Those individuals will remain in a pending status. Complete a DS-1622: Medical History and Examination for Foreign Service for Children Age 11 and Younger form. Misconduct in prior employment, including marginal performance or inability to interact effectively with others. 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. All personnel must update their medical clearance prior to departure for a new overseas assignment. Shreds security and medical sensitive materials as directed including medical reports and old chronological files. Each diagnosis must have a statement clarifying prognosis, stability, follow-up plan, and if that follow-up must be done by a specialist. 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. 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. An official website of the United States Government, Office of the U.S. After doing the grad school thing, I think I'm ready to take the plunge. Please check the signature area. Such information should be provided directly to the Director of Medical Clearances in the Office of Medical Services, not to the CDO. 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. List your prescription medications, hospitalizations, and medical conditions since your last clearance. 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 All chronic medical conditions must be listed on page 4 in assessment or problem list section. Plaza Level. Youll be asked to submit fingerprints to the Departments Bureau of Diplomatic Security as the first step in the security clearance process. If you are an institutional contractor, write the name of the specific contracting company or NGO. You may begin submitting documents up to one year prior to departing your current post or domestic assignment. List your prescription medications, hospitalizations, and medical conditions since your last clearance. Do NOT include any personal medical information in this communication to HR, only the posts you wish to bid upon. 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. All blanks need to be filled in. Persons who are not an ESCAPE post at the time of their medical clearance renewal must complete the below documents: Employees and their EFMs of one of the 5 Foreign Service Agencies: Employees, LE Staff, Contractors, and EFMs who are non-Foreign Service Personnel: Submit all medical documentation to Medical Records. Provide a current phone number and valid mailing address. 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. 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. In this case, the State Department denied Dara Katz the medical clearance she needed to qualify for an overseas assignment with the Foreign Service, and then denied her request for a waiver of the clearance. Failure to have all family members medical clearances completed will delay the issuing of travel orders for individuals departing Washington DC. .header-alert .icon.icon-close-thin.header-alert__close.js-header-alert-close{display:none;}. Parts 160 and 164. The medical clearance process is designed to identify medical, mental health, or educational issues before departing for an overseas assignment. Providers are also encouraged to submit supporting medical reports, labs, and consults for each chronic condition. For example, if an individual needs an English speaking speech therapist, there are many posts he or she can go to, but many others that would not have that resource. Global AIDS Coordinator and Global Health Diplomacy, Special Presidential Envoy for Hostage Affairs, Special Representative for Syria Engagement, U.S. Security Coordinator for Israel and the Palestinian Authority, Office of the U.S. EFMs, age 18 and over, must provide their own email address for privacy reasons. Add the DS-3057 Medical Clearance Update for redacting. 1 year after issuance of a medical clearance of all individuals who extend at an ESCAPE post. 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. Unsigned forms will not be accepted by Medical Records. The following information is designed to assist as you navigate the MED Post Approval process for those with a Post Specific 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. How Long Will the In-Service Clearance Process Take? Consult the Medical Capabilities database and alternatively consult with post directly. Clicking on My Clearance Status on the Customer Tools page of the MED Clearances SharePoint site, accessible via the Department of States OpenNet. The examiner/provider should complete the physical exam and lab portion of the exam. Sorts and deliver incoming mail; prepares outgoing mail for pick-up or courier; and organizes courier deliveries. Class 7 is not valid for travel to an assignment abroad. Or fax to 202-647-0292 (less preferred) Employees subject to the six or eight-year rule must work with their CDOs if they wish to request a waiver of the rule. Follow these fast steps to edit the PDF DS-3057 Medical Clearance Update online for free: Register and log in to your account. All individuals going to these posts must meet strict medical standards. Posted by 5 years ago. All foreign reports must be in English or translated into English. Reasonable doubt as to loyalty to the U.S. Government. Travel orders are not required to start the process. Please be sure that the name, DOB, and email address are all printed clearly. A list of all possible diagnoses and their severity that may cause an individual to be non-deployable would be too expansive. If you shuttle between two ESCAPE posts, especially Baghdad and Erbil, please indicate both. 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. Be sure to attach copies of any medical reports that can help clarify a medical condition(s). All persons posted overseas or on TDY travel for 30 or more consecutive days must have a valid medical clearance before they can access a posts Health Unit and other Medical Program benefits including assistance with a medical evacuation or hospitalization. For additional questions, contact pre-serviceunit@peacecorps.gov or 202-692-1504. This reduces the need for medical travel due to lack of local health resources and limits the number of curtailments for pre-existing medical conditions. For individuals with a Domestic Assignment Only (Class 5) clearance we recommend you notify MED Clearances when it appears your medical, mental health or educational has stabilized and improved to the point where health care or educational needs can reasonably be obtained abroad. 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. Each fellow, therefore, must meet rigorous medical standards in order to qualify for the required worldwide medical clearance. The waiver justification need only provide enough information from the employee and/or MED to demonstrate a strong basis for the request to enable the Committee to make are commendation. Employees or eligible family members with a Class 5 medical clearance may not be [] There are often no blood banks or limited medical supplies and medications available locally. The healthcare provider must print or stamp their name, as well as sign and date page 4. Such clearances may only be issued to candidates whom the Office of Medical Services deems able to serve at the most isolated and restricted overseas posts. It is your clearance. 6/8 Waivers Waivers of the Six-Year and Eight-Year Limits on Continuous Domestic Service Individuals with a Domestic Only (Class 5) clearance have a medical condition which is incapacitating or for which specialized medical care is best obtained in the United States. 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. 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. The process for completing an ESCAPE post clearance varies by your employment status and where you are going. Individuals extending at an ESCAPE post have a medical clearance valid for one year from the date of issuance. The employee and/or EFM should complete the separation exam within 90 days of retiring or separating from the Foreign Service. People who have no significant health concerns can be posted anywhere in the world and are given a Worldwide Available (Class 1) clearance. CONUS-based TDY and WAE/REA should list all known posts they will travel to. The following in-service employees, contractors and EFMs are required to update their medical clearance and can use the MCU form: The following employees, contractors and EFMs must under-go a complete physical and should complete either a DS 1843: Medical History and Examination Form Over 12 Years of Age or a DS-1622: Medical History and Examination for Children Age 11 and Younger . DOD Contractors must include a 3308: DOD ICASS Verification Form. Individuals assigned to any of these ESCAPE posts, including TDY travel of 30 or more consecutive days, must meet more rigid standards, and undergo further medical vetting than addressed in this document. The security clearance process involves a comprehensive background investigation, conducted by the U.S. Department of State in cooperation with other federal, state, and local agencies. Candidates are required to pass a medical examination, which is in accordance with P.O.S.T. Coordinator for the Arctic Region, Deputy Secretary of State for Management and Resources, Office of Small and Disadvantaged Business Utilization, 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 Antisemitism, 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 the Comptroller and Global Financial Services, Bureau of Information Resource Management, 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, U.S. For How Long is a Medical Clearance Valid? The examiner must sign page 4. Please read and follow the instructions in Medical Clearance Guidance for Deploying to ESCAPE Posts. 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. Provide explanations in section IIA on page 2 or on a separate sheet of paper. Patients can arrange appointments on personal travel, during R&R, home leave or other government funded travel when services are not available at the post of assignment. The medical clearance process is designed to identify medical, mental health, or educational issues before departing for an overseas assignment. The post approval process for non-Foreign Service agencies, contractors and their EFMs mirrors the approval process for Foreign Service agencies. Failure to have all family members medical clearance in order may delay your travel orders. The following information will help explain the process of completing a Separation Exam. ESCAPE posts have limited medical capabilities and personal security risks. Contractors and DOD Civilians should contact their sponsors human resources. 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. The following information will help explain the pre-employment/pre-assignment process. MED Clearances will issue a Post Specific (Class 2) clearance only to posts capable of meeting that individuals needs. Do NOT submit bids to Medical Clearances. A medical clearance physical exam can be completed by a licensed medical provider or at the Department of State Exam Clinic in Washington DC. Scan and e-mail the completed 2-page form to MEDMR@state.gov or fax to 202-647-0292. This investigation provides the information necessary to determine a candidates suitability for appointment to the Foreign Service and for a Top Secret security clearance. Submit internal consults or reach out to you for additional data, as needed. . Via email in PDF format to MEDMR@state.gov (preferred) 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. An MCU can be submitted to your health unit (preferred) or directly submitted to. Take charge! The point of contact in MED is the Director of Medical Clearances, who will relay the request to the appropriate office or person in MED and return a formal recommendation to the CDO or Committee, as appropriate. Employees or eligible family members with a Class 5 medical clearance may not be assigned outside the United States. Employees of other Government agencies, contractors, fellows and Eligible Family Members (EFMs) and do not need to meet this worldwide availability requirement on their first overseas assignment. Criminal, dishonest, or disgraceful conduct. Medical exams are done at the State Department during the orientation period. The Eight-Year Rule is set forth in the Foreign Service Act at 504, 22U.S.C.3984, which states, A member of the Service may not be assigned to duty within the United States for any period of continuous service exceeding eight years unless the Secretary approves an extension of such period for that member because of special circumstances.. These reports should include not only the diagnosis and previous treatments, but also a summary report of what follow-up care you require. Angina pectoris Bipolar disease Cardiac valve replacement The Six-Year Rule is set forth in 3 FAH-1 H-2423.2, which states that continuous domestic assignments may not exceed six years without a waiver from the Director General. Early in the bidding season submit your bid list or post choices to your State Department CDO or agency human resources. 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. Medical Clearances matches that individuals medical needs with posts capable of providing the specific medical or educational services they need. The examiner/provider should complete the physical exam, lab, and assessment/plan portion of the exam. The Foreign Affairs Information Technology (FAIT) Fellowship is not only a unique opportunity for highly qualified, diverse college students to receive academic funding, internships and mentorship from the U.S. Department of State it is also a path to your career in the Foreign Service. Medical Clearances must see reports from your specialists regarding the status of your health or educational issues. Other agency employees, contractors or their family members may begin one year prior to their overseas assignment or training. This brief, two page document requires does not require a physical exam. Tips for Your In-Service Medical Clearance Update. All blanks need to be filled in. Take charge! A MED Clearances Clearance Consultant assigned to you will: Post Approval Process for employees of non-Foreign Service agencies, CONUS-based TDY, WAE/REAs, contractors and their EFMs with a Post Specific (Class 2) Clearance. Get involved! Employees or eligible family members with a Class 5 medical clearance may not be assigned outside the United States. extending at an ESCAPE post, the MCU (plus, any individual who has had a new medical condition that may affect their medical clearance at the posting they are currently at or will be posted to. Individuals with Post Specific (Class 2) medical clearances must be approved for their post of assignment. These are DOD medical standards. Where a particular physical or mental health condition, extraordinary stress, or similar circumstances a represented as the justification for a 6/8 waiver, MED or an outside medical professional must confirm the basis for the A-4.4A-04 revised 01/2018 request. Do NOT submit to Medical Clearances. Everyone is cleared to be in the United States. 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. The medical clearance process is designed to identify medical, mental health, or educational issues before departing for an overseas assignment. Include the Medical Records coversheet. The Department of State has identified certain posts as Employee Self-Certification and Ability to Perform in Emergencies (ESCAPE) posts. Please return to Start Here to click on the steps to a medical clearance that best fits your status and overseas assignment. 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. This is an opportunity to establish or re-establish a professional relationship with your primary care provider. They are reminded that they must update their clearance before their next overseas assignment. Additional countries can be submitted after the first 15 have been reviewed. The in-service clearance process is simplified using a DS-3057: Medical Clearance Update (MCU) form. 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