INCAPACITATION PAY AND ALLOWANCES BENEFITS PROGRAM
After several years of working with and talking with a several hundred Warriors pertaining to Incapacitation Pay and Allowances, it’s hard to determine just what and how much information to place on this site for your review and utilization. As you have already determined that there is so much information out there and depending on who you talk to you may or may not get the information that you need…
So I have decided to make it as simple as I can and at the same time, providing some critical narrative information taken from the references as listed below.
I will also have to say that I find it embarrassing and upsetting as a retired Lieutenant Colonel and a past commander to find out what the current Commands all across the US Military are doing, or should I say, “Failing To Do” for you, our “Wounded Warriors”. Especially when you, our military’s most important asset, become incapacitated in the line of duty and are no longer able to perform and or function in either your military and or civilian occupations. Fortunately there are laws written, directives and instructions written, and regulations written throughout the US military command structure specifically to deal with these situations and for this purpose. All Commanders are suppose to know the Laws, the directives, the instructions, and the regulations that administer and implement the programs for Incapacitation Pay and Allowances benefits at the onset. Why they turn their heads, prolong the initial admin processing, etc., etc., is beyond me. I cannot answer for their actions and lack thereof. What I can tell you is this… they are in violation of the 37 USC Laws, DoD Directives and Instructions, and military regulations by failing to act accordingly. Bottom-Line, they are in “Violation of the US Manual for Military Courts Martial, and the UCMJ. Can they be held accountable? You Bet!
You have a part to do as well. And that is:
1st – I ask that you do your part by following and adhering to each and every policy and procedure that you are required to perform.
2nd – I ask you to start a personal journal, if you haven’t already done so, to record each and every action and encounter you have during your disability process(s). This means the submission of paperwork and documentation, telephone calls, emails, medical appointments, in-person meetings/conversations etc., etc., etc. This journal will become your reference resource document in which you can refer back to it. Include items such as:
* Your 1st entry should be the date and circumstances about your injury etc., etc .
* Initial medical treatment and follow-up etc., etc.
* Who you contacted at the unit and when. This is the date/time frame that you admin process should be documented at the unit and an LODI (Line of Duty Investigation) started. Also note when the LOD actually started/completed. NOTE: In most cases an informal LOD is done on the same day since all information is usually known and can be verified. Do Not Let This Go On For a Week or More! A “Formal may be necessary later and this will take more time.
* Date determined that you were not able to work in any capacity. This is the date that the admin process for INCAP Pay should be imitated.
* Contact, in person, your unit when it is determined that you are incapacitated and unable to work etc., etc.. Ensure you provide and have copies of all required documentation. Also make sure you include all names and contacts that you discussed the situation with.
* Annotate the time it takes for your unit do initiate the INCAP Pay process and all follow-up from your unit and higher command. This will reflect Command “Failing” to process an Line of Duty Investigation (LODI) in a timely manner as per regulations.
* Whatever else you feel is appropriate but it must be consistence and continuance by date.
So I ask that before you call and ask for my help and assistance, please read and become familiar with the appropriate references pertaining to your branch of service and the INCAP process. Then call me and we will have a much better conversation and starting point to work from.
To sum this up… I feel confident that this information will provide you with the knowledge and ammunition you need to get the pay and allowances that you are entitled to. You’ll need to know this information and how it applies to you since you will be referencing it to your commands for your benefits and allowances.
The information and references below are for your review and utilization as appropriate. Read it. Use it. Highlight the information you feel is important as well as cross-referencing the references so you can refer back as needed.
INCAPACITATION PAY AND ALLOWANCES INTRODUCTION.
The information below is provided for your review and utilization as it pertains to the military’s Incapacitation Pay and Allowances Benefits Programs. The information is a summary taken from the all the numerous references mandating and directing the policies and procedures for implementing the Incapacitation Pay and Allowances Benefits Program as allowed under the law for all military branch of services.
THE BASIS FOR INCAP PAY AND ALLOWANCES.
A. The basis for Incapacitation Pay and Allowances benefits comes from Public Law and is stated in the 37 United States Code (USC). Specifically as stated in Chapter 3, section 204 and section 206.
B. Supplemented by the Department of Defense Directive (DoDD) 1241.01, the Department of Defense Instructions (DoDI) 1241.02, directing the Army, Navy, Air Force, Marine, and Coast Guard to develop and implement programs, policies, and procedures as required under current law.
PITFALL AND MISUNDERSTANDING TO INCAP.
A major “PITFALL” that a lot of our Reserve Component (RC) service members (SMs) get caught up in and can cause some “MAJOR” trouble areas for receiving the benefits and care deserved are from not doing and or be ill-advised pertaining to the following:
A. FOR SERVICE MEMBERS (SMS) ON ACTIVE DUTY (AD) ORDERS 30 DAYS OR LESS…..
may with the soldier’s consent be continued on AD orders while being treated for, or recovering from, an injury, illness, or disease incurred or aggravated in the line of duty (ILOD). This also applies to those on orders over 30 days.
B. FOR SERVICE MEMBERS (SMs) ON ACTIVE DUTY (AD) ORDERS 30 days or less may not have orders terminated due to incapacitation alone.
BUT may become entitled to incapacitation pay upon the end of their orders If Qualified. Same applies to those on orders over 30 days.
* SPECIAL NOTES: IF you are injured, ill, and or have a disease incurred with on AD status, I recommend that you “Choose” to stay on AD orders if at all possible until such time that you know what your medical status (your diagnosis) and treatment care-plan is and or will be. You need to know what your options are for care are and or will be (short term and long term). You need to ensure that any and all paperwork (medical records, LODI, request for either INCAP pay or WTU orders) is completed, submitted, and processed with approved “PRIOR” to making any decisions to come off AD. IAW with the law, directives, and regulations, command/commanders and or their representatives cannot and should not talk you into, coheres you, nor attempt to force you to come off AD orders regardless of their reason(s) or reasoning. This can work against you if you do. In other words… “Do Not Let Them Sweet-talk you, Pressure You, Intimidate You, and or Coheres You.” This is a violation(s) of the law under the Military Manual for Court-Martial of the United States (MCM) and the Uniform Codes Military Justice (UCMJ) and may be punishable under the same as applicable. Think the big picture before you act!
THE PURPOSE OF INCAPACITATION PAY AND ALLOWANCES BENEFITS.
A. THE PURPOSE FOR INCAP PAY
is to compensate, to the extent permitted by law, members of the Reserve Component services (RC/NG) who are unable to perform military duties and or who demonstrate a loss in civilian earned income as a result of an injury, illness, or disease incurred or aggravated in the line of duty and to provide the required medical and dental care associated with the incapacitation.
B. THE PRIMARY RESOURCE DOCUMENTS THAT MANDATE AND AUTHORIZE PAYMENT OF BENEFITS UNDER INCAPACITATION PAY AND ALLOWANCES COME FROM.
1. The basis for Incapacitation Pay and Allowances benefits comes from Public Law and is stated in the 37 United States Code (USC). Specifically as stated in Chapter 3, section 204 and section 206.
2. Supplemented by the Department of Defense Directive (DoDD) 1241.01, the Department of Defense Instructions (DoDI) 1241.02, directing the Army, Navy, Air Force, Marine, and Coast Guard to develop and implement programs, policies, and procedures as required under current law.
3. Military Branch of Service regulations and references are listed below along with their reference source documents. Please refer to the appropriate references for it will make it easier to understand the ins and outs that all have to follow and adhere to. Cross-reference as appropriate.
USC: 10 USC 688; 10 USC 1074; 10 USC 1074(a); 10 USC 12301(a); 10 USC 12302; 10 USC 12322; 10 USC 12404; 10 USC 12406; 37 USC 204; 37 USC 404(g); 37 U.S.C. 204(h); 37 U.S.C. 204(j); 37 USC 206; 18 U.S.C. 1001
DOD: DoDD 1241.01; DoDI 1241.02; DoDI 1332.38; DoDD1332.18; DoD 7000.14R, Vol 7A (e thru g)
USA: AR 135-381; AR 40-501; AR 600-8-4; DA PAM 135-381; NGB (AR) 135-381; NGB-ARP, Memo, ARNG INCAP Pay Sub-Module – Implementation; MEDCHART LOD Website Log-in
USN/MC/CG: All States Log Letter D94-00; SECNAVINST 1770.3D; SECNAVINST 1850.4E; SECNAVINST 5216.5D; JAGINST 5800.7 Series; UNDERSECDEF MEMO, 6 Apr 2009; MANMED, P-117; MANMED, Chapter 18; BUPERINST 1001.39; MILPERSMAN 1050-180; USN INCAPACITATION PROGRAM DESKTOP GUIDE LINE OF DUTY (LOD);
(* USN NOTE 1): Refer to PERS-95 for the most current updates via the site below at: http://www.npc.navy.mil/CareerInfo/ReservePersonnelManagement/Medical.
(* USN NOTE 2): Routinely check this website for updates. Any policy or program changes can be found at: http://www.public.navy.mil/BUPERS-NPC/CAREER/RESERVEPERSONNELMGMT/Pages/MEDHOLDLODPhysicalRiskPrograms.aspx
USAF: ANGI 36-3001; AFI 36-2910; AFI 41-101; DFAS DA 117-373V3
*For Determination of pay as per DoDFMR 7000.14R, Vol 7a all services
D. WHO IS ELIGILBE/ENTITLED TO INCAPACITATION PAY AND ALLOWANCES BENEFITS PROGRAM?
The Status of the RC/NG Service Member (SM) at the time of injury, illness, or disease is critical in determining entitlement to medical, dental, disability, and hospitalization benefits, and incapacitation compensation. This is a “KEY” criteria for determining and receiving INCAP benefits. An LODI (Line of Duty Investigation) is mandatory and will determine your status.
1. The requirement to have been injured, become ill “while so employed” in a military status is a critical element that must be met in order to qualify for entitlements. The term “while so employed” means that a SM (service member) has not yet been released from military control and duty. EXAMPLE for not meeting the “employment” requirement: A Service Member is released from duty early, but his or her orders are not yet terminated. He or she is injured after returning home. In this example, even though the Service Member is entitled to receive pay for the full day of the release, the Service Member reverts to civilian status the instant he or she is released from military control (where no travel is involved). Therefore, the Service Member is then no longer entitled to the benefits as described under INCAP Pay and Allowances.
2. Service Members released from IDT for “UNSATISFACTORY” participation are not authorized medical coverage or dental treatment at government expense. Determinations will be made case by case by an incapacitation review board per regulations, if necessary.
3. Any member of the Reserve Components incurring or aggravating any injury, illness, or disease in the line of duty is entitled to medical and dental care, incapacitation pay, and travel and transportation incident to medical and/or dental care, in accordance with (IAW) 37 USC 204 and 37 USC 206. * NOTE: Additional support references are: 10 USC 688, 1074a, 12301(a), 12302, 12404, 12406; DoDD 1241.01, and DoDI 1241.02; in conjunction with (ICW) your appropriate branch of service policies, procedures and regulation).
E. WHAT IS COVERED UNDER THE INCAPACITATION PAY AND ALLOWANCES BENEFITS PROGRAM?
A SM incapacitated in the line of duty (ILOD) is entitled to medical and dental treatment in an MTF (Military Treatment Facility) or other authorized government treatment facility for the in-the-line-of-duty condition until qualified for return to military duty. If the resulting incapacitation cannot be materially improved by further hospitalization or treatment, the case will be processed and finalized through the DES/IDES (Disability Evaluation System/Integrated Disability Evaluation System) when eligible for disability processing. Procedures governing physical disability evaluation are provided in DoDI 1332.38 and Department of Defense Directive (DODD) 1332.18.
1. A SM on a call or order to AD (active duty) specifying a period of 30 days or less who incurs or aggravates an injury, illness, or disease will not have orders terminated solely because of the injury, illness, or disease, unless requested by the member. Upon release from active duty, the member is entitled to INCAP pay and allowance benefits as specified under current regulations etc., etc.
2. A SM able to perform military duties but demonstrating a loss of earned income as a result of an in-the-line-of-duty incapacitation will be compensated for lost earned civilian income. The compensation under this provision will be the lesser of the amount of demonstrated lost civilian income in the amount not to exceed military pay and allowances for which the member would be entitled if serving on active duty. Members will be compensated for loss of earned civilian income in accordance with 37 USC 204(h) and DoD 7000.14–R, Volume 7A, table 57–3.
F. WHO IS RESPONSIBLE FOR THE INCAPACITATION PAY AND ALLOWANCES BENEFITS PROGRAM?
* NOTE: Bottom-Line it is the SM who is ultimately responsible. The SM “MUST” notify the unit and their commander about their personal injury, illness, and or disease. Why? Your duty status change can potentially affect the unit’s status. It also initiates the need and requirement for an “Initial ILODI (Informal Line of Duty Investigation). A “Formal LOD may be required later. NOTE: Make sure you/they do this! Obtain a personal copy and retain it for your records.
1. The unit commander as well as all levels of command are responsibility to ensure all directives, policies, procedures, and regulations are followed and carried out to the letter of the law! Command has the ultimate responsibility to correctly and timely process any and all requests and or requirements for INCAP Pay.
2. Command must ensure the following:
(a) To initiate and complete an LODI expeditiously as per the regulations on an injury or illness likely to result in a claim against the Government for health care, compensation, or disability benefits. As per regulations the LODI must be initiated within 7 days. (See reference: 37 USC 204(g), 204(h), DoDD 1242.01, and DoDI 1242.02)
(b) To initiate and collect all documentation required for the submission of an INCAP Pay request. * NOTE: You as the SM must assist in providing this information in a timely manner as well.
(c) To ensure that the SM is receiving prompt and appropriate medical treatment as per the regulations.
(d) To ensure that prompt action is taken/initiated to process INCAP pay and allowances. * NOTE: These responsibilities are clearly defined and mandated in 37 USC 204(g), 204(h), DoDD 1242.01, and DoDI 1242.02. Your branch of service regulations must follow and adhere to these mandates, directives and instructions especially as it pertains to the criteria for time-lines for initial processing as well as ensuring INCAP benefits continuance as required.
(e) To monitor, verify and validate that all documentation is received and processed for the approval of INCAP Pay and allowances. * NOTE: Initial pay for a Soldier who has suffered an injury, illness, or disease that prevents the Soldier from performing military or civilian duties will be paid within 30 calendar days of notification of the injury, illness, or disease provided the Soldier has submitted the documentation as specified as per regulations.
(f) To ensure INCAP pay and allowances are continued for entitled Reserve Component SMs without interruption due to administrative error(s) as mandated in DoDD 1242.01, and DoDI 1242.02.
* NOTE 3: Initial pay for a Soldier who has suffered an injury, illness, or disease that prevents the Soldier from performing military or civilian duties will be paid within 30 calendar days of initial notification of the injury, illness, or disease provided the Soldier has submitted the documentation as specified as per regulations.
3. As mandated under 37 USC 204, DoDD 1242.01, and DoDI 1242.02, Commanders at “All” levels are mandated to:
(a) To Develop and Implement unit policies, procedures for INCAP pay and allowance processing.
(b) To “Provide” periodic briefings on entitlements to all assigned/attached SMs. Especially prior to annual training (AT), an FTXs (Field Training Exercises), and a mobilization and or deployment.