Medical, Fitness and Wellness Program

This program keeps members medically and physically able to do the work safely, for a whole career, and sends them home healthy at the end of it. When it is working, every operational member has a current medical evaluation against the department’s essential job tasks, performed by a physician who knows what firefighting demands (NFPA 1580, 2025); every member who wears SCBA has been medically cleared to wear it (CSA Z94.4-18); members know their own cardiac risk and have help to lower it; fitness is part of the working day, not a private hobby; a member who is hurt or ill has a planned, graduated way back to work (CSA Z1011:20); fatigue is managed as a hazard rather than a badge; and the department holds only the fitness determination, never the chart. The measure of success is a falling cardiac event count, a rising completion rate, and members who trust the program enough to use it.

Required for every department with operational members, career or volunteer. This is Program Profile Worksheet Part C item 5 (“Any operational members: Required”). Non-operational staff (administration, prevention, dispatch, mechanics) are in scope for the wellness, fatigue and return-to-work elements and for any medical requirement attached to their duties (for example, respirator clearance for mechanics who service SCBA in a fill room, or a driver medical for anyone who drives apparatus). The module switches only in its depth: section 5.4 sets the volunteer tiers.

Consistent with 06 Glossary and Acronyms.

• Accommodation: a change to duties, equipment, schedule or role that lets a member with a restriction do the work safely, up to the point of undue hardship for the employer.
• Bona fide occupational requirement (BFOR): a standard that is rationally connected to the job, adopted in good faith, and reasonably necessary because the member cannot be accommodated without undue hardship (British Columbia (Public Service Employee Relations Commission) v. BCGSEU, 1999).
• Category A condition: a medical condition that precludes safe performance of the essential job tasks; Category B condition: one assessed individually against the tasks (NFPA 1580, 2025).
• Essential job tasks: the physical and cognitive tasks a role must be able to perform; the anchor for every medical and fitness determination.
• Fatigue risk management system (FRMS): the rules, screening, reporting and monitoring that treat fatigue as a workplace hazard.
• Fire department physician: the physician or clinic lead the department designates to perform evaluations and make fitness determinations.
• Fitness-for-duty determination: the physician’s conclusion, in a category, about whether a member can perform the essential job tasks; the only medical output the department receives.
• Peer fitness trainer: a certified member who conducts fitness assessments and coaches peers; holds assessment results in confidence.
• Psychological health: the member’s mental health, protected through the psychosocial factors of CAN/CSA-Z1003 (CSA Z1003-13).
• Psychological safety: the shared belief in a team that it is safe to speak up, ask, admit error and challenge (Edmondson, 1999)DOI; an organizational condition created by leaders’ behaviour.
• Return to work: the planned, graduated process by which a member returns after injury or illness (CSA Z1011:20).
• Stage (S1, S2, S3): the implementation stage at which a requirement becomes mandatory in this system.

R = responsible, A = accountable (one per row), C = consulted, I = informed. Only the differences from 01 Roles and Responsibilities are shown; the Health, Wellness and Rehab Program Improvement Team owns this program (06 Program Improvement Teams).

Requirement. The department designates one physician (or an occupational health clinic with a named lead physician) as the fire department physician, with a written agreement that covers scope, confidentiality, turnaround, cost, and the physician’s orientation to the work (NFPA 1580, 2025). (S1)

Minimum method. The agreement names the physician by role, states that evaluations are against the department’s essential job tasks (5.2) and the NFPA 1580 criteria, requires the physician to receive the member’s exposure summary before each evaluation (Occupational Cancer Prevention, Exposure Tracking and Screening Program), and sets what the department receives: a fitness determination (fit, fit with restrictions, temporarily unfit, unfit), never results or diagnoses. The physician sits as clinical adviser to the Health, Wellness and Rehab team and the Respiratory Protection team. A new physician completes an orientation (half day): essential job tasks, SCBA and PPE loads, heat strain, the exposure profile, rehab, the volunteer tiers, and the department’s accommodation process.

Evidence. Signed agreement; orientation record; annual review of the agreement at the program appraisal.

Requirement. The department adopts a written list of the essential job tasks of each operational role, approved by the fire chief, included in job descriptions and postings, and used as the single reference for every medical and fitness determination (NFPA 1580, 2025). (S1)

Minimum method. Start from the NFPA 1580 list (legacy NFPA 1582; 14 tasks) in the toolkit (section 17.3), adjust for the department’s actual operations, and attach the task demands the department can document (SCBA and PPE load, ladder heights, hose line sizes, stair climbs typical of the district). The list is the BFOR anchor: a medical or fitness standard that is not traceable to a task on this list cannot be applied adversely to anyone (British Columbia (Public Service Employee Relations Commission) v. BCGSEU, 1999).

Evidence. Approved list with date; job descriptions citing it; collective agreement and volunteer by-law language reconciled with it.

Requirement. Every candidate for an operational role completes a medical evaluation to the NFPA 1580 candidate criteria and a validated physical ability test before appointment (NFPA 1580, 2025; NFPA 1550, 2024, s. 13.1.1). (S1)

Minimum method. Medical: full candidate content (section 17.1 column A) including respirator clearance. Physical ability: the Candidate Physical Ability Test (eight events, 10 minutes 20 seconds, 50 lb vest) at a licensed site (IAFF & IAFC, 2018), or an equivalent test validated against the department’s essential job tasks. Offer a mentoring and preparation program to candidates; the Wellness-Fitness Initiative reports it reduces adverse impact (IAFF & IAFC, 2018). For volunteer candidates, the same medical content applies; the physical ability test may be the department’s own task-based evaluation provided it is documented and applied to everyone.

Evidence. Candidate file: medical determination date, test date and result, mentoring offered.

Requirement. Every operational member has a periodic medical evaluation by the fire department physician against the essential job tasks (NFPA 1580, 2025; NFPA 1550, 2024, s. 13.1.2). Career members and all interior or SCBA-qualified members are evaluated annually; other volunteers on a tiered schedule by age and risk. (S1 for respirator clearance and the volunteer Tier 1 entry medical; S2 for the full annual content)

Minimum method. The annual content table is in the toolkit (section 17.1). Its core: history and symptom review, examination, vitals, body composition, vision, audiometry, spirometry, bloodwork, urinalysis, 12-lead ECG, exercise stress test by risk profile (age 40 and over or risk factors), chest radiograph at baseline and as indicated, cancer screening by age and sex, immunization and infectious-disease status, a mental-health screen, review of the member’s exposure summary, and respirator clearance (NFPA 1580, 2025). Cardiac risk stratification is the single most valuable line: overexertion and strain, nearly all cardiac, accounted for about 45 per cent of US on-duty firefighter deaths in 2025, and volunteers outnumbered career members among the year’s deaths (NFPA, 2026); the US Fire Administration reports 58 per cent of 2024 deaths as cardiovascular (USFA, 2025).

Volunteer tiers. A practical three-tier model, on the pattern used in volunteer-sector guidance:

A volunteer who declines or cannot complete the tier for their role is assigned to exterior or support roles in the roster system until cleared. That is an accommodation, not a penalty, and is recorded as such.

Evidence. Completion tracker (Form - Annual Medical and Fitness Completion Tracker) by member with tier and due date; physician’s determinations on file in HR; aggregate completion rate in the quarterly update.

Requirement. The physician determines fitness against the essential job tasks and reports a category; the department decides assignment and accommodation through a written process (NFPA 1580, 2025) that meets the duty to accommodate (British Columbia (Public Service Employee Relations Commission) v. BCGSEU, 1999). (S1)

Minimum method. Clearance categories (section 17.2): Fit for full duty; Fit with restrictions (listed by task number); Temporarily unfit (with a review date); Unfit for the role. NFPA 1580 carries forward the Category A and Category B condition structure of NFPA 1582 (NFPA 1580, 2025). The physician identifies restrictions; the department, not the physician, decides employment status.

The accommodation workflow (section 17.5) applies the three-step BFOR test before any standard is used to remove a member from duty: (1) the standard was adopted for a purpose rationally connected to the job; (2) it was adopted in an honest, good-faith belief that it is necessary; (3) it is reasonably necessary, meaning the department cannot accommodate the individual without undue hardship (British Columbia (Public Service Employee Relations Commission) v. BCGSEU, 1999). In practice: the standard is validated against the essential job tasks, applied individually with an alternative assessment where the standard test is not a fair measure for that person, and modified duties, non-SCBA roles and a time-limited improvement plan are considered and documented before a final decision. NFPA 1580’s percentile-based aerobic classification (below the 35th percentile of the general population for age and sex, or the 50th with certain conditions) triggers an exercise prescription and a recommendation on specific tasks (NFPA 1580, 2025); it is reconciled with absolute task demands before it is used adversely, because a percentile that passes an older member at a lower absolute capacity than a younger one is a weak basis for a BFOR.

Evidence. Written process; each case file shows the three steps, the options considered, the member’s input, the union or association’s involvement where the member asks for it, and the decision with reasons.

Requirement. A mandatory, non-punitive, on-duty health-related fitness program with an annual assessment and an individual exercise prescription for every member who wants one (NFPA 1580, 2025, fitness chapters; IAFF & IAFC, 2018). (S2; a voluntary program with assessment at Stage 1)

Minimum method. Built on the Wellness-Fitness Initiative with its five parts (medical, fitness, injury and medical rehabilitation, behavioural health, data collection and reporting) and its three rules: confidential, non-punitive, joint labour-management (IAFF & IAFC, 2018). Assessment results never go to the department as individual scores; the peer fitness trainer and the member hold them, and the program reports aggregates. The annual assessment protocol (section 17.4) measures aerobic capacity, muscular strength, muscular endurance, flexibility and body composition. The peer fitness trainer model: certified members (the Peer Fitness Trainer certification or its successor program) lead the assessment, write the prescription, coach, and run station fitness (IAFF & IAFC, 2018). Target one certified trainer per platoon per district, plus one per volunteer district. Fitness time is scheduled on duty (career) or credited as training time (volunteer); the program buys and maintains station equipment to a standard list.

Evidence. Trainer certifications; assessment completion rate; equipment inspection records; aggregate trend report.

Requirement. A fatigue risk management system that treats fatigue as a hazard: limits on hours, rest rules, screening for sleep disorders, non-punitive fatigue reporting, and monitoring. (S1 for the hours limits and the self-declaration rule; S2 for screening and monitoring)

Minimum method. The rules are in section 17.7. The core set: a maximum continuous duty period including overtime and call-backs; a minimum rest period between duty periods; a rest or nap policy on the night tour; post-incident rest after a prolonged or overnight working incident before driving home or taking another assignment; a member’s right and duty to declare fatigue without penalty, and the officer’s duty to act on it; obstructive sleep apnea and insomnia screening in the annual medical with a treatment pathway; driver fatigue rules; and monthly monitoring of overtime hours, back-to-back shifts and incidents by hour of day. Fatigue degrades situational awareness and decision-making, and volunteer responders often respond after a full working day (AFAC, 2022). Sleep-health studies in fire departments have reported high rates of undiagnosed sleep apnea and insomnia, and that screening programs reduce injury and disability. The Policy - Fatigue and Hours of Work carries the department’s limits once set.

Evidence. Policy; scheduling reports; screening completion in the aggregate medical report; fatigue declarations logged without names in the quarterly update.

Requirement. A work disability management program aligned to CSA Z1011 (CSA Z1011:20), coordinated with the workers’ compensation board, with a written modified-duties list and a graduated return for physical and psychological injury alike. (S2; a modified-duties list and a named coordinator at S1)

Minimum method. The workflow is in section 17.6. Early contact (within three working days of a lost-time injury), a named return-to-work coordinator, a modified-duties catalogue the physician can choose from, a written graduated plan with review dates, and a closure review. Psychological injury follows the same system with the clinical pathway in Psychological Health and Safety and Peer Support Program. The compensation board’s own return-to-work expectations and early-treatment programs apply, and the applicable statute may set employer and worker duties to co-operate in return to work (J33 Return to Work, Accommodation and Hours of Work).

Evidence. Plans on file; return-to-work outcomes (days to first contact, days to return, re-injury) reported in aggregate.

Requirement. Every member with patient contact or exposure risk is offered the immunizations in the schedule (section 17.8) at department cost, and has a post-exposure protocol available at every station (NFPA 1580, 2025, infection control chapters). (S1)

Minimum method. Schedule from NFPA 1580 (legacy NFPA 1581) reconciled with the provincial or territorial immunization schedule and occupational guidance for first responders (J25 Infection Control and Medical First Response): hepatitis B series with post-series titre, tetanus-diphtheria-pertussis, measles-mumps-rubella, varicella, annual influenza, COVID-19 per public health guidance, TB screening on hire and by risk (NFPA 1580, 2025). Records held by the physician or clinic; the department holds a status flag. The post-exposure protocol (within two hours for bloodborne exposure) is in Infection Control and Medical Response Safety Program.

Evidence. Status flags on the tracker; protocol posted; sharps containers on apparatus.

Requirement. Vision and hearing are assessed in every medical against the NFPA 1580 criteria and the licensing standard for apparatus operators (NFPA 1580, 2025). (S1)

Minimum method. Vision: distance acuity corrected and uncorrected, near acuity, colour discrimination, peripheral fields (far acuity corrected 20/40 binocular and the uncorrected limit); apparatus operators also meet the driver medical standard for the licence class the applicable traffic law requires (J30 Emergency Vehicles, Drivers and Licensing). Hearing: baseline and annual audiometry with standard-threshold-shift follow-up, under the Hearing Conservation Program.

Evidence. In the medical determination; audiometry tracker.

Requirement. The department provides health education and support on the modifiable cardiac risks (blood pressure, lipids, glucose, weight, tobacco, sleep) and makes cessation and nutrition support available (IAFF & IAFC, 2018; USFA, 2024a). (S2)

Minimum method. An annual wellness calendar: cardiac risk literacy at recruit and every three years; tobacco cessation through the employee and family assistance program or the provincial program; nutrition guidance in stations; heat-strain and hydration education before the summer season; sleep hygiene with the FRMS. The behavioural health component lives in Psychological Health and Safety and Peer Support Program.

Evidence. Calendar; attendance aggregates.

Requirement. Medical and fitness results are held by the physician, the clinic, the employee and family assistance provider or the peer fitness trainer, not by the department. The department holds only determinations, status flags and aggregate statistics (IAFF & IAFC, 2018). (S1)

Minimum method. Section 17.9 sets the rules. The physician and clinic are custodians under the applicable personal health information legislation; the department’s own records are governed by the applicable municipal access and privacy legislation (J10 Privacy and Health Information). A written information-sharing protocol names exactly what crosses the line. Fitness assessment scores stay with the trainer and the member. Program reports use cell sizes of 10 or more.

Evidence. Protocol signed by the department and the custodian; HR file audit shows no raw results.

Two things with similar names run through this program and are kept distinct. Psychological health is the member’s own mental health, protected through the 13 psychosocial factors of CAN/CSA-Z1003 (CSA Z1003-13) and the clinical pathways in Psychological Health and Safety and Peer Support Program. Psychological safety is an organizational condition: the shared belief in a crew that it is safe to speak up, ask, admit error and challenge, created by how officers behave, how meetings run and what happens to the last person who reported something (Edmondson, 1999)DOI. A medical program depends on the second to deliver the first: a member will only tell the officer about chest tightness, a sleepless week or a knee that will not take a ladder if telling is safe.

(a) Work-as-done. Before any medical, fitness, fatigue or return-to-work procedure is written or changed, the Health, Wellness and Rehab team runs a learning-team session with members who have been through it (06 Program Improvement Teams section 5): how a member actually gets to a medical on a 24-hour tour or a volunteer’s evening; what people do when a symptom shows up mid-shift; how call-backs really stack; what a member on modified duties actually does all day; what members believe happens to a result. The procedure is written from that description, not from the standard alone (Hollnagel, 2014).

(b) Capacity and margins. The work goes right most days because members pace themselves, crews watch each other, officers rotate the heavy tasks, and the body has reserve (Hollnagel, 2014). That reserve is eroded by short staffing, fatigue, heat, carrying extra weight, untreated sleep disorders, and a culture that treats rest as weakness. The program protects the margin with fitness time on duty, the fatigue limits, rehab with monitoring, and the stress test that finds the cardiac disease before the fireground does.

(c) Just culture. A member who hid a symptom, worked past the fatigue limit, or skipped a medical has usually done so because the system made that the sensible choice. The response is to find out why and fix the condition (Dekker, 2016). The learning firewall applies: what members say in learning teams, fatigue declarations, and after-action reviews is never used for discipline. Conduct concerns (reporting for duty impaired, falsifying a medical, refusing a clearance the law requires) go to a separate process run by different people under Policy - Internal Responsibility and Accountability and CSA Z1008 (CSA Z1008:21).

(d) Psychological safety. A member speaks up about fitness for a task by saying it plainly to the officer: “I am not good for interior today” or “I have had four hours’ sleep in two days.” The officer’s reply is fixed: acknowledge, reassign, and ask what the member needs. No interrogation, no comment in front of the crew, no record with a name. The officer reviews the pattern later for learning (is one station always short? is one shift always tired?). Leaders show it is safe by declaring their own fatigue, attending their own medicals on time and saying so, and reporting back to the crews what the aggregate numbers say and what changed because of a member’s concern (Edmondson, 1999DOI; Conklin, 2012).

(e) Learning link. Any cardiac event, collapse, heat illness or fatigue-related collision on duty or within 24 hours is at least a Tier 2 Post-Incident Analysis; a death is Tier 3 Independent Learning Review. A rehab transport, a fatigue declaration that was not honoured, or a member found working without clearance is a Tier 1 After-Action Review (The Human Factor, 2026a). The AAR questions after any incident where fitness or fatigue mattered: “Who was running on empty, and did anyone know?” “What made it hard to say so?” “What would have let us rest or rotate sooner?” Method: Incident Investigation and Learning Program and, for the full tiers, Manual 02 - The Three Tiers and Event Triage.

• SWP - Rehabilitation at Incidents and Training (jointly with the Rehabilitation program)
• SWP - Fit Testing (owned by the Respiratory Protection program; medical clearance is the input this program supplies)
• SWP - Infection Control and Post-Exposure (owned by the Infection Control program; immunization status is the input this program supplies)

• Form - Annual Medical and Fitness Completion Tracker
• Physician agreement and orientation record (toolkit 17.10)
• Essential job task list (toolkit 17.3), approved and dated
• Fitness-for-duty determination form (toolkit 17.2)
• Accommodation case file template (toolkit 17.5)
• Return-to-work plan (toolkit 17.6)
• Fatigue declaration record (toolkit 17.7)
• Information-sharing protocol (toolkit 17.9)
• Retention: the department’s determinations and trackers for the duration of service plus 30 years, matching the exposure record, on the US benchmark (OSHA, n.d.-a, 29 C.F.R. § 1910.1020), or longer where the applicable rules require it (J09 Records Retention); clinical records per the custodian’s own rule. See 05 Document Control and Records.

Loop test. A volunteer captain tells the program manager on Monday that three of her interior-qualified members have never had an SCBA medical clearance. By Wednesday the three are flagged on the tracker, restricted to exterior roles in the roster system, and booked for a Tier 1 medical; the captain has been told. By the end of the month the clearances are done or the restriction stands, and the quarterly update reports how many other stations had the same gap, what the fix was, and when every SCBA-qualified volunteer will be current.

Checklist: Checklist - Medical, Fitness and Wellness. Accreditation crosswalk: this program answers CPSE (2019), criteria 11B.1 (medical and fitness evaluations, a core competency), 11B.2 (fitness facilities and equipment), 11B.3 (wellness and fitness training) and 11B.6 (annual appraisal, a core competency), and supplies the cardiac assessment under criterion 11B.5; a peer assessor will ask for the appraisal and the evaluation records. The five questions an auditor asks first:

1. Show me the essential job task list the fire chief approved, and show me where the physician’s agreement says evaluations are against it.
2. Pull 10 members at random, including three volunteers: is each one’s medical current for their tier, and is each SCBA-qualified member cleared?
3. Open an HR file: does it hold a determination or a chart?
4. Show me the last accommodation case: where are the three BFOR steps and the member’s input?
5. What were last month’s overtime hours and consecutive-shift events, and who looked at them?

• Cardiac death in the 24-hour window. Overexertion and strain, nearly all cardiac, is the largest single cause of on-duty firefighter death in the US data year after year, and volunteers account for about half of those deaths (NFPA, 2026; USFA, 2025). What reduces it: annual medicals with cardiac risk stratification and stress testing, mandatory fitness, rehab with medical monitoring, management of the modifiable risks, and AEDs with early CPR on scene (USFA, 2024a). This program answers it with each of those.
• The generic “fit for work” note. A family physician who does not know the work signs a line; a Category A condition goes undetected. The physician agreement, the orientation and the essential job tasks answer it.
• Volunteers never cleared for SCBA. “They are volunteers” is not an exemption from the respiratory protection standard (CSA Z94.4-18). The volunteer tiers and the roster restriction answer it.
• Raw results in the personnel file. A privacy breach, a grievance, and a program nobody trusts. The custodian rule answers it.
• A fitness standard applied to incumbents without accommodation analysis. The leading Canadian BFOR case was itself a firefighter aerobic-standard case (British Columbia (Public Service Employee Relations Commission) v. BCGSEU, 1999). The accommodation workflow answers it.
• Unlimited overtime and stacked call-backs. Fatigue degrades decision-making the way impairment does and shows up in collisions and fireground injuries (AFAC, 2022). The FRMS answers it.
• Hearing loss discovered at retirement with no baseline. Answered in the Hearing Conservation program, which this program’s medical feeds.

Stage 1 minimum (first 12 months).

• Physician or clinic agreement signed; orientation done.
• Essential job task list approved.
• Every SCBA-qualified member, career and volunteer, medically cleared for respirator use (CSA Z94.4-18).
• Candidate medical and physical ability test in place for every new hire and every new volunteer.
• Volunteer Tier 1 entry medical for every active volunteer who has never had one.
• Fatigue limits and the self-declaration rule in policy.
• Modified-duties list and a named return-to-work coordinator.
• Information-sharing protocol signed.
• Completion tracker started.

Cost (order of magnitude; the department confirms locally).

• Physician or clinic agreement: a fixed annual retainer or a per-evaluation fee. A full annual medical with stress testing is the largest line; a Tier 1 volunteer medical is a fraction of it. Budget per operational member per year and stage the volunteer cohort over two years.
• Peer fitness trainer certification: course and exam fee per trainer, plus time; two to four trainers at Stage 1.
• Station fitness equipment: a one-time purchase per station on a standard list, then maintenance.
• AEDs: one per apparatus and station if not already present.
• Staff time: the program manager (about four hours a month plus the appraisal), the HSO’s quarterly sample, and member time for evaluations (on duty for career; credited for volunteers).

Record the department’s own figures in the Program Improvement Team’s budget worksheet (06 Program Improvement Teams section 11).

This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it.

Columns: A = career member and every interior or SCBA-qualified member (annual); B = volunteer minimum at Tier 1 (entry); C = volunteer Tier 2 (periodic). Tier 3 volunteers use column A. Source: NFPA 1580 (2025), medical evaluation chapters.

From NFPA 1580 (2025) (legacy NFPA 1582; 14 tasks). Delete tasks the department does not perform; add tasks it does.

Approved by: Fire chief (role) · Date: {{Effective date}} · JOHSC consulted: {{Date}} · Union and association consulted: {{Date}}

Built on the Wellness-Fitness Initiative fitness component (IAFF & IAFC, 2018). Results stay with the trainer and the member; the department receives aggregate counts only.

Rules. Voluntary participation in the assessment at Stage 1, mandatory at Stage 2 with the collective agreement’s and the association’s agreement; non-punitive at every stage: no result is ever a basis for discipline or removal from duty (fitness for duty is the physician’s determination under 17.2, not the trainer’s score). A member with a flagged medical condition is assessed only with the physician’s clearance. Trainers keep records in a system the department does not access. Pre-assessment screen before every assessment.

Peer fitness trainer selection. Volunteers from the membership; good standing; certification completed within 12 months of selection at department cost; one per platoon per district and one per volunteer district as the target; a lead trainer sits on the Health, Wellness and Rehab team.

1. Trigger: a determination of Fit with restrictions, Temporarily unfit, or Unfit;
   or a member's own request; or an officer's documented concern about fitness
   for a task (impairment concerns go to the CSA Z1008 process in the
   Psychological Health program; not this workflow).
2. Within 5 working days: program manager opens a case file; member told in
   writing what the determination is, what happens next, and that they may bring
   a union or association representative.
3. Step 1 (rational connection): identify the essential job task(s) at issue by
   number from 17.3 and the standard applied. If the standard is not traceable to
   a task, stop; the standard cannot be applied.
4. Step 2 (good faith): record why the standard is believed necessary for safe
   performance (the physician's opinion; the task demand data).
5. Step 3 (reasonable necessity): consider and document, in order:
   a. an individual assessment (alternative test, functional capacity evaluation,
      specialist opinion) where the standard test is not a fair measure for this
      member;
   b. modified duties or restricted assignment within the member's role;
   c. a non-SCBA or exterior role, or a support role (volunteer roster flag);
   d. a time-limited improvement plan with a re-evaluation date;
   e. any other accommodation the member proposes.
   Record the hardship analysis for any option rejected (safety of the member
   and others, cost, operational impact), with evidence.
6. Decision by the deputy chief with HR, in writing, with reasons, within 30
   working days of the determination; interim assignment stated at step 2.
7. Member may ask for a review by the fire chief; the collective agreement's
   grievance process and the human rights process are unaffected.
8. Case file: determination; steps 1 to 3; options considered and rejected with
   reasons; member's input; representative present; decision; review date.
   Held by HR, not in the operational file.
9. Closure: when the member returns to full duty, settles into an accommodated
   role, or leaves the role; reported in aggregate (count, outcome type) in the
   quarterly update.

Stay-at-work: where the member can remain at work with restrictions, the same plan is written from step 4 without a lost-time absence.

Reconcile with the provincial or territorial immunization schedule and occupational guidance for first responders (J25 Infection Control and Medical First Response). Source: NFPA 1580 (2025), infection control chapters (legacy NFPA 1581).

1. The fire department physician, clinic, employee and family assistance provider, treating practitioners and peer fitness trainers hold health information. They are the custodians under the applicable personal health information legislation (J10 Privacy and Health Information).
2. The department holds: the fitness-for-duty determination (17.2); restrictions by task number; respirator clearance status; immunization status flags; tracker dates; accommodation and return-to-work case files held by HR; aggregate statistics with cell sizes of 10 or more.
3. The department does not hold: test results, diagnoses, laboratory values, fitness assessment scores, mental-health screen results, peer support or counselling content.
4. A written information-sharing protocol between the department and each custodian names what crosses the line: (a) the determination and restrictions; (b) imminent risk to the member or others, to the extent the law permits or requires; (c) anything the member consents to in writing for a stated purpose and period.
5. Members have access to their own records from the custodian, and to their own department records within 10 working days.
6. Department records are written expecting access-to-information disclosure: roles, not names, in anything that leaves the file.
7. A breach is reported to the HSO the same day, logged in the Corrective Action Register, and handled under the municipal privacy process.

British Columbia (Public Service Employee Relations Commission) v. BCGSEU, [1999] 3 S.C.R. 3 (Supreme Court of Canada).

American Conference of Governmental Industrial Hygienists [ACGIH]. (n.d.). Threshold limit values for chemical substances and physical agents and biological exposure indices (current edition).

Occupational Safety and Health Administration [OSHA]. (n.d.-a). Access to employee exposure and medical records (29 C.F.R. § 1910.1020). U.S. Department of Labor. https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1020