the medical clearance.

c.  If the three-clinician panel and the Chief Medical Officer uphold the clearance decision, the employee may request an administrative waiver from the director of human resources of their agency.  If such waiver is granted, any subsequent assignment abroad will require a new clearance decision. There is no administrative waiver of clearance decisions for eligible family member(s).

16 FAM 216 ADMINISTRATIVE Waiver of MEDICAL Standards FOR CANDIDATES

(CT:MED-42; 08-16-2019)
(Uniform State/USAID/U.S. 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)

a. A Department of State Foreign Service candidate who was denied a worldwide available (Class 1) medical clearance may request an administrative waiver of the medical standards from the Director General of the Foreign Service (DG). Decisions of the Director General or his or her designee are final and are not subject to further appeal by the candidate.

b. Candidates from other foreign affairs agencies [USAID, Foreign Commercial Service, Foreign Agricultural Service, APHIS and the U.S. Agency for Global Media (USAGM)] who have been denied a worldwide available (Class 1) medical clearance may request an administrative waiver of medical standards from the director of human resources of their respective agency.

c. If an administrative waiver is granted by the Director General for State or by the director of human resources for other foreign affairs agencies, the candidate is issued a post-specific (Class 2) medical clearance.

16 fam 217 EMPLOYEE RESPONSIBILITiES

a. The employee and their eligible family members should renew their medical clearances prior to bidding on their next assignment. They may begin the medical clearance process up to 12 months before the departure from their current assignment.

b. If the employee or an eligible family member has a post-specific (Class 2) medical clearance, the employee must obtain MED approval for each post on the bid list.

c. The employee must ensure that he or she and all eligible family members have received a Class 1 medical clearance or a Class 2 medical clearance with the employee’s post of assignment approved by MED before traveling to post.

d. The employee must notify MED of any significant change in the employee’s or eligible family member’s medical condition at any time. Such changes include but are not limited to a hospitalization or urgent outpatient treatment; a change of or initiation of regularly taken medications; or the need for regular, frequent follow-up.

16 fam 218 MEDICAL CLEARANCE PROCESS FOR NEW FAMILY MEMBERS ACQUIRED THROUGH MARRIAGE, domestic partner affidavit, BIRTH OR LEGAL ADOPTION, OR GUARDIANSHIP

a. A new eligible family member may receive medical benefits for up to 90 days while obtaining a medical clearance decision. The employee is responsible for initiating the medical clearance process.

b. Eligible family member(s) who are abroad without a medical clearance, post approval, or waiver are not authorized medical benefits.

16 FAM 219 MEDICAL EXAMINATIONS for separation

a. All separating employees and/or eligible family members (EFMs) are authorized a separation medical examination. Separation for these purposes includes retirement, resignation, administrative separation of an employee, or children reaching the age of 21 regardless if they might be traveling to post on educational travel (16 FAM 122.2). The separating person must schedule the medical examination prior to separating and must complete the examination within 90 days of the separation.

b. Upon death of an employee, the eligible family members (EFMs) are authorized a separation physical examination.

UNCLASSIFIED (U)