Fire Crash Rescue Specialist/Supervisor and Military Affairs Security Officer/Supervisor Notification of Injury, Illness, or Disease and Return to Work Guidelines

Department of Military Affairs State Human Resources Practice and Procedure Manual

Owner: State Human Resources
Effective Date: 02/23/2022
Revision Date: 06/20/2025

Policy Number: DEPT 3504

I. Purpose

Fire Crash Rescue Specialists and Military Affairs Security Officers are professionals who perform high-risk duties. They must maintain physical and mental standards that are critical to successfully and safely performing their essential job duties. It is the DMA’s obligation to ensure that these employees can do so. Therefore, employees who are headquartered at Joint Force Headquarters, Mitchell Field, Truax Field, and Volk Field and who take any substance, have an injury, illness, or disease that might affect their ability to safely perform their essential job duties must follow the procedures outlined in this document.

II. Scope

This policy applies to all permanent, project, and limited term DMA state employees who are employed as Fire/Crash Rescue Specialists, Fire/Crash Rescue Crew Chiefs, and Fire/Crash Rescue Supervisors (collectively, FCRSs), or as Military Affairs Security Officers, Military Affairs Security Officer-Seniors, and Military Affairs Security Officer Supervisors (collectively, MASOs). For the purposes of this document, FCRSs and MASOs will collectively be referred to as “employees.”

III. Definitions

DMA: The Wisconsin Department of Military Affairs.

Physical Agility Assessment: Physical fitness/agility assessment/training for FCRS positions.

FCRS: Fire/Crash Rescue Specialist, Fire/Crash Rescue Specialist Crew Chief, Fire/Crash Rescue Supervisor.

MASO: Military Affairs Security Officer, Military Affairs Security Officer-Senior, Military Affairs Security Officer Supervisor.

Medical Coordinator: DMA position in the State Human Resources Office.

PRT: Physical Readiness Test for MASO positions.

Qualified Healthcare Provider: Physician, physician assistant, nurse, nurse practitioner, dentist, mental health professional, and others who by virtue of their education, credentials, and experience are permitted by law to evaluate and care for patients.

IV. Policy and Procedures

Use of Substances

Employees may not report to work or perform work after using any substance that might affect their ability to safely perform their job duties. The following procedures apply when such use occurs:
1. Report to Supervisor
  1. An employee who is at work must immediately inform their supervisor when they have used a substance that may adversely affect their ability to safely perform their job duties and will go on a leave status at that time. The employee does not need to disclose to their supervisor the type or details of the substance used.
  2. An employee who is not at work and uses a substance that may adversely affect their ability to safely perform their job duties during their next scheduled shift, must inform their supervisor as soon as possible prior to that shift that they need to take leave. The employee does not need to disclose to their supervisor the type or details of the substance used.
2. Report to Medical Coordinator
  1. After informing their supervisor as outlined above, the employee must immediately report the use of the substance to the DMA Medical Coordinator. The employee must disclose the name and necessary details of the substance used.
  2. The Medical Coordinator will help the employee coordinate leave to be used for any necessary absence(s). If it is determined that the employee may be eligible for leave under federal and/or state Family and Medical Leave Act (FMLA/WFMLA) laws, the Medical Coordinator will inform the employee.
3. Information Needed from a Qualified Health Care Provider
  
  Once notified of the substance use, the Medical Coordinator will do one of the following:
  1. Provide the employee with a form to be filled out by the qualified health care provider and a copy of their position description and instruct the employee to return the completed form by a specific date.
    
    OR
  2. With the employee’s consent and written authorization, send the employee’s position description to a qualified health care provider of the employee’s choice and ask whether the substance will impair the employee’s ability to safely perform their job duties and, if so, how.
4. Return to Work
  
  The employee may not return to an unrestricted work status until they have stopped taking the substance or a health care provider confirms that the substance will not impair the employee’s ability to safely perform the duties on their position description.
  1. If the employee’s health care provider determines that the employee’s use of the substance will not interfere with their ability to safely perform their job duties, the Medical Coordinator will inform the employee and the employee’s supervisor that the employee may return to work. The employee will work with their supervisor to determine a return- to-work date.
  2. If the health care provider indicates that there are accommodations that might be made to permit the employee to safely perform their job duties, the Medical Coordinator will initiate the interactive process with the employee and their supervisor to determine whether any proposed accommodations are reasonable and, if so, whether they would impose an undue hardship.
  3. DMA reserves the right to have the employee seen by an independent medical examiner or to have such provider review the employee’s health care provider’s records to determine if the employee may safely return to work.
  4. If the employee’s health care provider determines that the substance will interfere with the employee’s ability to safely perform their job duties, the Medical Coordinator will determine the next steps and will convey those to the employee and their supervisor.
5. If substance use is suspected but has not been reported by an employee, DMA reserves the right to have the employee undergo an occupational assessment by an independent medical examiner.
Illness, Injury, or Disease

Employees may not report to work if they suffer any injury, illness, or disease that might adversely affect their ability to safely perform their job duties. The following procedures apply when such injury, illness, or disease occurs.
1. Report to Supervisor
  1. While at work, an employee must report to their supervisor all incidents that may result in an illness, injury, or disease. If the injury, illness or disease could have an adverse effect on their ability to safely perform their job duties, the employee must stop working immediately and go on leave status.
  2. If, while not in work status, an employee suffers an injury, illness or disease that might adversely affect their ability to safely perform their job duties, the employee must notify their supervisor as soon as possible prior to their next scheduled shift. The employee will need to go on leave status. The employee does not need to disclose the nature of the injury, illness, or disease to their supervisor.
  3. Following the employee’s report of injury, illness, or disease, the supervisor must confirm with the Medical Coordinator that the employee has notified the Medical Coordinator as outlined below.
2. Report to Medical Coordinator
  1. After informing their supervisor as outlined above, the employee must immediately report the illness, injury or disease to the DMA Medical Coordinator. The employee must disclose the nature of the injury, illness or disease.
  2. The Medical Coordinator will help the employee coordinate leave to be used for the required absence(s). If it is determined that the employee may be eligible for leave under federal and/or state Family and Medical Leave Act (FMLA) laws, the Medical Coordinator will inform the employee. The Medical Coordinator will also assist with Workers Compensation claims, if applicable.
3. Information Needed from a Qualified Health Care Provider
  1. In most circumstances, DMA will require documentation from a qualified health care provider before the employee may return to work after going on a leave status. If requested by the Medical Coordinator, the employee must obtain written documentation from their qualified health care provider addressing whether the illness, injury, or disease adversely affects the employee’s ability to safely perform the employee’s job duties. The employee will remain on leave pending receipt of the documentation. If the Medical Coordinator does not ask for the documentation, they will inform the employee of the next steps.
  2. When the employee asks their qualified health care provider to provide the documentation, the employee must provide the qualified health care provider with a copy of the employee’s current position description, PRT/Physical Agility Assessment form relevant to their position (MASO or FCRS), and the Fitness For Duty Certification – Return to Work Release Form.
  3. The documentation must include a description of how the injury, illness or disease affects the ability of the employee to safely perform their job duties, identification of the job duties that cannot safely be performed because of the injury, illness or disease, the likely duration of the inability to safely perform the identified job duties and the likely duration of the injury, illness or disease and any restrictions. The provider must also have indicated in the documentation their opinion as to the employee’s ability to successfully perform the PRT/Physical Agility Assessment.
  4. The employee must provide the qualified health care provider’s written documentation to the Medical Coordinator within 72 hours of the health care provider visit, absent extenuating circumstances. If the employee learns that the health care provider will not be able to provide the required documentation within 72 hours of the visit, they should immediately contact the Medical Coordinator for further instructions. If restrictions are identified that require an accommodation, the employee should complete the Reasonable Accommodation Request form.
4. DMA Discretion
  
  DMA reserves the right to have an employee undergo an occupational assessment by an independent medical examiner if an injury, illness or disease is suspected but has not been reported or if validation of the employee’s qualified health care provider’s written documentation is required.
  1. In its sole discretion, DMA may also require the employee to be assessed by DMA’s independent medical examiner to determine if the employee can successfully pass the PRT/Physical Agility Assessment and be able to safely perform their job duties.
  2. DMA will give its provider a copy of the employee’s position description and the PRT/Physical Agility Assessment form prior to the provider beginning the assessment.
  3. After reviewing the type and severity of the injury, illness or disease, the DMA provider will determine the scope of their assessment.
5. Return to Work
  
  An employee who is on leave due to an injury, illness or disease that adversely affects their ability to perform their job may only return to work as follows.
  1. The employee must provide to the Medical Coordinator written documentation from their qualified healthcare provider indicating whether the employee can safely perform all their job duties. If they can safely perform some, but not all, of the job duties, the documentation must indicate which duties cannot be safely performed and the duration of the restriction(s). The provider must also have indicated in the documentation their opinion as to the employee’s ability to successfully perform the PRT/Physical Agility Assessment. See above section 4.2(3)(c) for clarification.
  2. The Medical Coordinator, in consultation with the supervisor will determine whether the documentation is sufficient to permit the employee to return to work and, if so, are any reasonable accommodations required.
  3. If the employee’s qualified health care provider determines that the employee can safely perform all their job duties and should be successful in performing the PRT/Physical Agility Assessment, the Medical Coordinator and the employee’s supervisor will determine on a case-by-case basis if the employee must take and pass a PRT/Physical Agility Assessment before returning to work.
  4. If an independent medical examination is required and the independent medical examination provider agrees with the employee’s health care provider, the Medical Coordinator and the employee’s supervisor will determine on a case-by-case basis if the employee must take and pass a PRT/Physical Agility Assessment before returning to work.
  5. If no PRT/Physical Agility Assessment is required, the employee can return to work and must coordinate the return date with their supervisor.
  6. If a PRT/Physical Agility Assessment was required and the employee passed, the employee can return to work and must coordinate the return date with their supervisor.
  7. If the employee fails the PRT/Physical Agility Assessment when it is required, they will remain on a leave of absence or work on light duty and must re-attempt the PRT/Physical Agility Assessment within 30 days of the failed attempt. The employee will have a maximum of four total attempts. During the period of time that the employee is on a continuous leave or is working light duty due to failed PRT/Physical Agility Assessment, it is the responsibility of the employee to continue providing, at the discretion of the Medical Coordinator, periodic documentation from their provider addressing their ability to return to full duty.

Employees will remain on a leave of absence and should not report to work until their return has been facilitated and approved by both their supervisor and the Medical Coordinator.

V. Authority and Cross Reference

National Guard Regulation 5-1

United States Air Force Technical Implementation Guide 1582-07

National Guard Bureau Cooperative Agreements governing security and fire services

National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments

Wisconsin Human Resources Handbook Chapter 410, Employee Work Rules and Discipline Procedure

Wisconsin Human Resources Handbook Chapter 416, Employee Impairment/Under the Influence

Wisconsin Human Resources Handbook Chapter 724, Family and Medical Leave

Wisconsin Department of Military Affairs, Military Affairs Security Officer Physical Readiness Test Handbook

Department of Military Affairs, Practice and Procedure Bulletin No.:3.150, Reasonable Accommodations Policy and Procedures

Department of Military Affairs, Practice and Procedure Bulletin No.:4.300, Pre-Hire Fitness for Duty (Military Affairs Security Officer/Supervisor)

Department of Military Affairs, Practice and Procedure Bulletin No.:5.400, Drug Free Workplace

Department of Military Affairs, Practice and Procedure Bulletin No.: 8110, Annual Physical Readiness Test Qualification for Military Affairs Security Officer/Senior/Supervisor

Department of Military Affairs, Practice and Procedure Bulletin No.:8.120, Weapons Qualifications for Military Affairs Security Officer/Supervisor

VI. Associated Forms

Employee Workplace Injury or Illness Report (Form DOA-6058) Employer’s First Report of Injury or Disease (Form WKC-12)

Supervisor and Safety Coordinator Investigation Report for Injury or Illness (Form DOA-6437)

Fitness For Duty Certification – Return to Work Release (Form DOA-15336)

Medical History and Examination Form for Firefighters (NFPA 1582 Standard on Medical Requirements)

Reasonable Accommodation Request Form (Form DOA-15104)

Military Affairs Security Officer Physical Readiness Test Record of Results (Form DMA-3501)

Fire Crash Rescue Specialist Physical Agility Assessment Record of Results (Form DMA-3502)

VII. Administrative Reference

This policy was updated in June 2025 to add information regarding notification of substance use. In addition, associated reference materials and forms were added.