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The tentative agreement between freight rail carriers and two major unions that averted a potentially costly strike last week will allow workers to miss work for routine medical appointments up to three times a year without disciplinary consequences, according to a copy of the deal circulated by one of the unions.

The two unions had moved to the brink of a strike because of frustrations over what workers said were unrelenting and unpredictable schedules that left them exhausted and made it difficult to attend to personal matters like doctor’s visits.

Some of the nation’s large rail carriers have attendance policies that penalize workers for missing work for such reasons, and easing these rules was a top priority for the unions.

Shortly after the announcement of the agreement last week, the two unions said they had tentatively resolved the time-off issue. “For the first time ever, the agreement provides our members with the ability to take time away from work to attend routine and preventative medical,” the unions said in a statement. But neither union had revealed the details of the agreement until one of them, SMART Transportation Division, did so in recent days.

Together, SMART Transportation Division and the other union, the Brotherhood of Locomotive Engineers and Trainmen, represent about half of the more than 100,000 freight rail workers covered by the negotiations.

The document circulated by the union said the time off for routine medical visits, in addition to being limited to three instances per year, could be taken only on Tuesdays, Wednesdays or Thursdays and must be scheduled at least 30 days in advance. A single instance may last more than one day, however, if the worker needs time to prepare for or recover from the appointment. In addition, workers won’t face a penalty for time spent in the hospital.

The tentative agreement could also lead to changes in the protocol for assigning trips, a move the rail carriers had been seeking. Currently, when conductors and engineers return home from a trip, they fall to the bottom of a list of available crews before working their way up again. If someone ahead of them calls in sick, a worker from a group of substitutes, known as an extra board, can step in so that the other conductors and engineers on the regular list can maintain roughly the same time off between trips. (Workers say cuts to the extra board in recent years have made their schedules more variable.)

Under the pending terms of the contract, the rail carrier could end up relying far less on substitute workers from the extra board. Instead, through a system called a self-supporting pool, engineers and conductors would move up the list more quickly when someone ahead of them is out sick.

The agreement appears to give the unions some say on implementing self-supporting pools, but a spokesman for SMART Transportation Division did not respond to a request for comment on the issue.

The unions have said they will submit the tentative agreement to their members for a ratification vote over the next several weeks. The results will probably be announced after the midterm elections in November, though another rail workers union, the International Association of Machinists and Aerospace Workers District 19, could authorize a work stoppage next week if it doesn’t reach an agreement with rail carriers.

The machinists union said in a statement on Thursday that it continued to negotiate with the industry and that the rail carriers had been “somewhat receptive to making some needed changes” to an earlier agreement. That agreement was voted down in mid-September by the union’s membership, which includes mechanics and maintenance workers.

It is unclear whether members of the conductors and engineers unions will be satisfied with the proposal presented to them, which some rail workers criticized on social media on Thursday.

A representative of the locomotive engineers union said by email, “Any discussion on what members think and how they would vote is still premature,” noting that a three- or four-week question-and-answer process will provide additional clarification from the carriers before members are asked to vote.

Michael Paul Lindsey, a member of the locomotive engineers union based in Idaho, said in an interview that he was very disappointed with the details of the proposal.

Mr. Lindsey said the time-off provision for routine medical appointments was unsatisfactory because workers often did not know 30 days in advance if they needed to see a doctor. He also said the union was typically able to undo any discipline that workers had received as a result of having taken time off for medical reasons, so the proposed terms would not have a major practical effect.

(Dennis Pierce, the president of the locomotive engineers union, made a similar point in an interview last week.)

Mr. Lindsey also said a shift to self-supporting pools would formalize the unpredictability in scheduling that had been exhausting workers amid staffing shortages over the past few years — the source of the frustration that had brought unions close to striking.