Attch 1 SOW Fitness for Duty - Independent Medical Examinations- DRAFT 1.26.2026.pdf

Attachment 1

RFI # 70T01026I7663N001

DRAFT

Statement of Work for Fitness for Duty / Independent Medical Examinations

Background

TSA requires that Medical and psychological examinations consistent with the TSA medical guidelines ( https://www.tsa.gov/sites/default/files/hc-job-tso-medical-guidelines.pdf ).

Specifically, the examination shall include an assessment of the employee’s history, past medical treatment records, the employee’s current mental and physical status and provide sufficient information concerning the individual’s condition in order for the Agency to make a final determination of medical qualification or suitability for the position.

Scope

Independent Medical Evaluations (IME) include scheduling of the employee for the evaluation and all nursing support. A physician specializing in the area of medicine concurrent with the employee’s medical condition or a psychologist will perform the examination.

IMEs will be fixed price per examination to include a thorough review and summary of the medical records, scheduling fees, all nursing support, examination, and a comprehensive report. Permanent medical records will be stored by TSA and may be deleted by the contractor three months after sharing records with TSA.

The Government defines nursing support to include requesting and collecting past medical treatment records (when the records are not provided by TSA), transferring records to the IME examiner prior to the exam, scheduling and tracking the progress of the IME process, and coordinating with the Government on the final IME report.

In the event additional hours of physician or psychologist time are required, prior approval must be received from the Contracting Officer.

The Government will request an IME whenever there is a question regarding the employee’s fitness for duty, which requires the training and experience of a particular type of specialty consultant, such as: Orthopedics, Internal Medicine, Cardiology, Neurology, Ophthalmology, Psychology, General Psychiatry, Functional Capacity Evaluation by a Physical Therapist, etc.

IMEs include scheduling fees. This level of service will be requested by the Government when there are general questions concerning an employee’s diagnosis or fitness for duty as noted on the TSA Fitness for Duty Request. TSA will provide all medical records to the contractor. The final report from the IME will include, as applicable:

1. List of medical records reviewed in conjunction with this evaluation.

2. Diagnosis, severity of the condition at present, and prognosis for the condition with a detailed explanation.

3. Statement whether the employee is able to perform all of the essential duties of the position with a detailed explanation.

Attachment 1

RFI # 70T01026I7663N001

DRAFT

4. Recommended, if any, restrictions or limitations the employee currently have with respect to performing the essential duties of the position with a detailed explanation.

5. Additional questions may be provided by the IME requester.

IMEs covered in this SOW will be specified by TSA and will include all of the following:

Scheduling of the applicant for applicant medical screening, all nursing support, and a Final IME Report that addresses the questions posed, along with the provision of a fitness for duty recommendation.