The Office of Personnel Management (OPM) approved medical qualification standards for 1811 treasury enforcement agents, also referred to as criminal investigators and/or special agents (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 (GOV). IRS special agents are required to meet these standards throughout their career. See OPM 1811 requirements.

On May 5, 1997, the IRS implemented a mandatory Medical Evaluation and Clearance Program (MECP), for all CI 1811 criminal investigators (special agents), to uniformly ensure special agents are medically fit to safely perform all essential law enforcement duties (see Exhibit 1) without undue risk or harm to themselves or others. The MECP has evolved and is currently referred to at the 1811 Medical Program.

CI contracts with a medical services provider specializing in occupational health to assist in the administration of the 1811 Medical Program. The medical services provider delivers medical and advisory services. The contract includes a medical review officer (MRO), also referred to as a Reviewing Medical Officer (RMO), who is a licensed medical physician with expertise in occupational medicine specific to law enforcement duties. The MRO conducts an impartial, comprehensive, individualized assessment prior to reaching a clearance determination regarding an agent’s health status and its impact on the job. The MRO does not conduct a physical or medical examination but bases the clearance determination on the information received from annual medical screenings, treating physicians, contracted physicians, the agent, and/or the IRS, and advises management accordingly. CI relies on the MRO’s review to determine if the agent can safely carry out law enforcement duties and participate in the Physical Fitness Program (PFP).

29 CFR 1910.95 Occupational Safety and Health Administration (OSHA) Standards, Occupational Noise Exposure.

29 CFR 1910.1025 Occupational Safety and Health Administration (OSHA) Standards, Lead.

29 CFR 1910.1030 Occupational Safety and Health Administration (OSHA) Standards, Bloodborne Pathogens.

IRM 9.1.4.25, Delegation Order No. 21 - Delegation of Authority in Employee Relations Matters.

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

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

Title 5 of the U.S. Code of Federal Regulations (CFR), Part 339, Medical Qualification Determinations.

This section outlines responsibilities for:

Assistant Director - Personnel Administration - Human Resources:

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

The table lists commonly used acronyms and their definitions:

IRM 1.14.5.3.11, Hearing Conservation.

IRM 6.550.2.2.21, Law Enforcement Availability Pay (LEAP).

IRM 6.752.1, Disciplinary Suspensions of 14 Calendar Days or Less.

IRM 6.752.2, Adverse Actions for the Agent in Question.

IRM 6.800.1, Workers’ Compensation Program.

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

IRM 9.1.4.7, Directive No. 6 - Use of Alcohol

IRM 9.2.2.4, Authorized Program Activities.

IRM 9.11.5.15, Reasonable Suspicion Alcohol Testing.

IRM 9.11.5.14.2, Requesting a Breath Alcohol Test.

IRM 9.11.5.14.3(4), Time Limitations.

IRM 10.23.1.8, Reporting Personal and Foreign Activity.

When a medical examination to assess FFD is authorized, the general medical examination consists of:

Independent Medical Examinations (IME) are authorized based on the individual circumstances of a case and the MRO’s judgement. An IME is conducted by a medical expert specializing in a particular field (e.g., cardiologist, orthopedist, psychologist, psychiatrist).

A Functional Capacity Evaluation (FCE) may be ordered to reliably measure the functional physical ability of an agent.

The FCE is a set of tests, practices, and observations performed by highly trained healthcare professionals.

Psychological or psychiatric examinations are authorized only when the results of a general medical examination provide no physical explanation for an agent’s behavior or actions which may affect the agent's safe and efficient performance of essential law enforcement duties.

Agents who undergo refractive surgery will be placed on TRD until the MRO determines they are able to safely return to full duty.

Agents planning to undergo refractive surgery must:

Management must:

Obstructive sleep apnea (OAS) is a common sleep related breathing disorder in which breathing is intermittently stopped during sleep due to an upper airway blockage, often cause by relaxed throat muscles. OAS can lead to serious health problems and an increased risk of workplace accidents.

Agents diagnosed with OAS must provide clinical evidence documenting compliance and effectiveness of their treatment approach to OAS. Those applying positive airway therapy using a continuous positive airway pressure (CPAP) machine are required to submit a 90-day CPAP compliance report demonstrating good compliance. The industry standard for good compliance is CPAP use for 4 hours (or more) a night for at least 70% of nights. Those employing other methods of treatment are required to submit relevant documentation as requested by the MRO. For more information see:

Reportable medications include prescription and non-prescription drugs.

Agents must 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. (See Exhibit 9.11.5-2, Forms)

Agents are not required to report every non-prescription medication they take. They 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 agents discuss all medications and side effects with their private physician to determine their ability to safely perform law enforcement duties.

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

Agents must immediately report every instance of narcotic 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. Agents should seek advice from their physician or pharmacist to determine whether their prescribed medication is a narcotic. See Drug Enforcement Administration Drug Fact Sheet, April 2020.

Agents are subject to call-back at any time, so management must be aware of an agent’s ability to carry out law enforcement duties at all times as taking narcotics increase the risk of impairment to an agent's mental and physical abilities.

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

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. Agents should seek advice from their physician or pharmacist to determine whether their prescribed medication is a benzodiazepine. See National Institute of Health, National Library of Medicine, December 2021.

Agents are subject to call-back at any time, so management must be aware of an agent’s ability to always carry out law enforcement duties as taking benzodiazepines increase the risk of impairment to an agent's mental and physical abilities.

Agents must 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.

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

Agents prescribed anticoagulant medication will immediately be placed on TRD for a minimum of six (6) months. After reporting, agents 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 agent may be cleared to resume unrestricted law enforcement duties.

Agents cleared to return to full duty must submit status reports every six (6) months from their physician documenting therapeutic control while taking anticoagulants. If therapeutic control is maintained, the agent will be cleared to participate in the full range of law enforcement duties.

Management must promptly contact ERM to obtain a TRD memorandum whenever an agent is placed on TRD. ERM will prepare the TRD memorandum and a Request for Medical Documentation memorandum if applicable, and forward to management for issuance. The memoranda include:

Management will provide ERM with documentation to support the need for TRD. Documents or other evidence relating to an agent's medical, physical, or psychological condition could include, but are not limited to:

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

Management cannot authorize an agent on TRD to perform 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 agent’s firearm when they are placed on TRD.

Management will restrict an agent’s use of a GOV while on TRD. If medically cleared to drive by the MRO, an agent may be allowed to conduct non-law enforcement duties using a GOV during the duty day. Agents on TRD will not be authorized home-to-work use of the GOV.

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

Personnel Security may need to be notified when an agent is placed on TRD. Management should refer to IRM 10.23.1.8, Reporting Personal and Foreign Activity, for guidance on security clearance restrictions for agents placed on TRD.

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

Formal notification of the NMQ determination includes:

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

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

An agent requesting reconsideration of the NMQ determination must notify their manager in writing of their intent to request reconsideration within 15 calendar days of receipt of the NMQ notice. The agent will then have 30 calendar days from receipt of the NMQ notice to provide any new information and documentation to their manager. Managers will promptly forward the information to the MRO.

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

The MRO will issue a final medical qualification determination after reviewing the new information submitted for reconsideration. If the MRO determines the agent is:

If the Deputy Director of Strategy - REAL determines sufficient information was provided documenting the agent’s ability to safely perform law enforcement duties despite not meeting the medical qualification standards, and/or the agent, 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 submit a medical qualification standards waiver request to 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 requested but denied, CI will attempt to place the agent 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.

Agents 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 agent is intoxicated or under the influence of alcohol while on duty. The SAC must contact the medical services provider call center at 1-800- 638-8476 and provide the following information:

The medical services provider call center immediately notifies the medical services provider who schedules an appointment at a clinic as close as possible to where the agent is located, and the medical services provider will promptly follow up with the SAC and provide the agent’s appointment information.

After contacting the medical services provider 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 agent is under the influence of alcohol, and provide the appointment information.

A designated manager will drive the agent to the clinic for testing. Upon arrival at the designated clinic, the agent must provide acceptable photo identification (e.g., driver’s license) to ensure proper identification. A BAT will administer a breath alcohol screening test which produces immediate results. The BAT will share the results of the test with the agent and the accompanying manager.

Initial Test - is a diagnostic procedure to determine whether an agent may have a prohibited concentration of alcohol in a breath specimen. 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 with the completion of the initial test. The waiting period shall not exceed twenty (20) minutes. During the waiting period, agents 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 agent fails to follow test instructions.

Invalid Test - if a screening or confirmation test cannot be completed, or if an event occurs 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 agent 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 agent refuses to submit to testing if they:

The BAT will immediately terminate the test if the agent refuses to cooperate during the testing process and inform the accompanying manager 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 agent is unable to provide a sufficient amount of breath for a valid breath test due to a medical condition, the agent will be instructed to make a second attempt to provide the necessary amount of breath. If the agent 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 manager.

An agent’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 agent’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 screening test, the test administrator will share the test results with the agent and the accompanying manager. The manager will promptly provide the final results to the SAC who will then notify 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.).

When the tested agent next reports for duty, upon receipt of acceptable test results, the temporary restrictions can be lifted as long as management has no reasonable belief or suspicion the agent has been drinking in the past eight hours, is under the influence of alcohol, or is intoxicated. If any of these circumstances exist, management will immediately initiate steps for another alcohol test.