Medical Standards

10 C.F.R. Part ..., Subpart B
in effectEffective: 2024-07-01

10 C.F.R. § 712.30 Applicability.

This subpart establishes standards and procedures for conducting medical assessments of DOE and DOE contractor individuals in HRP positions.

10 C.F.R. § 712.31 Purpose.

The standards and procedures set forth in this subpart are necessary for DOE to: (a) Identify the presence of any mental/personality disorders, physical, or behavioral characteristics or conditions that present or are likely to present an unacceptable impairment in reliability; (b) Facilitate the early diagnosis and treatment of disease or impairment and foster accommodation and rehabilitation; (c) Determine what functions an HRP-certified individual may be able to perform and to facilitate the proper placement of individuals; and (d) Provide for continuing monitoring of the health status of individuals to facilitate early detection and correction of adverse health effects, trends, or patterns.

10 C.F.R. § 712.32 Designated Physician.

(a) The Designated Physician must be qualified to provide professional expertise in the area of occupational medicine as it relates to the HRP. (b) The Designated Physician must: (1) Be a graduate of an accredited school of medicine or osteopathy; (2) Have a valid, unrestricted state license to practice medicine in the state where HRP medical assessments occur; (3) Have met the applicable HRP instruction requirements; and (4) Be eligible for the appropriate DOE access authorization. (c) The Designated Physician is responsible for the medical assessments of HRP candidates and HRP-certified individuals, including determining which components of the medical assessments may be performed by other qualified personnel. Although a portion of the assessment may be performed by another physician, physician's assistant, or nurse practitioner, the Designated Physician remains responsible for: (1) Supervising the evaluation process; (2) Interpreting the results of evaluations; (3) Documenting medical conditions or issues that may disqualify an individual from the HRP; (4) Providing medical assessment information to the Designated Psychologist to assist in determining psychological fitness; (5) Determining, in conjunction with DOE if appropriate, the location and date of the next required medical assessment; and (6) Signing a recommendation about the medical fitness of an individual for certification or recertification. (d) The Designated Physician must immediately report to the SOMD any of the following about himself or herself: (1) Initiation of an adverse action by any state medical licensing board or any other professional licensing board; (2) Initiation of an adverse action by any Federal regulatory board since the last designation; (3) The withdrawal of the privilege to practice by any institution; (4) Being named a defendant in any criminal proceedings (felony or misdemeanor) since the last designation; (5) Being evaluated or treated for alcohol use disorder or drug dependency or abuse since the last designation; or (6) Occurrence, since the last designation, of a physical, mental/personality disorder, or health condition that might affect his or her ability to perform professional duties.

10 C.F.R. § 712.33 Designated Psychologist.

(a) The Designated Psychologist reports to the SOMD and determines the psychological fitness of an individual to participate in the HRP. The results of this evaluation may be provided only to the Designated Physician or the SOMD. (b) The Designated Psychologist must: (1) Hold a doctoral degree from a clinical psychology program that includes a one-year clinical internship approved by the American Psychological Association or an equivalent program; (2) Have accumulated a minimum of three years postdoctoral clinical experience with a major emphasis in psychological assessment and testing; (3) Have a valid, unrestricted state license to practice clinical psychology in the state where HRP medical assessments occur; (4) Have met the applicable HRP instruction requirements; and (5) Be eligible for the appropriate DOE access authorization. (c) The Designated Psychologist is responsible for all psychological evaluations of HRP candidates, HRP-certified individuals, and others as directed by the SOMD. Although a portion of the psychological evaluation may be performed by another psychologist, the Designated Psychologist must: (1) Supervise the psychological evaluation process and designate which components may be performed by other qualified personnel; (2) Upon request of management, assess the psychological fitness of HRP candidates and HRP-certified individuals for HRP duties, including specific work settings, and recommend referrals as indicated; and (3) Make referrals for psychiatric, psychological, substance abuse, or personal or family problems, and monitor the progress of individuals so referred. (d) The Designated Psychologist must immediately report to the SOMD any of the following about himself or herself: (1) Initiation of an adverse action by any state medical licensing board or any other professional licensing board; (2) Initiation of an adverse action by any Federal regulatory board since the last designation; (3) The withdrawal of the privilege to practice by any institution; (4) Being named a defendant in any criminal proceeding (felony or misdemeanor) since the last designation; (5) Being evaluated or treated for alcohol use disorder or drug dependency or abuse since the last designation; or (6) Occurrence since the last designation of a physical, mental/personality disorder, or health condition that might affect his or her ability to perform professional duties.

10 C.F.R. § 712.34 Site Occupational Medical Director.

(a) The SOMD must nominate a physician to serve as the Designated Physician and a clinical psychologist to serve as the Designated Psychologist. The nominations must be sent through the Manager to the Director, Office of Environment, Health, Safety and Security or his or her designee. Each nomination must describe the nominee's relevant training, experience, and licensure, and include a curriculum vitae and a copy of the nominee's current state or district license. (b) The SOMD must submit a renomination report biennially through the Manager to the Director, Office of Environment, Health, Safety and Security or his or her designee. This report must be submitted at least 60 days before the second anniversary of the initial designation or of the last redesignation, whichever applies. The report must include: (1) A statement evaluating the performance of the Designated Physician and Designated Psychologist during the previous designation period; and (2) A copy of the valid, unrestricted state or district license of the Designated Physician and Designated Psychologist. (c) The SOMD must submit, annually, to the Director, Office of Environment, Health, Safety and Security or his or her designee through the Manager, a written report summarizing HRP medical activity during the previous year. The SOMD must comply with any DOE directives specifying the form or contents of the annual report. (d) The SOMD must investigate any reports of performance issues regarding a Designated Physician or Designated Psychologist, and the SOMD may suspend either official from HRP-related duties. If the SOMD suspends either official, the SOMD must notify the Director, Office of Environment, Health, Safety and Security or his or her designee and provide supporting documentation and reasons for the action.

10 C.F.R. § 712.35 Director, Office of Environment, Health, Safety and Security.

The Director, Office of Environment, Health, Safety and Security or his or her designee must: (a) Develop policies, standards, and guidance for the medical aspects of the HRP, including the psychological testing inventory to be used; (b) Review the qualifications of Designated Physicians and Designated Psychologists, and concur or nonconcur with their designations by sending a statement to the Manager and an informational copy to the SOMD; and (c) Provide technical assistance on medical aspects of the HRP to all DOE elements and DOE contractors.

10 C.F.R. § 712.36 Medical assessment process.

(a) The Designated Physician, under the supervision of the SOMD, is responsible for the medical assessment of HRP candidates and HRP-certified individuals. In carrying out this responsibility, the Designated Physician or the SOMD must integrate the medical evaluations, psychological evaluations, psychiatric evaluations, and any other relevant information to determine an individual's overall medical qualification for assigned duties. (b) Employers must provide a job task analysis for those individuals involved in HRP duties to both the Designated Physician and the Designated Psychologist before each medical assessment and psychological evaluation. HRP medical assessments and psychological evaluations may not be performed if a job task analysis has not been provided. (c) The medical process by the Designated Physician includes: (1) Medical assessments for initial certification, annual recertification, and evaluations for reinstatement following temporary removal from the HRP; (2) Evaluations resulting from self-referrals and referrals by management; (3) Routine medical contacts and occupational and nonoccupational health counseling sessions; and (4) Review of current legal drug use. (d) Psychological evaluations must be conducted: (1) For initial certification. This psychological evaluation consists of a generally accepted psychological assessment (test) approved by the Director, Office of Environment, Health, Safety and Security or his or her designee and a semi-structured interview. (2) For recertification. This psychological evaluation consists of a semi-structured interview, which is conducted annually at the time of the medical examination. (3) Every third year. The medical assessment for recertification must include a generally accepted psychological assessment (test) approved by the Director, Office of Environment, Health, Safety and Security or his or her designee. (4) When the SOMD determines that additional psychological or psychiatric evaluations are required to resolve HRP concerns as listed in § 712.13(c). (e) Following absences requiring return-to-work evaluations under applicable DOE directives, the Designated Physician, the Designated Psychologist, or the SOMD must determine whether a psychological evaluation is necessary. (f) Except as provided in paragraph (g) of this section, the Designated Physician must forward the completed medical assessment of an HRP candidate and HRP-certified individual to the SOMD, who must make a recommendation, based on the assessment, to the individual's HRP management official. If the Designated Physician determines that a currently certified individual no longer meets the HRP requirements, the Designated Physician must immediately, orally, inform the HRP management official. A written explanation must follow within 24 hours. (g) The Designated Physician, the Designated Psychologist, or the SOMD may make a medical recommendation for return to work and work accommodations for HRP-certified individuals. (h) The following documentation is required after treatment of an individual for any disqualifying condition: (1) A summary of the diagnosis, treatment, current status, and prognosis to be furnished by the treatment provider to the Designated Physician; (2) The medical opinion of the Designated Physician advising the individual's supervisor whether the individual is able to return to work in either an HRP or non-HRP capacity; and (3) Any periodic monitoring plan, approved by the Designated Physician or the Designated Psychologist and the SOMD, used to evaluate the reliability of the individual.

10 C.F.R. § 712.37 Evaluation for hallucinogen use.

If DOE determines that an HRP candidate or HRP-certified individual has used any hallucinogen, the individual is not eligible for certification or recertification unless: (a) Five years have passed since the last use of the hallucinogen; (b) There is no evidence of any flashback within the last five years from the previous hallucinogen use; and (c) The individual has a record of acceptable job performance and observed behavior.

10 C.F.R. § 712.38 Maintenance of medical records.

(a) The medical records of HRP candidates and HRP-certified individuals must be maintained in accordance with the Privacy Act, 5 U.S.C. 552a, and DOE implementing regulations in 10 CFR part 1008; the Department of Labor's regulations on access to individual exposure and medical records, 29 CFR 1910.1020; and applicable DOE directives. DOE contractors also may be subject to section 503 of the Rehabilitation Act, 29 U.S.C. 793, and its implementing rules, including confidentiality provisions in 41 CFR 60-741.23 (d). (b) The psychological record of HRP candidates and HRP-certified individuals is a component of the medical record. The psychological record must: (1) Contain any clinical reports, test protocols and data, notes of individual contacts and correspondence, and other information pertaining to an individual's contact with a psychologist; (2) Be stored in a secure location in the custody of the Designated Psychologist; and (3) Be kept separate from other medical record documents, with access limited to the SOMD and the Designated Physician.

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