Authority: IC 5-10.5-4-2; IC 36-8-8-5; IC 36-8-8-19

Affected: IC 36-8-8-7

Sec. 4. (a) The first component of the baseline statewide physical examination consists of a comprehensive general medical history. The comprehensive general medical history shall cover the applicant's known health problems, such as major illnesses, surgeries, medication use, and allergies. Symptom review is also important for detecting early signs of disqualifying conditions and excludable conditions. The comprehensive general medical history shall include the following:

1. (1) A personal health history.
2. (2) A family health history.
3. (3) An immunization history.
4. (4) A reproductive history.

An occupational history shall also be completed to collect information about the person's past occupational and environmental exposures.

(b) After the examining physician completes the comprehensive medical history, the physician shall conduct a general physical examination of the candidate. Requirements for the baseline statewide physical examination shall be as follows:

1. (1) The baseline statewide physical examination is intended to test the following organ systems:

   1. (A) Dermatological system.
   2. (B) Ears, eyes, nose, mouth, and throat.
   3. (C) Cardiovascular system.
   4. (D) Respiratory system.
   5. (E) Gastrointestinal system.
   6. (F) Genitourinary system.
   7. (G) Endocrine and metabolic systems.
   8. (H) Musculoskeletal system.

2. (2) The baseline statewide physical examination shall include the following tests:

   1. (A) Vital signs, such as pulse, respiration, blood pressure, and, if indicated, temperature.
   2. (B) Visual testing, using a Snellen chart or other comparable chart. Vision testing shall also include field of vision testing and color vision testing.
   3. (C) Audiometric testing. (An audiogram should be performed in a soundproof booth pursuant to the American National Standards Institute (ANSI) standard S3.1-1991 with equipment calibrated to ANSI standard S3.6-1989). If a booth is unavailable, the test room sound pressure levels should not exceed those specified in 29 CFR 1910.95 (July 1, 1992 edition).
   4. (D) Pulmonary function testing. Only a spirogram that is technically acceptable and demonstrates the best efforts by an individual should be used to calculate the forced vital capacity (FVC) and forced expiratory volume in one (1) second (FEVI).
   5. (E) Quantiferon test (TB blood test).

   6. (F) Laboratory testing must include the following:

      1. (i) Baseline blood testing, including complete blood count (CBC) and HIV testing.
      2. (ii) Biochemical test battery (SMA), including, at a minimum, liver function tests (bilirubin, direct & indirect, SGOT, SGPT, GGT), fasting blood glucose, electrolytes, BUN, creatinine, fasting serum lipids, and test for syphilis.
      3. (iii) Routine urinalysis to detect specific illnesses.
      4. (iv) Drug abuse testing.
      5. (v) Alcohol abuse testing, if indicated.
   7. Additional laboratory testing should be conducted as indicated.
   8. (G) Chest x-ray. Posterior-anterior (PA) and lateral views required; spine x-rays and other diagnostic imaging, if indicated.
   9. (H) Twelve (12) lead electrocardiogram (resting) test.
   10. (I) Treadmill cardiac stress test.
   11. (J) Each candidate must complete a respirator clearance questionnaire.
   12. (K) Submax (Bruce protocol) treadmill evaluation.
   13. (L) Functional movement screening or orthopedic screening, or both.

(c) The local board shall determine the standards for passage of the baseline statewide mental examination. The local board may designate a community health center, a hospital, a licensed physician, or a licensed psychologist to administer the baseline statewide mental examination required under IC 36-8-8-7 and IC 36-8-8-19. The examining physician must have no pre-existing personal relationship with the applicant. The baseline mental examination shall consist of the Minnesota Multiphasic Personality Inventory III. The results of the baseline statewide mental examination shall be interpreted by a licensed physician or a licensed psychologist.

(Board of Trustees of the Indiana Public Retirement System; 35 IAC 2-9-4; filed May 27, 1993, 12:00 p.m.: 16 IR 2339, eff Jul 1, 1993; filed May 7, 1998, 4:15 p.m.: 21 IR 3332; readopted filed Oct 31, 2001, 2:21 p.m.: 25 IR 898; adopted Nov 9, 2007: 20071205-IR-035070818ONA; adopted Feb 19, 2010: 20100310-IR-035100124ONA; adopted May 7, 2021: 20210519-IR-035210173ONA)