Appendix_B_DOJ_Medical_Standards_1999.pdf

r~ (' fAl,),"'P 11 fI-'''' u.s. DEPARTMENT OF JUSTICE

IMMIGRATION AND NATURALIZATION SERVICE

MEDICAL STANDARDS

U.S. BORDER PATROL AGENT. GS-1896

CRIMINAL INVESTIOATOR (SPECIAL AGENT), OS-1811

IMMIGRATION AGENT ( ENFORCEMENT). GS-1801

IMMIGRATION INSPECTOR, GS-1816

DEPORTATION OFFICER. OS-1801

DETENTION ENFORCEMENT OFFICER, OS-1801

Under 5 CFR Part 339 Medical Qualifications Determinations, medical standards may be established for positions with duties that are arduous or hazardous in nature. The medical standards described in this section are required because of the arduous and hazardous occupational, functional and environmental requirements of the positions covered by these standards. The medical standards are provided to aid the Agency medical reviewing physician and the Immigration and Naturalization Service (INS) officials in determining what medical problems may hinder the individual's ability to satisfactorily perform the actual work without undue risk to himselflherself or others. They are also to be used to ensure consistency and uniformity in medical eligibility determinations.

Any other disease. condition or impairment. not specifically listed in the medical standards. which interferes with the safe. efficient and expected performance of the duties and responsibilities may also constitute grounds for medical disqualification.

These standards will be guided by the considerations set forth in 5 CFR Part 339, Medical Qualifications Determinations. Listed below are examples of medical conditions and/or physical impairments that may be disqualifying. Individualized assessments will be made on a case-by-case basis to determine an individual's ability to meet the performance-related requirements of positions covered by these standards. Final consideration and medical determination may require additional medical information and/or testing that is not routinely required during either the pre-placement or periodic medical examination.

These medical standards are intended to serve as a general guideline for the safe placement into and continued working in hazardous and arduous job positions within the INS. Each of the medical standards listed in this document are su~ject to the clinical interpretation of the condition by the Service's medical review officer who will incorporate his/her knowledge of the job requirements and environmental conditions in which employees must work.

June 15, 1999

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Any disease or condition which interferes with cardiac function is generally disqualifying. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATIONINCLUDE,BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

1. PACEMAKERS or PROSTHETIC VALVES are generally disqualifying. Any other condition or post-surgical management that requires the use of coumadin or other anti-coagulants is generally disqualifying.

2. CORONARY ARTERY DISEASE.

3. HYPERTENSION that requires the use of any medication to stabilize the blood pressure may be disqualifying. Systolic blood pressure exceeding 140 and/or diastolic blood pressure exceeding 90 mm Hg may be disqualifying. Confirmation of hypertension will require at least three (3) serial readings of blood pressure taken on different days and should include readings in both anns in a standing) sitting~and recumbent position.

Additional testing may be required to render a final medical opinion, including, but not limited to a maximal, symptom-limited exercise stress EKG, dilated funduscopic exam of the eye to detect hypertensive retinopathy, and a cardiologist evaluation to determine whether there exists any contraindication for vigorous intensity physical exercise.

Individuals on medication will have to demonstrate the absence of orthostatic hypotension with blood pressure measurements in the sitting, standing, and recumbent positions.

If there is no history of hypertension and the systolic pressure is marginally elevated (between 140 mm Hg and 150 mm Hg) and the diastolic pressure is below 90 mm Hg on the pre-placement medical examination, no further testing is necessary.

If there is a history of hypertension not currently treated on medication and the systolic pressure is marginally elevated (140 mm Hg to 150 mm Hg) and/or the diastolic pressure is 90 mm Hg or higher, serial blood presure measurements will be requested and additional diagnostic testing may be requested.

If there is a history of hypertension currently treated with medication and the systolic pressure is above 140 mm Hg and/or the diastolic presaure is above 90 mm Hg.

additional documentation and diagnostic testing will be requested.

Additional diagnostic tests may be required to render a final medical opinion, depending upon the individual's clinical history, treatment regiment. and the results of the pre-

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c ( placement examination. The final medical determination will consider the pharmacology of the medication, dosage, and frequency.

4. LEFT BUNDLE BRANCHBLOCK. -

5. MYOCARDITISI ENDOCARDITIS! PERICARDITIS (Active or recently resolved cases). A past history of these diseases may require additional testing to determine the current capabilities.

6. History of MYOCARDIAL INFARCTION.

7. A history of CARDIAC SURGERY (depending on the procedure and when it was perfonned).

8. VALVULAR HEART DISEASE such as mitral valve stenosis, mitral valve regurgitation, aortic stenosis, mitral valve prolapse, etc. Exceptions may be granted depending upon the current clinical findings and diagnostic studies.

9. DYSRHYTHMIAS: such as ventricular tachycardia or fibrillation, Wolff-Parkinson- White syndrome, Paroxysmal Atrial Tachycardia with or without block.

10. CEREBROVASCULAR ACCIDENT or TRANSIENT ISCHEMIC ATTACKS.

11. PULMONARY EMBOLISM (within the past six months or if there is a recurrent history or use of anticoagulants.

12. ANGINA PECTORIS or chest pain of unknown etiology.

13. CARDIOMYOPATHY from any cause.

14. CONGESTIVE HEART FAILURE

15. MARF AN'S SYNDROME

CONGENITAL ANOMALIES (case-by-case review of clinical presentation)

ERIPHE

STANDARD

Any disease or condition which interferes with the central or peripheral nervous system function may be considered disqualifying. Cases will be reviewed on a case-by-case basis.

I. Cerebral and cerebellar functions must be normal.

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2. The peripheral nervous system and all reflexes must be normal.

3. An individual with a history of seizures controlled on any medication(s) may be disqualified. Evaluation of an individual is subject to the seizure policy outlined below.

SEIZURE POLICY

A history of seizures requires an individual to meet the following criteria before further medfual consideration:

1. The individual must present the results of an awake and sleeping electroencephalogram (EEG) following an acceptable, non-medicated, seizure-free period of time. The current EEG must be free of epileptiform abnormalities.

An acceptable period of time will be defined by the prevailing scientific standards of medicine. a review of the current medical literature and the opinions of the individual's private Neurologist and, if necessary, a Neurologist selected by the Agency.

2. The medical history and/or documentation regarding the etiology of the seizure disorder must be submitted from the private physician(s), if available.

3. The agency may require a complete neuropsychological evaluation prior to further consideration of an individual.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

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13.

ATAXIA

CHOREOA THETOSIS

EPILEPSY (See the seizure poJicy above)

HUNTINGTON'S CHOREA

MUL TIPLE SCLEROSIS

MUSCULAR DYSTROPHY

NARCOLEPSY

NEUROFIBROMATOSIS

PARKINSON S DISEASE

CEREBROVASCULAR ACCIDENT (STROKE)

TRANSIENT ISCHEMIC ATTACKS

SENSORY DYSFUNCTION (smell. touch. taste).

MIGRAINE CEPHALGIA

.. Any neurological disease or disorder that is not listed above shall be reviewed on a case-by-case basis.

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Any disease or condition which interferes with respiratory function may be considered disqualifying. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

1. FORCED VITAL CAPACITY (FVC) AND/OR FORCED EXPIRATORY

VOLUME AT ONE SECOND (FEVl) THAT IS LESS THAN 70% OF THE

EXPECTED VALUE.

2. THE FEVIIFVC RATIO SHOULD NOT REFLECT EVIDENCE OF A

SIGNIFICANT OBSTRUCTIVE OR RESTRICTIVE DISORDER.

3. ASTHMA currently controlled on any medication is generally disqualifying. A history of asthma after the age of 12 years must be considered on a case-by-case basis.

4. ACTIVE PULMONARY TUBERCULOSIS (TB): A history of confirmed TB that has been treated for longer than 6 months is acceptable provided that documentation.

supports the treatment history. Additionally, diagnostic studies may be required following the case evaluation. Evidence of significant lung destruction in fully treated cases will be evaluated on a case-by-case basis. Any case of active TB would delay medical qualification until a sufficient period of time has passed to render the person non-communicable and documentation must be provided to show evidence of medical regimen compliance.

5. HISTORY OF CHRONIC BRONCHITIS ASSOCIATED WITH DECREASED

PFT RESULTS.

6. LUNG ABSCESS

7. SPONTANEOUS PNEUMOTHORAX (if recurrent)

EMPHYSEMA

SARCOIDOSIS (if associated with an impaired pulmonary function)

10. PULMONARY EMBOLISM

PULMONARY INFARCTION

TUMORS OF THE LUNG

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13. PNEUMONECTOMY (ifFEVlless than 70%)

... Respiratory disorders not listed above will be reviewed on a case-by-case basis and may require the evaluation by a pulmonologist.

Any disease or condition which may cause the person to be unduly susceptible to injury or -disease as a consequence of environmental exposures including the sun may be considered disqualifying. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

L ALBINISM.

2. UNTREATED SKIN CANCER.

3. CHLORACNE: This condition should be reviewed on a case-by-case basis for its association with toxic exposures.

4. KAPOSI'S SARCOMA.

5. SEVERE CHRONIC DERMATITIS.

Any excess or deficiency in hormonal production can produce metabolic disturbances affecting weight, stress adaptation, energy production, and a variety of symptoms or pathology such as elevated blood pressure, weakness, fatigue and collapse. Any condition affecting normal hormonal/metabolic functioning and response that is likely to adversely affect safe and efficient job performance is generally disqualifying. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

I. ADRENAL DYSFUNCTION (In the fonl1of Addison's Disease or Cushing's Syndrome).

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2. THYROID DISEASE (uncontrolled or associated with complications). Hypothyroidism adequately controlled by hormone replacement may be considered acceptable.

3. PITUITARY DYSFUNCTION

-4. INSULIN DEPENDENT DIABETES MELLITUS

5. HYPERGL YCEMIA will require additional tests including but not limited to a glycohemoglobin (or hemoglobin AIC), fasting glucose, and a 3 hour glucose tole~ce test before a final medical determination. -

6. DIABETES INSIPITUS.

.D

The gastrointestinal tract (01) should be evaluated from the mouth to the anus by the examining physician. Any disorder of the 01 tract capable of rendering the individual suddenly incapacitated or incapable of sustaining attention to required tasks, i.e.. chronic diarrhea, may be considered disquaHfying. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

I. ACUTE AND CHRONIC ACTIVE HEPATITIS

2. ACUTE VIRAL HEPATITIS (After being asymptomatic for three (3) months the applicant may be re-evaluated).

3. CROHN'S DISEASE I ULCERATIVE COLITIS I REGIONAL ENTERITIS or IRRITABLE BOWEL SYNDROME (Control of these conditions with surgical and/or medication treatments will be reviewed on a case-by-case basis.)

COLOSTOMIES

5. ILEITIS either recurrent or chronic.

CHOLELITHIASIS either symptomatic or asymptomatic.

CHOLECYSTITIS (chronic or recurring).

DIVERTICULITIS (symptomatic).

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9. DYSPHAGIA from any cause. Controllseverity/treatmentofthese conditions will be reviewed on a case-by-case basis

10. CIRRHOSIS OF THE LIVER (depending upon the degree of severity and the etiology).

11. INTESTINAL OBSTRUCTION

12. PANCREA TITIS .;.

13. AN UNTREATED INGUINAL, INCISIONAL OR VENTRAL HERNIA.

The folJowing clinical scenarios and aUother gastrointestinal conditions will be considered on a case by case basis:

>ItA history of bowelresectionis generallydisqualifyingif thereis any evidenceof recurrent pain, hemorrhage or any dietary restrictions that might interfere with the perfonnance of the duties and responsibilities.

... A history of gastric resection is generally disqualifying if there is any evidence (historical or physical) of pain, hemorrhage, fainting episodes or dietary restrictions that might interfere with the perfonnance of the job.

... A historyof a symptomatichiatalherniaresultingin chestpain.gastrointestinalhemorrhage (occult or massive), or respiratory symptoms is generally disqualifying. The complication of gastroesophageal reflux controlled on antacids will generally be considered acceptable.

In general, any dysfunction of the genitourinary or reproductive system that has the capability of interfering with the required tasks or rendering the person suddenly incapacitated is generally disqualifying. Any functional disorders rendering the individual incapable of sustained attention to work tasks, i.e., urinary frequency and/or significant discomfort secondary to such disorders, are disqualifying. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

1.

2.

3.

4.

POL YCYSTIC KIDNEY DISEASE

ACUTE or CHRONIC RENAL FAILURE NEPHROTIC SYNDROME c

SYMPTOMATIC URINARY CALCULI

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NEUROGENIC BLADDER

BERGER'S DISEASE

HISTORY OF RENAL VEINTHROMBOSIS

UNCORRECTED OBSTRUCTIVE UROPATHIES

RENAL TOXICITY FROM ANYCAUSE

A general examination of the head and neck should be perfonned during the physical examination. Attention should be given to any skull deformities, loss of bony substance or any evidence of past surgery. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

1.

2.

3.

4.

5.

MUTISM! APHONIA (INABILITY TO SPEAK) is generally disqualifying.

ANOSMIA

ARTIFICIAL LARYNX OR ESOPHAGEAL SPEECH is generally disqualifying.

FACIAL DEFORMITIES

TEMPOROMANDIBULAR JOINT SYNDROME (MODERATE TO SEVERE

CASES) .

NASAL POL YPS THAT SIGNIFICANTLY OBSTRUCT BREATHING

RESTRICTED RANGE OF MOTION IN THE NECK

NECK MASSES, LYMPHADENOP ATHY OR TRACHEOSTOMY

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* Any other chronic disease or condition which significantly interferes with speech or breathing and bears the potential to render the person suddenly incapacitated is generally disqualifying. .

H

Any disease or condition which interferes with the ability to hear may be considered disqualifying. Cases will be reviewed on a case-by-case basis.

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3.

1. In the frequency range from 500 -2,000 hertz (Hz), the deficit should not exceed 30 decibels in either ear.

At 3,000 Hz. the deficit should not exceed 40 decibels in either ear.

HEARING AIDS: The use of any hearing aid to comply with the medical standards is unacceptable.

A pure tone audiogram must be performed in an approved sound proof hearing booth that conforms to the American National Standards Institute (ANSI) standards, without hearing aids.

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2.

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The person must be binaural (have hearing in both ears). A whisper test is not acceptable.

Additionaltestingmaybe requiredto rendera finalmedicalopinion. '

OTOLOGICAL CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION

INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING EXAMPLES:

1.

2.

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5.

6.

MENIERE'S DISEASE

VESTIBULAR NEURONITIS

VERTIGO & PAROXYSMAL POSITIONAL VERTIGO

ACOUSTIC NEUROMA

WEGENER S GRANULOMATOSIS

OTOSCLEROSIS

* Any other disease or defect of the ear which adversely affects hearing or equilibrium and which potentially interferes with the safe and efficient job performance is generally disqualifying.

Any hematopoetic disease or condition which interferes with the expected performance of these jobs is generally disqualifying. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

1. ANEMIA- GeneraJly considered as a:

HEMATOCRIT OF LESS THAN 39% AND A HEMOGLOBIN OF LESS THAN 13.6

gmldl FOR MALES HEMATOCRIT OF LESS THAN 33% AND A HEMOGLOBIN OF 12gmldl FOR

FEMALES

(If anemia does exist but physical performance levels and pulmonary function are normal then this condition may be acceptable.)

INHERITED CLOTTING DISORDERS (ex. Hemophilia) are generally disqualifying

CHRONIC LYMPHANGITIS

THROMBOCYTOPENIA OR CLOTTING DISORDER

SICKLE CELL ANEMIA

SPLENOMEGAL Y

IMMUNE

Any communicable disease which can directly affect the occupationaljob performance and/or directly threaten the health and safety of others is generally disqualifying. Cases wiJIbe reviewed on a case-by-case basis.

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CONDITIONS WHICH MAY RESULT IN DISQUALIFICATIONINCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES: -

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HEREDITARY ANGIOEDEMA

GOODP ASTURES' SYNDROME

AUTOIMMUNE HEMOLYTIC ANEMIA

VASCULITIS

HASHIMOTO'S THYROIDITIS

MYASTHENIA GRAVIS

SYSTEMIC LUPUS ERYTHEMATOSUS

MED

All medication requirements, including psychotropic medication. will be evaluated to ensure that safe and efficient job perfonnance will not be adversely affected. Cases will be reviewed on a case-by-case basis. Each of the following considerations will enter the medical recommendations:

l.

2.

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5.

MEDICATION(S) (Type and dosage requirements)

POTENTIAL DRUG SIDE EFFECTS

DRUG-DRUG INTERACTIONS

ADVERSE DRUG REACTIONS

DRUG TOXICITY AND ANY MEDICAL COMPLICATIONS ASSOCIATED WITH

LONG TERM DRUG USE

DRUG-ENVIRONMENTAL INTERACTIONS

DRUG-FOOD INTERACTIONS

HISTORY OF PATIENT COMPLIANCE

Medications such as narcotics, sedative hypnotics, barbituates, amphetamines, or any drug with the potential for addiction, that is taken for extended periods of time (usually beyond 10 days) or is prescribed for a persistent or recurring underlying condition would generally be considered disqualifying.

ANABOLIC STEROID USE

Any person currently using anabolic steroids may be disqualified. Note: Anabolic steroids were legislated a controlled substance on February 27. 1991.and now require a physician's prescription.

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Any condition that adversely impacts on an individual's movement, agility, flexibility, strengih, dexterity. coordination or the ability to accelerate, decelerate and change directions efficiently is generally disqualifying. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE. BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

1. ARTHRITIS (any etiology) if there is limited joint motion and/or pain.

2. AMPUTATIONS of more than one digit if it directly affects the ability to grip and efficiently handle weapons.

3. AMPUTATIONS OF AN EXTREMITY: Any loss ofan upper or lower extremity.

Less than five (5) digits on each hand will be evaluated on a case-by-case basis.

4. ANKYLOSING SPONDYLITIS.

5. SCOLIOSIS, IF THE LATERAL CURVATURE IS 20 DEGREES OR MORE,.

6. MUSCULAR DYSTROPHY

7. LUMBOSACRAL INSTABILITY: pain or limitations of flexibility and strength causing an inability to stand, bend, stoop, carry heavy objects or sit for long periods of time.

8. DEGENERA TIVE DISK DISEASE

9. FIXED LORDOSIS OR KYPHOSIS which limits mobility and skeletal strength.

10. FRACTURES: may require orthopedic evaluation to determine whether functional limitations currently exist. A recent fracture with current immobilization (such as casting, bracing, etc.) ofa limb that prevents the performance of the full range oflaw enforcement duties will require documentation from the treating physician that immobilization is no longer required and that no physical limitations are present.

II. SPINA BIFIDA.

SCIA TICA OR OTHER NEUROPATHIES

CHRONIC LOW BACK PAIN (by medical history) without demonstrable pathology may be considered disqualifying. Each case will be reviewed in context to the original

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-- - - -- - -- - -. - - - - - . n_- - _n_- - n- --history of the injury (or whatever the etiology), the response to therapeutic regimes, frequency of recurrence, exacerbating factors, and lengths of disability associated with the recurrences combined with the current clinical presentation. Any other documenb!.tion submitted or requested will be considered before a medical opinion is generated.

A history of a CHRONIC SPRAIN OR STRAIN OF THE NECK limiting mobility or causing recuning cephalgia (headaches) may be disqualifying.

Any PROSTHETIC DEVICE will be reviewed on a case-by-case basis.

Evidence of a CERVICAL RIB, SUBLUXATION, TORTICOLLIS, SYMPTOMATIC THORACIC OUTLET SYNDROME or a BRACHIAL CLEFT

CYST

Any evidence ofa CERVICAL NEUROPATHY including numbness, tingling or loss of motor strength in the upper extremities may be disqualifying.

Any medical condition. congenital or acquired, which would interfere with a person's agility, dexterity, the lifting of heavy objects or the ability to perfonn the full range of law enforcement duties may be disqualifying.

A condition may be disqualifying if there is evidence that the general body symmetry may directly interfere with the safe utilization of issued standard and specialty equipment, including but not limited to handguns, shotguns, handcuffs, motor vehicles, etc.

RENAL TRANSPLANTATIONmay be considered disqualifying unless the applicant is not taking immunosuppressive drugs and is medically cleared by the surgeon who perfonned the operation to participate in strenuous activities. The applicant must be considered by the surgeon to be capable of withstanding blunt trauma to hislher flanks without a significant probability of untoward personal damage.

OCULAR LENS IMPLANT ATION may be acceptable considering an adequate post surgical recovery period and if the visual acuity meets the medical standards. (See vision standards)

COCHLEAR IMPLANT ATION is acceptable provided that the applicant meets the hearing standards and can localize sound satisfactorily. (See hearing standards)

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PACEMAKERS or PROSTHETIC VALVESare generallydisqualifying.Any other conditionor post-surgicalmanagementthatrequirestheuseof coumadinor otheranti-coagulants is disqualifying. (Seecardiovascularstandards)

. Other transplantations or prosthetic devises will be considered on a case-by-case basis.

p

Any'condition which significantly interferes with peripheral vascular function is generally -disqualifying. The peripheral vascular system involves the veins and arteries of the legs and arms. Cases will be reviewed on a case-by-case basis.

CONDITIONS WHICH MAY RESULT IN DISQUALIFICATION INCLUDE, BUT ARE

NOT LIMITED TO, THE FOLLOWING EXAMPLES:

1.

2.

3.

CHRONIC VENOUS INSUFFICIENCY

DEEP VEIN THROMBOSIS

CHRONIC THROMBOPHLEBITIS

Any disorder which affects nonnal perceptual judgment and safe and acceptable behavior or, if there is evidence of serious mental impainnent, is generally disqualifYing. Cases will be reviewed on a case-by-case basis.

SPECIFIC PSYCHIATRIC DISORDERS THAT MAYBE DISQUALIFYING INCLUDE

BUT ARE NOT LIMITED TO THE FOLLOWING EXAMPLES. All diagnosis must be consistent with the diagnostic criteria as established by the Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition (DSM-IV). or any subsequent revisions. Any psychiatric illness not listed here shall be reviewed on a case-by-case basis.

AXIS I DISORDERS:

DELIRlUM. DEMENTIA, AMNESTIC AND OTHER COGNTIVE

DISORDERS

MAJOR DEPRESSION

MANIC-DEPRESSIVE DISORDER

DISSOCIATIVE DISORDERS

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KLEPTOMANIA

PANIC DISORDER AND OTHER ANXIETY DISORDERS (depending upon -etiology, duration and severity of clinical expression)

PATHOLOGICAL GAMBLING

PYROMANIA

SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS (Exceptions may be made in cases of a single episode of schizophrenic reactions associated with an acute illness capable of causing such reaction.)

SEXUAL AND GENDER IDENTITY DISORDERS. (Reviewed on a case-by-case basis). Areas of concern include: transsexualism, fetishism, pedophilia. sexual sado-masochism, voyeurism and transvestic fetishism

AXIS II DISORDERS

NARCISSISTIC PERSONALITY DISORDER

ANTISOCIAL PERSONALITY DISORDER

DEPENDENT PERSONALITY DISORDER

PARANOID PERSONALITY DISORDER

SCHIZOID PERSONALITY DISORQER

ORGANIC BRAIN SYNDROME

D

Any disease or condition which interferes with a person's vision may be considered disqualifying. Cases will be reviewed on a case-by-case basis.

1. UNCORRECTED DISTANT VISION

Bonier Patrol Only: must be equal to or bener than 20/J00 in each eye.

All Other Positions: must be equal to or better than 20/200 in each eye.

BINOCULAR DISTANT VISION must be correctable to 20/20.

MONOCULAR VISION is generally disqualifying.

DEPTH PERCEPTION must be equal to.or better than 70 seconds of arc.

PERIPHERAL VISION must be nonna!.

2.

3.

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5.

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6. COLOR VISION must be normal. Acceptable measure of color discrimination are the Ishihara color (14 plates). X-Chrome lenses are not acceptable to the INS as a means for correcting color deficiencies.

OPHTHALMOLOGIC CONDITIONS WHICH MAY RESULT IN

DISQUALIFICATION INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING

EXAMPLES:

Ophthalmologic conditions which are particularly susceptible to environmental exposures such as sunlight, dusts, fumes, various volatile compounds may cause an applicant to be disqu81itied.

1. REFRACTIVE SURGICAL PROCEDURES (Le., Radial Keratotomy, Photorefractive surgery [laser], Keratoplasty, Lasik Surgery, etc.)

These operative procedures are considered acceptable provided that the individual's vision meets the above standards post-operatively and an acceptable recovery time period since the time of the operation has occurred. The individual must be free of post-operative complications. The results of an eye examination by a board-certified Ophthalmologist will be required to insure that vision is not impeded due to post-operative complications such as infection, glare, and contrast-sensitivity.

2. CHRONIC CONJUNCTIVITIS

If it causes visual impairment and/or increased susceptibility to environmental exposures which could interfere with the job performance. this condition may result in a medical disqualification.

3. PTERYGIUM

This condition is generally disqualifying if vision is impaired by the growth.

4. CORNEAL ABRASIONS

Because this condition may interfere with visual acuity it is generally disqualifying. The degree of impairment must be determined by an Ophthalmologist.

5. CORNEAL DYSTROPHY

This condition is generally disqualifying if the individual can not meet the outlined INS visual standards. Varying degrees of this condition could sufficiently impair the visual acuity which may result in a medical disqualification.

6. CORNEAL SCARS

This condition is generally disqualifying if the individual can not meet the INS visual standards. Varying degrees of this condition could sufficiently impair the visual acuity which may result in a medical disqualification.

CORNEAL ULCERS

This ~ondition is generally disqualifying since essential duties of the position could further exacerbate the condition. in addition to the condition causing impairments of the

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I visual acuity. This condition must be treated and cleared by an Ophthalmologist before any further consideration is given to the individual.

8. . KERATITIS

Any visual impairment associated with keratitis that is likely to interfere with job performance is generally disqualifying.

9. KERATOCONUS

This conditioncausesa coneshapeto the corneaandresultsin majorchangesin the -refracting power of the eye which necessitates frequent changes in the eye glass -prescriptions. If the visual acuity is cUlTentIycorrected to the above standards then the individual would be considered acceptable.

10. RETINAL DETACHMENT

This condition is generally disqualifying due to the serious visual obstruction.

11. RETINITIS PIGMENTOSA

12. LENS OPACITIES .

This condition could be considered disqualifying if the individual can not meet the INS visual standards.

13. GLAUCOMA

This condition is generally disqualifying if there is any impairment of peripheral vision.

An individual with a diagnosis of glaucoma established by a physician other than an ophthalmologist may be disqualified. until an evaluation by an ophthalmologist has been conducted and reviewed by the medical reviewing physician.

. Any other ocular disease or disorder not listed above wiJIbe reviewed on a case-by-case basis.

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United States

Office of Personnel Management Washington, DC 20415-0001

In R.opIy~ To; y...lW-

Ms. Carol A. Hall Assistant Commissioner for Human ResourCes Immigration and Naturalization Service Department of Justice 800 K Street, NW., Room 5147 washin15~~~'pDC 20536

Dear ~:

JUN I 5 19E

We are very pleased to approve your new medical standard covering a number of law enforcement positions in the U.S.

Immigration and Naturalization Service.

We recognize that this new standard has been under development for quite some time. We believe the final product is a good one and we appreciate the cooperation shown by your staff and the opportunity to work with them.

CONI'

Ju

D.S, Departm(."of Justice Immigration and Naturalization Service

100/6.8

425 I Street NW Washingtoll, DC 20536

SEP I 5 i999

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MEMORANDUM FOR MANAGEMENT TEAM

REGIONAL DIRECTORS

DISTRICT DIRECTORS

CHIEF PATROL AGENTS

ASYLUM OFFICE DIRECTORS

ADMINISTRATIVE CENTER DIRECTORS

SERVICE CENTER DIRECTORS

ASSISTANT DIRECTORS

HUMAN RESOURCES AND DEVELOP

FROM:

GEORGE I-I.BOHLINGER, III

EXECUTIVE ASSOCIATE C

OFFICE OF MANAGEMEN

t~carolA. Hall ~- (&r;L--L--f.= ''-." .

Assistant Commissioner

I-luman Resources and De lopment

NT

THROUGI-l:

SUBJECT: Medical Qualifications Standards"

This transmits, for your information and reference, a copy of the Service's new medical standards for entry-level Border Patrol Agent, Criminal Investigator, Immigration Agent, Immigration Inspector, Deportation Officer, and Detention Enforcement Officer, which were recently approved by the Office of Personnel Management.

EtTective July 19, these standards are being used by the Service's medical review officer for preemployment medical qualifications determinations performed under our interagency agreement with the Public Health Service, Division of Federal Occupational Health, Federal Law Enforcement Program. Currently, the standards are not to be applied to current employees of the Service, except those being hired through competitive examining for the entry-level positions above, You will note that the standards contain considerable detail about potentially disqualifying medical conditions and frequent references to the fact that they are to be applied on an individualized basis. Due to the level of medical knowledge required to assess medical

Memorandum for Management Team Subject: Medical Qualifications Standards qualifications, you should not attempt to interpret and apply the standards. We ask that you and your staff leave this to our medical review officer rather than attempting to do so on your own.

If you have any questions, now or in the future, regarding the medical standards, please call the Headquarters' Staffing, Recruitment and Employment Policy Section on (202) 514-0896. Any assistance you need from the medical review officer regarding the standards can also be obtained by calling this number.

Attachment

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