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AR 635-40 Disability Evaluation for Retention, Retirement, or Separation (19 Jan 2017)

AR 635-40 Disability Evaluation for Retention, Retirement, or Separation (19 Jan 2017) (626 KB)

Comments: To view or download the complete regulation, click on the link to it in the box above these comments.

Chapter 4
Section III
Medical Processing Related to Disability Evaluation

4-9. Medical examination

The MTF commander having primary medical care responsibility will conduct an examination of a Soldier referred for evaluation. The commander will advise the Soldier's commanding officer of the results of the evaluation and the proposed disposition. If it appears the Soldier is not medically qualified to perform duty, the MTF commander will refer the Soldier to a MEBD.

Comments: "MTF" is Medical Treatment Facility ."MEBD" is Medical Evaluation Board, also referred to as "MEB".

4-10. The medical evaluation board

The MEB are convened to document a Soldier's medical status and duty limitations insofar as duty is affected by the Soldier's status. A decision is made as to the Soldier's medical qualification for retention based on the criteria in AR 40-501, chapter 3. If the MEBD determines the Soldier does not meet retention standards, the board will recommend referral of the Soldier to a PEB.  For  MEB’s  rules  for  documentation,  recommendations,  and  disposition  of  the
evaluated  Soldier,  see  AR  40–400,  chapter  7.

Comments: "PEB" is Physical Evaluation Board.

4-12. Counseling Soldiers who have been evaluated by a medical evaluation board

a. The PEBLO will advise the Soldier of the results of the MEBD. The Soldier will be given the opportunity to read and sign the MEB proceedings. If the Soldier does not agree with any item in the medical board report or NARSUM, he or she will be advised of appeal procedures.

Comments: "PEBLO" is Physical Evaluation Board Liaison officer.  "NARSUM" is the The Narrative Summary of the Soldier's condition.

b. The decisions below are exclusively within the province of adjudicative bodies. Neither the PEBLO nor the attending medical personnel will tell the Soldier that

(1) The Soldier is medically or physically unfit for further military service.

(2) The Soldier will be discharged or retired from the Army because of physical disability.

(3) A given percentage rating appears proper.

(4) A LD decision is final (unless final approval has been obtained according to AR 600-8-4).

Comments: "LD" is Line of Duty; an "LD decision" is a decision as to whether the Soldier's condition was incurred in the Line of Duty.

4-13. Referral to a physical evaluation board

a. The MEBD will recommend referral to a PEB those Soldiers who do not meet medical retention standards. Those who apply for COAD under the provisions of chapter 6 will be included. Do not refer Soldiers to a PEB who request discharge under the provisions of chapter 5. A Soldier being processed for nondisability separation will not be referred to a PEB unless the Soldier has medical impairments that raise substantial doubt as to his or her ability to continue to perform the duties of his or her office, grade, rank, or rating. Soldiers previously found unfit and retained in limited assignment duty status under chapter 6, or a previous authority, will be referred to a PEB.

Comments: "COAD" is continuation on active duty.

b. A Soldier may provide additional information to the MTF commander to forward to the PEB. The information may be from the unit commander, supervisor, or other persons who have knowledge regarding the effect the condition has on the Soldier's ability to perform the duties of the office, grade, rank, or rating.

AR 40-501 Standards of Medical Fitness (14 June 2017)

AR 40-501 Standards of Medical Fitness (1.5 MB)

Comments: To view or download the complete regulation, click on the link to it in the box above these comments.

Chapter 2
Physical Standards for Enlistment, Appointment, and Induction


Chapter 3
Medical Fitness Standards for Retention and Separation, Including Retirement

Comments: This is from the Table of Contents of this 139-page document. Chapter 3 describes the conditions that may qualify a Soldier for a discharge for Disability. To see the detailed description of each condition, click on the link to the regulation in the box above these comments.

Abdominal and gastrointestinal defects and diseases 3-5

Gastrointestinal and abdominal surgery 3-6

Blood and blood-forming tissue diseases 3-7

Dental diseases and abnormalities of the jaws 3-8

Ears 3-9

Hearing 3-10

Endocrine and metabolic disorders 3-11

Upper extremities 3-12

Lower extremities 3-13

Miscellaneous conditions of the extremities 3-14

Eyes 3-15

Vision 3-16

Genitourinary system 3-17

Genitourinary and gynecological surgery 3-18

Head 3-19

Neck 3-20

Heart 3-21

Vascular system 3-22

Miscellaneous cardiovascular conditions 3-23

Surgery and other invasive procedures involving the heart, pericardium, or vascular system 3-24

Trial of duty and profiling for cardiovascular conditions 3-25

Tuberculosis, pulmonary 3-26

Miscellaneous respiratory disorders 3-27

Surgery of the lungs 3-28

Mouth, esophagus, nose, pharynx, larynx, and trachea 3-29

Neurological disorders 3-30

Disorders with psychotic features 3-31

Mood disorders 3-32

Anxiety, somatoform, or dissociative disorders 3-33

Dementia and other cognitive disorders due to general medical condition 3-34

Personality, psychosexual conditions, transsexual, gender identity, exhibitionism, transvestism, voyeurism, other paraphilias, or factitious disorders; disorders of impulse control not elsewhere classified 3-35

Adjustment disorders 3-36

Eating disorders 3-37

Skin and cellular tissues 3-38

Spine, scapulae, ribs, and sacroiliac joints 3-39

Systemic diseases 3-40

General and miscellaneous conditions and defects 3-41

Malignant neoplasms 3-42

Benign neoplasms 3-43

Sexually transmitted diseases 3-44

Heat illness and injury 3-45

Cold injury 3-46
Chapter 5
Medical Fitness Standards for Miscellaneous Purposes
5-14. Medical fitness standards for deployment and certain geographical areas

Comments: Chapter 5, Section 5-14 describes conditions that may disqualify a soldier for deployment. To see the detailed description of each condition, click on the link to the regulation in the box above these comments.

f. ... The following medical conditions must be reviewed carefully by the clinician before making a recommendation as to whether the Soldier can deploy to duty in a combat zone (or austere isolated area where medical treatment may not be readily available).

(1) Diabetes requiring insulin. ...

(2) Diabetes requiring oral medication for control. ...

(3) Cardiovascular conditions...the Soldier should not be deployed with any of the following conditions-

(a) Hypertension not controlled with medication.

(b) Recent episodes necessitating emergency room visits or closely monitored follow-up care.

(c) Permanent pacemakers, implanted antitachycardia and automatic implantable cardiac defibrillator (AICD) devices, ...

(d) Conditions requiring anticoagulants.

(e) Bare metal coronary stents. ...

(f) Drug eluting coronary stents. ...

(g) Closure device for patent foramen ovale or atrial septal defect. ...

(h) Cardiac arrhythmias. ...

(i) Smallpox vaccine associated myocarditis. ...

(4) Neurological conditions. Review paragraph 3-30 for profile guidance and MEB/PEB processing criteria.

(a) Seizure disorders. ...

(b) Demyelinating conditions...

(5) Asthma...

(6) Sleep apnea...

(7) Musculoskeletal...

(8) Psychiatric...

(a) A psychiatric condition controlled by medication should not automatically lead to nondeployment. Soldiers with a psychiatric disorder in remission or whose residual symptoms do not impair duty performance may be  considered for deployment  duties.  The  commander  makes  the  ultimate  decision  to  deploy  after  consulting  with  the  treating  physician or  other  privileged  provider.  The  availability,  accessibility,  and  practicality  of  a  course  of  treatment  or  continuation  of treatment  in  theater  or  austere  environment  should  be  consistent  with  clinical practice  standards.  If  there  are  any questions  on  the  safety  of  psychiatric  medication,  a  psychiatrist  must  be  consulted.

(b) Psychotic  and  bipolar  disorders  are  considered  disqualifying  for  deployment.

(c) Psychiatric  disorders  that  meet  medical  retention  standards  must  demonstrate  a  pattern  of  stability  without significant  symptoms  for  at  least  3  months  prior  to  deployment.

(d) Soldiers must demonstrate behavioral stability and minimal potential for deterioration or recurrence of symptoms in  a  deployed,  austere  environment,  to  the  extent  this  can  be  predicted.  The  potential  for  deterioration  must  be evaluated  considering  potential  environmental  demands  and  individual  vulnerabilities.

(e) Medication  disqualifying  for  deployment  include—
1. Antipsychotics used to control psychotic, bipolar, and chronic insomnia symptoms; lithium and anticonvulsants to control  bipolar  symptoms;
2. Medications  that  require  special  storage  considerations,  for  example,  refrigeration;
3. Medications  that  require  laboratory  monitoring  or  special  assessments,  including  lithium,  anticonvulsants,  and antipsychotics;
4. Medication  prescribed  within  3  months  prior  to  deployment  that  has  yet  to  demonstrate  efficacy  or  be  free  of significant  impairing  side  effects.

(f) Psychotropics clinically and operationally problematic during deployments include short half-life benzodiazepines and  stimulants.  Decisions  to  deploy  personnel  on  such  medications  should  be  balanced  with  necessity  for  such medication  in  order  to  effectively  function  in  a  deployed  setting,  susceptibility  to  withdrawal  symptoms,  ability  to secure  and  procure  controlled  medications,  and  potential  for  medication  abuse.

(9) History of exertional heat injuries...

(10) Pregnancy. Pregnant Soldiers will not deploy.

(11) History of cancer. ...

(12) Chronic infectious diseases (HIV, Hepatitis B or C) ...

(13) Abnormal Cervical Cytology. ...

(14) Malignant hyperthermia. ...

(15) Contact lenses. ...

(16) Miscellaneous conditions. ...

(17) Medications. Soldiers taking medications should not automatically be disqualified for any duty assignment. Medications used for serious and/or complex medical conditions are not usually suitable for extended deployments. The medications on the list below are most likely to be used for serious and/or complex medical conditions that could likely result  in  adverse  health  consequences...

(18) Dental. Soldiers that are in Dental Fitness Classification (DFC) 3 or 4 should not automatically be disqualified
for any duty assignment. DFC 3 or 4 Soldiers should receive the necessary dental exam/treatment to make them at least a DFC 2 and thus deployable. Certain geographical areas with specific operational demands and limited access to care may require that the Soldier be in DFC 1 prior to deployment.

Chapter 7
Physical Profiling

7-4. Temporary vs. permanent profiles
b.  Permanent   profiles. 

A  profile  is  considered  permanent  unless  a  modifier  of  “T” (temporary)  is  added.  A permanent  profile  may  only  be  awarded  or  changed  by  the  authority  designated  in  paragraph  7–6,  below.  All permanent  “3”  and  “4”  profiles,  for  Soldiers  on  active  duty,  will  be  reviewed  by  an  MEB  physician  or  physician approval  authority.  An  MEB  physician  is  an  MTF  dedicated  subject  matter  expert  trained  to  perform  disability evaluations  per  guidelines  established  in  DODI  1332.38  (see  AR  40–400  for  MEB  process).  The  MEB  physician  will assist  the  MTF  commander  in  educating  profiling  officers  on  current  physical  profiling  regulation  and  policy  guidance.

(1)   If  the  profile  is  permanent,  the  profiling  officer  must  assess  if  the  Soldier  meets  the  medical  retention  standards of  chapter  3.  Those  Soldiers  on  active  duty  who  do  not  meet  the  medical  retention  standards  must  be  referred  to  an MEB  as  per  chapter  3.  (See  paras  9–10  and  10–25,  respectively,  for  disposition  of  USAR  and  ARNG  Soldiers  not  on active  duty  who  do  not  meet  medical  retention  standards.)

(2)  Soldiers who have one or more condition(s) that do not meet medical retention standards are referred to a MEB /PEB  after  attaining  the  Medical  Retention  Determination  Point  (MRDP).  The  MRDP  is  when  the  Soldier’s  progress appears  to  have  medically  stabilized;  the  course  of  further  recovery  is  relatively  predictable;  and  where  it  can  be reasonably  determined  that  the  Soldier  is  most  likely  not  capable  of  performing  the  duties  required  of  his  MOS,  grade, or  rank.  This  MRDP  and  referral  to  a  MEB/PEB  will  be  made  within  1  year  of  being  diagnosed  with  a  medical condition(s)  that  does  not  appear  to  meet  medical  retention  standards,  but  the  referral  may  be  earlier  if  the  medical provider  determines  that  the  Soldier  will  not  be  capable  of  returning  to  duty  within  1  year.  The  MEB  physician  or physician  approval  authority  will  review  all  MEB  referrals  to  insure  that  MRDP  has  been  achieved  prior  to  initiating  a medical  evaluation  board;  coordinate  inappropriate  MEB  referrals  back  through  the  profiling  officer  for  appropriate disposition;  and  assist  physician  approving  authorities  in  reconciling  profiling  officer’s  questions  and  concerns  about MRDP  timing  and  MMRB  versus  MEB  referrals.  The  MEB  physician  or  physician  approval  authority  will  review  all profiles  to  confirm  that  the  MRDP  has  been  reached  before  obtaining  the  approving  authority  signature.

(3)  Those Soldiers (active duty and USAR/ARNG) who meet retention standards but have at least a 3 or 4 PULHES serial  will  be  referred  to  a  Medical  MOS  Retention  Board  (MMRB)  in  accordance  with  AR  600–60,  unless  waived  by the  MMRB  convening  authority.

(4)  Permanent profiles may be amended (following the correct procedure) at any time if clinically indicated and will automatically  be  reviewed  and  verified  by  the  privileged  provider  at  the  time  of  a  Soldier’s  periodic  health  assessment or  other  medical  examination.

(5)  The  Soldier’s  commander  may  also  request  a  review  of  a  permanent  profile,  in  accordance  with  paragraph 7–12b.

c.  Temporary  profiles. 

Soldiers  receiving  medical  or  surgical  care  or  recovering  from  illness,  injury,  or  surgery,  will be  managed  with  temporary  physical  profiles  until  they  reach  the  point  in  their  evaluation,  recovery,  or  rehabilitation where  the  profiling  officer  determines  that  MRDP  has  been  achieved  but  no  longer  than  12  months.  A  temporary profile  is  given  if  the  condition  is  considered  temporary,  the  correction  or  treatment  of  the  condition  is  medically advisable,  and  correction  usually  will  result  in  a  higher  physical  capacity.  Soldiers  on  active  duty  and  RC  Soldiers  not on  active  duty  with  a  temporary  profile  will  be  medically  evaluated  at  least  once  every  3  months  at  which  time  the profile  may  be  extended  for  a  maximum  of  6  months  from  the  initial  profile  start  date  by  the  profiling  officer.

(1)   Temporary  profiles  exceeding  6  months  duration,  for  the  same  medical  condition,  will  be  referred  to  a  specialist (for  that  medical  condition)  for  management  and  consideration  for  one  of  the  following  actions:

(a) Continuation  of  a  temporary  profile  for  a  maximum  of  12  months  from  the  initial  profile  start  date;
(b) Change  the  temporary  profile  to  a  permanent  profile;
(c) Determination of whether the Soldier meets the medical retention standards of chapter 3 and, if not, referral to an

(2)   The  profiling  officer  must  review  previous  profiles  before  making  a  decision  to  extend  a  temporary  profile  and refer  the  Soldier  to  a  medical  specialist  for  management  if  the  temporary  profile  has  been  in  effect  for  6  months.  Any extension  of  a  temporary  profile  must  be  recorded  on  DA  Form  3349,  and  if  renewed,  item  8  on  the  DA  Form  3349 will  contain  the  following  statement:  "This  temporary  profile  is  an  extension  of  a  temporary  profile  first  issued  on (date)."

(3)  Temporary profiles will specify an expiration date. If no date is specified, the profile will automatically expire at the  end  of  30  days  from  issuance  of  the  profile.  In  no  case  will  Soldiers  carry  a  temporary  profile  that  has  been extended  for  more  than  12  months.  If  a  profile  is  needed  beyond  the  12  months,  the  temporary  profile  will  be  changed to  a  permanent  profile.  Exceptions  to  the  12-month  temporary  physical  profile  restriction  must  be  approved  by  the medical  treatment  facility  (MTF)  commander  or  their  designated  senior  physician  approval  authority  (often  the  deputy commander  for  clinical  services).

Chapter 10
Army National Guard

10-15. Duty restrictions

a. Any recommendation for restricted activity that has been made by a private physician will be reported in writing, before performing any duty.

b. It is the individual Soldier's responsibility to report any medical problems immediately to the chain of command and to comply with medical restrictions. Commanders will honor the private physician's recommendations until the Soldier is evaluated by a military provider, and a recommended course of action is determined by a profiling officer (see para 7-6).

c. Soldiers and commanders will abide by the medical restrictions and limitations documented on any profile (DA Form 3349) issued.

AR 135-381 Incapacitation of Reserve Component Soldiers (27 December 2006)

AR 135-381 Incapacitation of Reserve Component Soldiers (73.2 KB)

Comments: To view or download the complete regulation, click on the link to it in the box above these comments.


1–5. Objective
The objective of the RC Incapacitation System is to compensate, to the extent permitted by law, members of the Reserve Components 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.

1–6. Entitlement
a. A member of the RC 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 37 USC 204 and 37 USC 206. The amount of incapacitation pay for the member will be  determined in accordance with DOD 7000.14–R, Volume 7A.
   b. Members incapacitated in the line of duty are entitled to medical and dental treatment in an MTF 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 Disability Evaluation System (DES) when eligible for disability processing. Procedures governing physical disability evaluation are provided in DODI 1332.38 and Department of Defense Directive (DODD) 1332.18.
   c. A member on a call or order to 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 benefits provided by this regulation.

   d. Members authorized incapacitation pay under 37 USC 204(g) will not be allowed to attend inactive duty training (IDT) periods or to acquire retirement points for drills. However, a member may earn retirement points in order to satisfy the requirements for a qualifying year of service by completing correspondence courses....

1–8. Members unable to perform military duties
   a. A member who is unable to perform military duties because of incapacitation under the circumstance described in paragraph 1–6 is entitled to full pay and allowances, including all incentive pay to which entitled, less any civilian
earned income for the same period the member receives incapacitation pay (see DOD 7000.14–R, Volume 7A for entitlements).
   b. Incapacitation pay under paragraph 1–8a is adjusted only by the amount of earned income received. The civilian income of the member other than earned income received will not be a consideration in calculating incapacitation pay
under that paragraph.
   c. For establishing fitness, an RC member will be determined to be unable to perform military duties if, under service procedures in AR 40–501 the member would be determined to be medically unfit to perform his or her military duties.
   d. A member authorized incapacitation pay under 37 USC 204(g) of reference will not be allowed to attend IDT or to acquire retirement points for performing IDT. A Soldier attending IDT and performing military duties may be evidence that they are not suffering from a disability that entitles them to incapacitation pay (tier 1 cases). This will not be used as a basis for terminating entitlement to medical treatment.
   e. Return to or acceptance of civilian employment may not terminate entitlement to medical care at Government expense.

1–9. Members able to perform military duties
Members 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....

1–11. Duration of incapacitation pay
a. Incapacitation pay will be paid only during the period a member remains unfit for military duty or demonstrates a loss of earned income as a result of the incapacitation.
   b. Payment in any particular case may not be made for more than 6 months without review of the case by appropriate headquarters as outlined in paragraph 3–6.
   c. To insure that continuation of incapacitation pay is warranted under this regulation, a review will be made every 6 months.
   d. Incapacitation pay will continue as long as the conditions warranting the incapacitation pay exist and the approving authority determines that it is in the interest of fairness and equity to continue the payment.
   e. When incapacitation lasts for over a year, the case should be processed through the DES for disability separation or retirement. Incapacitation pay will end upon retirement, separation for physical disability, or determination by military service medical personnel that the member has recovered sufficiently to perform military duties, when actually returned to military duty, whichever occurs first....

1–13. Compensation
   a. Soldiers are entitled to a portion of the same monthly pay and allowances as are provided members of the Active Army with corresponding grade, length of service, marital status, and dependent status for each period the Soldier is unable to perform military duties (tier 1 cases) or can demonstrate loss of compensation from civilian earned income (tier 2 cases). Maximum amount payable for any given period is an amount equivalent to military pay and allowances for the period in question.
   b. Soldiers will not be issued AD orders in place of incapacitation pay as a means of providing benefits to which they might otherwise not be entitled....

Army Pamphlet 135-381 Incapacitation of Reserve Component Soldiers Processing Procedures

Army Pamphlet 135-381 Incapacitation of Reserve Component Soldiers Processing Procedures

Comments: To view or download the complete pamphlet, click on the link to it in the box above these comments.

Chapter 1 Introduction

1-1. Purpose
This pamphlet provides procedures regarding incapacitation pay and allowances for Reserve Component (RC) Soldiers.

1-2. References
Required and related publications and prescribed and referenced forms are listed in appendix A.

1-3. Explanation of abbreviations and terms
Abbreviations and special terms used in this publication are listed in the glossary.

AR 600-8-4 Line of Duty Policy, Procedures, and Investigations (4 September 2008)

AR 600-8-4 Line of Duty Policy, Procedures, and Investigations (84.5 KB)

Comments: To view or download the complete regulation, click on the link to it in the box above these comments.

1-1. Purpose
This regulation prescribes policies and procedures for investigating the circumstances of disease, injury, or death of a soldier. It provides standards and considerations used in determining line of duty (LD) status.

2–1. General
Line of duty determinations are essential for protecting the interest of both the individual concerned and the U.S. Government where service is interrupted by injury, disease, or death. Soldiers who are on active duty (AD) for a period of more than 30 days will not lose their entitlement to medical and dental care, even if the injury or disease is found to have been incurred not in LD and/or because of the soldier’s intentional misconduct or willful negligence, Section 1074, Title 10, United States Code (10 USC 1074). A person who becomes a casualty because of his or her intentional misconduct or willful negligence can never be said to be injured, diseased, or deceased in LD. Such a person stands to lose substantial benefits as a consequence of his or her actions; therefore, it is critical that the decision to categorize injury, disease, or death as not in LD only be made after following the deliberate, ordered procedures described in this regulation.

2–2. Reasons for conducting line of duty investigations
The following are reasons for conducting LD investigations:
a. Extension of enlistment.
An enlisted soldier who is unable to perform duties for more than one day because of his or her intemperate use of drugs or alcohol or because of disease or injury resulting from the soldier’s misconduct is liable after returning to duty to serve for a period that, when added to the period that he or she served before the absence from duty, amounts to the term for which he or she was enlisted or inducted (10 USC 972).
b. Longevity and retirement multiplier.
Eligibility for increases in pay because of longevity and the amount of retirement pay to which a soldier may be entitled depends on the soldier’s cumulative years of creditable service. An enlisted soldier who is unable to perform duties for more than one day because of his or her intemperate use of drugs or alcohol or because of disease or injury resulting from misconduct is not entitled to include such periods in computing creditable service in accordance with the Department of Defense Financial Management Regulation (DODFMR).
c. Forfeiture of pay.
Any soldier on AD who is absent from regular duties for a continuous period of more than one day because of disease that is directly caused by and immediately following his or her intemperate use of drugs or alcohol is not entitled to pay for the period of that absence. Pay is not forfeited for absence from duty caused by injuries. Pay is not forfeited for disease not directly caused by and immediately following the intemperate use of drugs and alcohol.
d. Disability retirement and severance pay.
For soldiers who sustain permanent disabilities while on AD to be eligible to receive certain retirement and severance pay benefits, they must meet requirements of the applicable statutes. One of these requirements is that the disability must not have resulted from the soldier’s "intentional misconduct or willful neglect" and must not have been "incurred during a period of unauthorized absence" (10 USC 1201, 1203,
1204, 1206, and 1207). Physical Evaluation Board determinations are made independently and are not controlled by LD determinations. However, entitlement to disability compensation may depend on those facts that have been officially recorded and are on file within the Department of the Army (DA). This includes reports and investigations submitted in accordance with this regulation.
e. Medical and dental care for soldiers on duty other than AD for a period of more than 30 days. A soldier of the National Guard or U.S. Army Reserve (USAR) is entitled to hospital benefits, pensions, and other compensation, similar to that for soldiers of the Active Army for injury, illness, or disease incurred in LD, under the following
conditions prescribed by law (10 USC 1074a):
(1) while performing AD for a period of 30 days or less;
(2) while performing inactive duty training;
(3) while performing service on funeral honors duty under 10 USC 12503 or 32 USC 115;
(4) while traveling directly to or from the place at which that soldier is to perform or has performed—
    (a) active duty for a period of 30 days or less;
    (b) inactive duty training; or
    (c) service on funeral honors duty under 10 USC 12503 or 32 USC 115;
(5) while remaining overnight immediately before the commencement of inactive duty training, or while remaining overnight, between successive periods of inactive duty training, at or in the vicinity of the site of the inactive duty training; or
(6) while remaining overnight immediately before serving on funeral honors duty under 10 USC 12503 or 32 USC 115 at or in the vicinity of the place at which the soldier was to so serve, if the place is outside reasonable commuting distance from the soldier’s residence.
f. Benefits administered by the Department of Veterans Affairs (DVA).
In determining whether a veteran or his or her survivors or family members are eligible for certain benefits, the DVA makes its own determinations with respect to LD. These determinations rest upon the evidence available. Usually this consists of those facts that have been officially recorded and are on file within DA, including reports and LD investigations submitted in accordance with the provisions of this regulation. Statutes governing these benefits generally require that disabling injury or death be service connected, which means that the disability was incurred or aggravated in LD (38 USC 101). The statutory criteria for making such determinations are in 38 USC 105.

2–3. Requirements for line of duty investigations
Line of duty investigations are conducted essentially to arrive at a determination of whether misconduct or negligence was involved in the disease, injury, or death and, if so, to what degree. Depending on the circumstances of the case, an LD investigation may or may not be required to make this determination.
a.The LD determination is presumed to be "LD YES" without an investigation—
(1) In the case of disease, except as described in paragraphs c (1) and (8) below.
(2) In the case of injuries clearly incurred as a result of enemy action or attack by terrorists.
(3) In the case of death due to natural causes or while a passenger in a common commercial carrier or military
b. In all other cases of death or injury, except injuries so slight as to be clearly of no lasting significance (for example, superficial lacerations or abrasions or mild heat injuries), an LD investigation must be conducted.
c. Investigations can be conducted informally by the chain of command where no misconduct or negligence is indicated, or formally where an investigating officer is appointed to conduct an investigation into suspected misconduct
or negligence. A formal LD investigation must be conducted in the following circumstances:
(1) Injury, disease, death, or medical condition that occurs under strange or doubtful circumstances or is apparently
due to misconduct or willful negligence.
(2) Injury or death involving the abuse of alcohol or other drugs.
(3) Self-inflicted injuries or possible suicide.
(4) Injury or death incurred while AWOL.
(5) Injury or death that occurs while an individual was en route to final acceptance in the Army.
(6) Death of a USAR or ARNG soldier while participating in authorized training or duty.
(7) Injury or death of a USAR or ARNG soldier while traveling to or from authorized training or duty.
(8) When a USAR or ARNG soldier serving on an AD tour of 30 days or less is disabled due to disease.
(9) In connection with an appeal of an unfavorable determination of abuse of alcohol or other drugs (para 4–10 a).
(10) When requested or directed for other cases.

2–4. Informal LD investigations
Documentation for an informal LD investigation typically consists of DA Form 2173 completed by the MTF and the unit commander and approved by the appointing authority, State AG, or higher authority. The final determination of an informal LD investigation can result in a determination of "in LD" only, except as provided in paragraph 4–8(c)(1). (See chap 3, sect I, for a detailed discussion of the informal LD investigation.)

2–5. Formal LD investigations
A formal LD investigation is a detailed investigation that normally begins with DA Form 2173 completed by the MTF and annotated by the unit commander as requiring a formal LD investigation. The appointing authority, on receipt of the DA Form 2173, appoints an investigating officer who completes DD Form 261 and appends appropriate statements and other documentation to support the determination, which is submitted to the GCMCA for approval. (See chap 3, sect II, for a detailed treatment of the formal LD investigation.) ...