Form 1429-A Employer Statement of Support for Waiver Request

NATIONAL SCIENCE FOUNDATION
4201 WILSON BOULEVARD
ARLINGTON, VIRGINIA 22230

OFFICE OF POLAR PROGRAMS
The National Science Foundation’s Office of Polar Programs requires all applicants for travel to Antarctica under the auspices
of the United States Antarctic Program to provide a complete medical history and take a comprehensive physical examination.
Those individuals wintering over in Antarctica, will also be required to take a comprehensive psychological examination.
The medical staff at Raytheon Polar Services Company notifies, in writing, all individuals who do not meet the medical
standards for Antarctic deployment that they are not physically qualified. Concurrently, the individuals are informed that an
administrative waiver process exists. This process allows individuals, who believe they can demonstrate an ability to work in
the harsh Antarctic environment in spite of their medical conditions, an opportunity to make a request for consideration on a
case-by-case basis for an exception to the standards.
The waiver process is administered by the National Science Foundation’s Office of Polar Programs. You may direct your
inquiries to Ms. Gwendolyn M. Adams at 703-292-7438 or you may send a fax to 703-292-9001. You may also contact
Ms. Adams via email at [email protected].
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EMPLOYER STATEMENT OF SUPPORT FOR WAIVER REQUEST
On behalf of the National Science Foundation, Raytheon Polar Services Company notified _______________ that he/she does
not meet the USAP medical standards for Antarctic deployment. _______________________informed me of his/her medical
condition and the reason for the disqualification. He/She also informed me that the National Science Foundation will only
consider an administrative waiver if the applicant obtains the employing organization‘s support.
____________________________ and I discussed Antarctica’s extreme climate and remoteness. We also discussed the NSF’s
determination that if _____________________ deploys to Antarctica he/she is placing him/herself at a higher risk than those
individuals who meet the medical standards. The National Science Foundation informed us that there is limited medical care
available at the three primary stations and that this care is equivalent to what we might receive from an ambulatory care facility
in the United States. However, those working in remote areas, such as, the Dry Valleys, must be transported by helicopter to
the nearest primary station for medial care. If ___________________ requires any sophisticated diagnostic procedures or
treatment, they would not be available in Antarctica. We both understand that medical evacuations are extremely costly and
require a great deal of logistic coordination which will take hours and sometimes days or longer, depending on the weather to
accomplish. We recognize that all the concerns mentioned above make it necessary for NSF to impose stringent medical and
dental criteria for “fitness for Antarctic duty” determinations. We further discussed the potential impacts that this deployment
may have on our organization. For example, there may be a potential impact on the employee’s ability to perform his or her job
while in Antarctica. This issue affects both the individual and the Organization. We acknowledge NSF’s determination that
the employing organization must endorse all requests for waivers before consideration is given. Finally, both
______________________ and I recognize that the NSF’s approval of waiver requests in no way suggests that the medical
problem does not exist; but, rather indicates a recognition that the individual may be able to perform his or her duties, despite
the limitations of the medical condition, at a level of acceptable risk.
This organization understands that if the National Science Foundation has to evacuate _______________ to a tertiary care
facility outside of Antarctica, the NSF shall incur no additional expense beyond that required to evacuate the individual to that
facility. As an authorized representative of the Organization and on its behalf, I acknowledge the potential increased risk to
_______________________ of deploying to Antarctica with his/her medical condition and I support his/her request for an
administrative waiver from the National Science Foundation.

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NSF Form 1429-A (APR 2002)
Page 1 of 1
OMB CONTROL NUMBER 3145-0177: Expires SEP 2010

Original: Submitted with packet

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