The Office of Personnel Management approved medical qualification standards for 1811 treasury enforcement agents, also referred to as criminal investigators and/or special agents, because the duties of the position require moderate to arduous physical exertion, the use of firearms, exposure to inclement weather, and the operation of government owned vehicles. IRS special agents are required to meet these standards throughout their career. See U.S. Office of Personnel Management 1811 requirements.

Criminal Investigation contracts with a medical services provider specializing in occupational health to assist in the administration of the 1811 Medical Program. The contractor delivers medical and advisory services. The contract includes a medical review officer, also referred to as a Reviewing Medical Officer, who is a licensed medical physician with expertise in occupational medicine specific to law enforcement duties. The medical review officer conducts an impartial, comprehensive, individualized assessment when providing advisory services regarding an agent’s health status and its impact on the job. Criminal Investigation can request the medical review officer’s advisory services if needed to determine if the agent can safely carry out law enforcement duties and participate in the physical fitness program. The medical review officer does not conduct a physical or medical examination but bases recommendations on information received from the annual health history questionnaire, treating physicians, contracted physicians, the agent, and/or the IRS, and advises management accordingly.

Occupational Safety and Health Administration standards:

IRM 9.1.4.24, Delegation Order No. 21 - Delegation of Authority in Employee Relations Matters.

Department of the Treasury Criminal Investigator - Treasury Enforcement Agent, 1811 Medical Qualification Standards.

Department of Treasury Delegation of Authority to IRS for Medical Qualifications for Treasury Enforcement Agent GS-1811 Positions on December 14, 2012.

5 CFR 339, Medical Qualification Determinations.

This section outlines responsibilities for:

The Assistant Director, Human Resources-Personnel Administration will manage this IRM’s content by:

The Assistant Director, Human Resources-Personnel Administration will review the instructions and guidelines relating to special agent medical policies and recommend procedural, operational, and editorial changes as needed.

The table lists commonly used acronyms and their definitions:

IRM 1.20.2, Providing Reasonable Accommodation for Individuals with Disabilities

IRM 6.800.1, Workers’ Compensation Program.

IRM 6.800.3, IRS Employee Assistance Program & Work-Life Referral Services.

IRM 9.1.4.7, Directive No. 6 - Use of Alcohol.

IRM 10.23.1.7, Reporting Personal and Foreign Activities.

Criminal Investigation Hearing Conservation Program.

Psychological or psychiatric examinations are authorized only when the results of a FFD provide no physical explanation for an SA’s behavior or actions affecting the safe and efficient performance of essential law enforcement duties.

SAs who undergo refractive surgery will be placed on TRD until the SA’s treating ophthalmologist certifies they are able to safely return to full duty and the MRO concurs with treating physician.

SAs planning to undergo refractive surgery must:

Management must:

Reportable medications include prescription and non-prescription drugs.

SAs must immediately self-report their use of all prescription medications that could increase the risk of injury, harm or incapacitation to themselves and others, or impede their ability to safely perform law enforcement duties or other job-related activities. Exhibit 9.11.5-2.

SAs are not required to report every non-prescription medication they take. SAs must consider warnings and advice provided by their physician and/or pharmacist about the effects of the medication. Side effects of non-prescription medication are extensive and vary over time, so it is recommended SAs discuss all medications and side effects with their personal physician to determine their ability to safely perform law enforcement duties.

Reportable medications with the following side effects include, but are not limited to:

SAs must immediately report every instance of narcotic and/or benzodiazepine use, regardless of the duration, their duty status, side effects or perceived safety concerns.

Narcotics, also known as opioids, refers to opium, opium derivatives, and their semi-synthetic substitutes. Narcotics are most often prescribed for pain relief. SAs should seek advice from their physician or pharmacist to determine whether their prescribed medication is a narcotic.

Benzodiazepines are depressants that produce sedation, relieve anxiety, and reduce seizures. Benzodiazepines are most often prescribed for anxiety and sleep disorders, as a muscle relaxant, and for alcohol withdrawal. SAs should seek advice from their physician or pharmacist to determine whether their prescribed medication is a benzodiazepine.

SAs are subject to call-back at any time, so management must be aware of an SA’s ability to carry out law enforcement duties at all times. Taking a narcotic and/or benzodiazepine increases the risk of impairment to an SA's mental and physical abilities.

SAs must immediately self-report anticoagulant use. Anticoagulants are prescribed to prevent blood clots but can result in excessive bleeding. Anticoagulants decrease the body’s blood clotting ability and can result in an increased possibility of serious external or internal bleeding resulting from injury.

SAs taking prescribed anticoagulants may undergo frequent blood tests to maintain a balance between the drug’s purpose and its side effects.

SAs prescribed anticoagulant medication will immediately be placed on TRD for a minimum of six (6) months. After reporting, SAs will be required to provide physician reports to the MRO every month for a minimum of six (6) months.

If the MRO concludes that overall therapeutic control has been documented and achieved and the underlying condition does not pose a safety risk, the SA may be cleared to resume unrestricted law enforcement duties.

SAs must submit status reports every six (6) months from their physician documenting therapeutic control.

Management must promptly contact ERM to obtain a TRD memorandum whenever an SA is placed on TRD. The memoranda include:

Management will promptly provide ERM with documents or other evidence supporting the need for TRD. This could include, but is not limited to:

ERM will prepare a Request for Medical Documentation memorandum if applicable, and forward to management for issuance.

Management must keep ERM apprised of changes to the SA’s condition, new documentation received, or revised restrictions.

Management cannot authorize an SA on TRD to perform law enforcement duties. Any assignment involving the possible use of a firearm or use of force is prohibited while on TRD. Examples of prohibited duties include, but are not limited to:

Management will immediately secure an SA’s firearm when they are placed on TRD. This will include long guns and undercover firearms.

Management will restrict an SA’s use of a GOV while on TRD.

If medically cleared to drive by the MRO, an SA may be allowed to conduct non-law enforcement duties using a GOV during the duty day. SAs on TRD will not be authorized home-to-work use of the GOV.

SAs on TRD may be restricted from participating in the PFP. This recommendation is updated by the MRO as new medical information becomes available. If management questions whether an SA’s medical condition permits safe participation in the PFP, ERM will assist the supervisor in forwarding necessary information to the MRO for a recommendation. If the MRO recommends the SA cannot clear an SA to participate in PFP activities, management must prohibit the use of official time for exercise and the SA must report the restriction to their PFP coordinator.

Personnel Security may need to be notified when an SA is placed on TRD. Management should refer to IRM 10.23.1.7, Reporting Personal and Foreign Activity, for guidance on security clearance restrictions for SAs placed on TRD.

Depending on the circumstances of each case, management may permit an SA on medical TRD to participate in the following non law enforcement duties:

Formal notification of the NMQ determination includes:

The reconsideration process permits NMQ SAs an opportunity to submit new, relevant information for consideration.

When an SA is formally notified of a NMQ determination, the SA may request reconsideration of the determination if the SA has information that demonstrates they can safely perform all essential law enforcement duties of the 1811 position.

If an SA requests reconsideration of the NMQ determination, they must notify their supervisor in writing within 15 calendar days of receipt of the NMQ notice. The SA has 30 calendar days from receipt of the NMQ notice to provide any new information and documentation to their special agent in charge (SAC) or equivalent. The SAC will promptly forward the information to the MRO and notify ERM.

On a case-by-case basis, the Deputy Director of Strategy - REAL, may grant additional time for the SA to submit medical documentation in response to the NMQ determination; however, SAs cannot exceed 60 days from the date of initial NMQ notification.

The MRO will issue a final medical recommendation after reviewing the new information. If the MRO determines the SA is:

If the Deputy Director, Strategy - REAL determines sufficient information was provided documenting the SA’s ability to safely perform law enforcement duties despite not meeting the medical qualification standards, and/or the SA, with or without a reasonable accommodation, can perform all essential law enforcement duties without endangering the health and safety of themselves or others, The Deputy Director, Strategy – REAL will request a waiver of the medical qualification standards from the Chief, CI.

The Chief will review and either approve or deny the waiver request.

If the final NMQ determination remains, a waiver is not requested, or a waiver is denied, CI will attempt to place the SA in a non-1811 position within CI or main IRS. If no suitable position is found, the Deputy Director, Strategy - REAL serves as the proposing official for a removal action.

SAs are in violation of IRM 9.1.4.7, Directive No. 6 - Use of Alcohol, and other standards of conduct if they:

Reasonable suspicion must be based on specific objective facts and reasonable inferences drawn by management. Reasonable suspicion does not require certainty; however, mere "hunches" are not sufficient to meet the standard. Examples of the types of observations, actions, or other sources of information for consideration include, but are not limited to, the following:

Testing should be conducted as soon as possible after establishing reasonable suspicion or belief that an SA is intoxicated or under the influence of alcohol while on duty. The SAC must contact the medical contractor call center at 1-800- 638-8476 and provide the following information:

The call center will immediately notify the medical contractor who will schedule an appointment at a clinic as close as possible to where the SA is located, and the medical contractor will promptly follow up with the SAC and provide the SA’s appointment information.

After contacting the call center, the SAC must promptly call ERM to discuss the events leading to the need for testing, provide all documentation related to their belief that the SA is under the influence of alcohol, and provide the appointment information.

A designated supervisor will drive the SA to the clinic for testing.

Upon arrival at the clinic, the SA must provide acceptable photo identification (e.g., driver’s license) to ensure proper identification.

A BAT will administer a breath alcohol screening.

The BAT will share the results of the test with the SA and the accompanying supervisor.

A breath alcohol test is a diagnostic procedure to determine whether an SA may have a prohibited concentration of alcohol in a breath specimen.

Initial Test - If the initial test result shows an alcohol concentration of less than 0.02, no further testing is done.

Confirmation Test - If the result of the initial test is equal to 0.02 or greater, a confirmation test will be conducted. A confirmation test is performed after a fifteen (15) minute mandatory waiting period which begins at the completion of the initial test. The waiting period shall not exceed twenty (20) minutes. During the waiting period, the SAs will be given instructions to prevent any accumulation of alcohol in the mouth which could lead to an artificially high reading. The confirmation test is conducted at the end of the waiting period on the same EBT as the initial test. The confirmation test is done even if the SA fails to follow test instructions.

Invalid Test - If a screening or confirmation test cannot be completed, or if an event occurred that would invalidate the test, the BAT shall, if practicable, begin again (e.g., new screening or confirmation test, as applicable). If a test cannot begin again due to the unavailability of an EBT, the test shall be declared invalid, and the testing process shall stop. If the test is declared invalid, the BAT shall note the problem in the remarks section. Both the SA and the BAT shall initial or sign the remark. An invalid test will be treated as if it had never been conducted.

Time Limitations - If the initial alcohol test is not conducted:

An SA refuses to submit to testing if they:

The BAT will immediately terminate the test if the SA refuses to cooperate during the testing process and inform the accompanying supervisor who will promptly notify the SAC and ERM. Failure to participate or cooperate in the testing process can result in disciplinary action, up to and including removal.

If an SA is unable to provide a sufficient amount of breath for a valid breath test due to a medical condition, the SA will be instructed to make a second attempt to provide the necessary amount of breath. If the SA refuses to make the attempt or attempts and fails to provide an adequate amount of breath, testing will stop, and the BAT will note the circumstances and inform the accompanying supervisor

An SA’s inability to produce an adequate amount of breath due to a medical condition will not be deemed a refusal to take a test. However, resulting safety concerns may lead to temporary restricted duty and a comprehensive medical examination to determine the SA’s continuing ability to meet the medical qualification standards for 1811s.

In the event the initial and confirmation test results differ, the confirmation result is the final result.

Immediately following the test, the BAT will share the test results with the SA and the accompanying supervisor. The supervisor will promptly provide the final results to the SAC and ERM:

If the breath alcohol test results reflect a blood alcohol content (BAC) of .20 or higher, the employee should remain under management’s supervision until a responsible third party takes custody of the employee (i.e. emergency contact, adult family member, treating medical facility, etc.).

Regardless of the final test results, the SAC and ERM will discuss whether the SA can be returned to full duty.