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AR 600-8-4 Line of Duty Policy, Procedures, and Investigations (15 March 2019)

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

Chapter 1 Introduction

Section I

Information

1–1.Purpose

This regulation prescribes policies and procedures for investigating the circumstances of injury, illness, disease, or death of a Soldier. It provides standards and considerations used in making line of duty (LOD) determinations.

Chapter 2 Program Elements

2–2. Requirements for line of duty investigations

LOD investigations determine: duty status at the time of incident and whether misconduct was involved and, if so, to what degree. Additionally, LOD investigations may be required to determine an EPTS condition, and, if so, determine service aggravation.

a. An LOD investigation will be conducted for all Soldiers, regardless of Component if the Soldier experiences a loss of duty time for a period of more than 24 hours and—

  • (1) The injury, illness, or disease is of lasting significance (to be determined by a physician, physician assistant, or nurse practitioner) (see para 5–4b for other guidance);
  • (2) There is a likelihood that the injury, illness, or disease will result in a permanent disability;
  • (3) If an RC Soldier requires follow-on care for an injury, illness, or disease incurred during a period of active duty.

b. An injury, illness, or disease diagnosed while serving on active duty or in a duty status as outlined in AR 638–8 does not mean that the injury, illness, or disease was incurred while serving on active duty or that an EPTS condition was service aggravated. An expert medical opinion from an appropriate provider is required and must address when the condition was incurred, if the condition existed prior to the current military service and whether the condition was service aggravated (see para 4–8). If an LOD determination has been made during a period of prior military service and the same condition arises in a subsequent period of military service, the prior determination will remain unchanged unless intervening events exist.

c. Depending on the circumstances of the case, an LOD investigation may or may not be required to make this determination. Only AHRC can make a presumptive in line of duty (PILD) finding, with the exception of identifying service connection for RC Soldiers who were previous members of one compo and transfers to another compo for which clear evidence is documented in the active duty medical records….

Comment: AHRC is Army Human Resource Command.

d. In all other cases of injury, illness, disease, or death, except minor injuries that will not result in a permanent disability (for example, sprain, contusion, or minor fracture), an LOD investigation must be conducted.

  • (1) Conduct an informal LOD investigation in cases where no misconduct or gross negligence is suspected.
  • (2) Conduct a formal LOD investigation in the following circumstances:

(a) Injury, illness, disease, or death that occurs under strange or doubtful circumstances or is apparently due to misconduct or gross negligence.

(b) Injury, illness, or death involving the abuse of alcohol or other drugs.

(c) Self-inflicted injuries or suspected suicide.

(d) Injury, illness, or death incurred while AWOL.

(e) Injury or death that occurs while an individual was enroute to final acceptance in the Army.

(f) When a USAR or ARNG Soldier serving on orders for less than 30 days who becomes disabled due to injury, illness, disease, or death.

(g) When directed by higher authority (AHRC, approval authority, or appointing authority).

(h) Conditions that the MTF commander or other medical provider determine EPTS.

(i) Injury or death of a USAR or ARNG Soldier while traveling to or from authorized training or duty.

(j) Death of a USAR or ARNG Soldier while participating in authorized training or duty.

(k) Under any circumstances the commander believes should be fully investigated.

  • (3) Currently a restricted LOD is authorized by the Army for sexual assault related cases: Victims of sexual assault will receive medical care for sexually related assaults through a restricted or unrestricted LOD investigation. Only the unit sexual assault response coordinator (SARC) is authorized to process restricted LODs.

e. At no time will an LOD be initiated, regardless the circumstance(s), for a Soldier not in an authorized duty status at the time of injury, illness, disease, or death. A Soldier must be in an authorized duty status before an LOD can be initiated.

f. Any Soldier, retired or separated from Service and requesting a Line of Duty investigation be initiated and/or adjudicated, must submit a request and proper documentation to the Army Review Boards Agency.

2–3. Benefits affected by line of duty Investigation

The following are possible consequences of an LOD investigation:

a. Extension of enlistment….

b. Longevity and retirement multiplier….

c. Forfeiture of pay….

d. Disability retirement and severance pay….

e. Medical and Dental care for Soldiers on duty other than active duty….

f. Benefits administered by the Department of Veterans Affairs….

2–4. Standards applicable to line of duty determinations

a. A Soldier’s injury, illness, disease, or death is presumed to have occurred ILD unless rebutted by the evidence.

  • (1) Injury, illness, disease, or death proximately caused by the Soldier’s misconduct or gross negligence is “not in line of duty-due to own misconduct (NLD–DOM).”
  • (2) Simple negligence, alone, does not constitute misconduct and is, therefore, still considered to be ILD.

b. Standard of proof. Unless another regulation or directive, or an instruction of the appointing authority, establishes a different standard, the findings of investigations governed by this regulation must be supported by a greater weight of evidence than supports a contrary conclusion (such as, by a preponderance of the evidence). The weight of the evidence is not determined by the number of witnesses or volume of exhibits, but by considering all the evidence and evaluating factors, which as a whole shows that the fact sought to be proved is more probable than not….

2–5. Line of duty determination(s)

One of the following 8 determinations will be applied to the Soldier’s injury, illness, disease, or death….

a. In line of duty. The injury, illness, disease, or death did not occur while the Soldier was AWOL and was not due to the Soldier’s own misconduct or gross negligence. For USAR/ARNG Soldiers, the injury, illness, disease, or death occurred while the Soldier was in a duty status, as defined in AR 638–8 or direct travel status. This finding also applies in suicide cases when Soldiers are AWOL and considered mentally unsound at both the inception of AWOL and at time of death (mental soundness can only be determined by a behavioral Health expert).

b. Not in line of duty-not due to own misconduct (NLD–NDOM). A formal investigation with supporting evidence, that the injury, illness, disease, or death occurred during a period when a Soldier was AWOL, was mentally sound at the inception of AWOL, and which was not directly caused by Soldier’s own misconduct or gross negligence (mental soundness can only be determined by a behavioral Health expert). EPTS conditions typically falls under this determination.

c. Not in line of duty-due to own misconduct (NLD–DOM). A formal investigation determined that the Soldier’s injury, illness, disease, or death was proximately caused by the Soldier’s own misconduct or gross negligence. Mental soundness can only be determined by a behavioral Health expert.

d. In line of duty-existed prior to service-service aggravated (ILD–EPTS–SA). This finding is made when there is clear and unmistakable evidence the Soldier’s injury, illness, or disease existed prior to service and the condition has been service aggravated. Aggravation will be determined by an appropriate provider in accordance with DODI 1332.18. (Annotate in remarks section of DD Form 261, ILD–EPTS–SA). Mental soundness can only be determined by a behavioral Health expert.

e. Not in line of duty-EPTS-not service aggravated (NLD–EPTS–NSA). This finding is made when there is clear and unmistakable evidence the member’s injury, illness, or disease EPTS and the condition has not been service aggravated. Aggravation will be determined by an appropriate military provider in accordance with DODI 1332.18. (Annotate in remarks section of DD Form 261, NLD–EPTS–NSA). Mental soundness can only be determined by a behavioral Health expert.

f. In Line of Duty-This Episode Only (ILD-This Episode Only). This determination relates to a one-time event, where no serious injury or illness has occurred, but warranted the Soldier be attended to by a medical physician. This incident occurred while the Soldier was in an authorized duty status at the time of the episode. Treatment should be limited for this particular episode only. A Reserve Component Soldier is not authorized military treatment if episode occurs while not in an authorized duty status. A Formal LOD should be conducted to determine the cause of episode.

g. Presumptive in line of duty (PILD)-Reserved for AHRC and Reserve Component for purposes of Soldiers transferring components only. AHRC uses this determination in cases of hostile action, death of natural causes, or death of passengers in a commercial carrier or military vehicles (see para 2–2c (1–3)). Specific Reserve Component personnel (specified in the Delegation of Authority memorandum from the TAG) can use this determination in cases of Soldiers transferring between components with the proper medical documentation. (See paragraph 2–2c for eligible RC personnel and who is responsible within the RC and guidelines for issuing a PILD finding).

h. No Finding-Reserved for AHRC purposes only. Used in cases where an LOD investigation was completed but was not required in accordance with paragraph 2–2. If the RC has an LOD case and feels that a No Finding is necessary, the RC can send the case to AHRC–PDC–P, AHRC will review and grant approval/ disapproval on a case-by-case basis.

Chapter 3 The Line of Duty Investigation Process

Section I

Informal Line of Duty Investigations

3–1. General

The unit commander may, if approved by the appointing authority, elect to conduct an informal investigation so long as misconduct or gross negligence is not suspected on the part of the Soldier and a formal investigation is not required in accordance with paragraph 2–2d(2)….

3–2. Timeline

All informal line of duty investigations must be initiated within 5 calendar days of the command’s discovery of the injury, illness, disease, or death. When an informal investigation is not completed within the given time, the reasons the report is late should be included in the remarks section of DA Form 2173 (Statement of Medical Examination and Duty Status). The timeline for completing an informal investigation is no more than 60 days….

3–4. Line of duty determination

a. The final determination of an informal LOD investigation will only result in a determination of “ILD” with the exception of EPTS.

Comment: EPTS stand for existed prior to service.

b. The mere fact that the Soldier was in an “authorized status” (duty, pass, leave, and so forth) does not necessarily support a determination of ILD in and of itself. (Also see para 2–4b)….

Section II Formal Line of Duty Investigations

3–10.Timeline

All formal line of duty investigations must be initiated within 5 calendar days of the command’s discovery of the injury, illness, disease, or death. When a formal investigation is not completed within the given time, the reason(s) the report is late should be included in the remarks section on DD Form 261 (Report of Investigation Line of Duty and Misconduct Status) and as part of the investigating officer’s comments. The timeline for completing a formal investigation; to include the approving authority finding, is no more than 180 days. If evidence required to support a determination is not available within the prescribed time frame, the IO must provide the reason(s) in the 30-day investigative update to the appointing authority, CAC, GCMCA, and Commander, U.S. Army Human Resources Command (AHRC–PDC–C), 1600 Spearhead Division Avenue, Fort Knox, KY 40122–5405. If evidence required to support a determination is not available within the prescribed time frame, the IO must request in writing, a request for an extension from the appointing authority….

Chapter 4 Special Considerations and Other Matters Affecting Line of Duty Investigations

4–1. Relationship to disciplinary actions

An LOD determination is an administrative action and is not to be used for punitive/judicial action. The LOD determination does not prohibit a commander from pursuing disciplinary and/or administrative actions….

4–4. Time limitations for processing and initiating

LOD actions must be completed within the time limits given in paragraphs 3–2 and 3–10.

a. In death cases, significant benefits to the survivors are pending until unit leadership has reviewed the investigation and final action has been taken by HRC.

b. In injury, illness, or disease cases, final action by the medical evaluation board, physical evaluation board, and the U.S. Army Physical Disability Agency (USAPDA) may be pending an LOD determination.

c. In general, an RC Soldier has 180 calendar days from the end of the qualified duty status to request a LOD determination, for the purpose of determining eligibility for medical and dental treatments and incapacitation pay entitlements, absent special circumstances. See DODI 1241.01. Submission of AGR LOD investigations, solely for the purpose of retirement, is not authorized. Exceptions to the 180-day timeline include:

  • (1) A Behavioral Health diagnosis which may occur at some point beyond the 180 day period;
  • (2) A Soldier is currently enrolled in the Integrated Disability Evaluation System (medical evaluation board (MEB)/physical evaluation board (PEB)) and a line of duty is directed by the Physical Disability Agency;
  • (3) The covered condition pre-dated the 180 day period (such as with latent onset symptoms of post-traumatic stress disorder).

d. In general, a Soldier who transfers from RA to RC has 180 calendar days from their separation date from RA to request an LOD determination, for the purpose of determining eligibility for medical and dental treatments and incapacitation pay entitlements, absent special circumstances. The accepting RC will initiate and/or adjudicate an LOD provided the Soldier can provide substantiating medical documentation to support an LOD determination. In RA–RC transfers, the Soldier can seek medical attention directly through the Veterans Administration using all current medical documentation.

e. Sexual assault related incidents. Medical entitlements for Reserve Component Soldiers are dependent on a LOD determination as to whether or not the sexual assault incident occurred in an active service or inactive duty training status (see DODI 6495.02, Encl. 5, Para 5b)….

4–7. Absent without leave

For any injury, illness, disease, or death incurred during a period of AWOL the finding will be NLD unless a behavioral health provider has determined that the Soldier was mentally unsound, such that the Soldier did not possess the ability to form the intent to go AWOL. In cases of suicide or attempted suicide or suspected mental unsoundness, a behavioral health provider will render an opinion of the Soldiers mental soundness at both the inception of AWOL as well as at the time of incident. Any Soldier that is found not mentally sound at the time of inception and at the time of the incident will be handled as ILD. In cases of suicide or attempted suicide, a behavioral health provider assigned to the nearest military treatment facility will render an opinion as to the Soldier’s mental soundness at both the inception of AWOL as well as at the time of incident….

4–17. Appeals

The following information addresses policy and procedures concerning appeals to NLD determinations:

a. The Soldier may appeal, in writing, within 30 days after receipt of the notice of the LOD determination to the approval authority of his or her unit. For appeals not submitted within the 30-day time limit, the reason for delay must be fully explained and a request for exception to the time limit justified. The appeal must be personally signed by the Soldier unless the Soldier is physically unable to sign or is mentally incompetent. In such cases, the appeal will include evidence of the condition that prevented the Soldier from personally signing….

4–21. Limits on use of a line of duty investigation

An LOD determination will not be used for the following purposes:

a. Disciplinary action and other administrative action. A NLD determination is an administrative determination and not a punitive or judicial action. Disciplinary and other administrative actions, if warranted, will be taken independently of any LOD determination. A determination of ILD does not preclude separate disciplinary or administrative actions. An LOD determination is not binding on the issue of guilt or innocence of the Soldier in a separate disciplinary action, the issue of pecuniary liability in a financial liability investigation of property loss, or any other administrative determination.

b. Reimbursement of medical expenses. An LOD determination does not authorize the U.S. Government to recoup the cost of medical care from a Soldier. Soldiers on active duty for a period of more than 30 days cannot be denied treatment based on an LOD determination. However, future access to care may be limited by the LOD determination….

Chapter 5 Line of Duty Determination Procedures for Soldiers of the Army National Guard and U.S. Army Reserve …

5–3. Responsibilities

Commanders, medical officers, S1s, SJAs, unit administrators, noncommissioned officers, and RC Soldiers who learn of a Soldier’s injury, illness, disease, or death that occurred under circumstances that warrant an LOD investigation/determination must take an active role in ensuring that an investigation/determination is initiated, completed, and uploaded into eMMPS in a timely manner.

a. Individual Mobilization Augmentees (IMAs) will be processed by the Regular Army command to which they are assigned or attached….

b. IRR Soldiers are processed by the Regular Army command to which they are assigned or attached when in an active status. The LOD for an injury, illness, or disease incurred while on active duty is the responsibility of the Regular Army command to which the Soldier is assigned to include Warrior Transition Units. The LOD will be initiated and completed before the IRR Soldier REFRADs. An LOD will be completed for any injury, illness, or disease for which the IRR Soldier is receiving treatment while assigned to a Warrior Transition Unit that warrants an LOD. In exceptional cases the AHRC Surgeon General’s office (AHRC–SG) will complete an LOD after REFRAD (for example, post-traumatic stress disorder).

c. For RA Soldiers who have transferred or transitioned to the RC whose medical conditions are reported after the Soldier is a member of the RC, only the named personnel from the Delegation of Authority memorandum signed by the TAG may initiate a PILD memorandum with proper medical documentation and a medical review from a physician, physician assistant, or nurse practitioner from the active duty medical records to support the injury, illness, or disease that may have been diagnosed and/or treated while serving on active duty. This does not include RC Soldiers who are/were mobilized or who are/were in a federalized duty status.

d. The S1 has overall responsibility for the management and processing of LOD’s as outlined in this regulation.

e. For Soldiers assigned to the IRR and ordered to perform muster duty; an LOD will be initiated by the muster officer in charge or authorized representative. DA Form 2173 and all supporting medical documents will be forwarded to: Commander, U.S. Army Human Resources Command (AHRC–SG), 1600 Spearhead Division Avenue, Fort Knox, KY 40122–5405 for processing and completion.

f. For USAR, the Army Reserve Medical Management Center, the MSC or RD surgeon’s office are responsible for assisting commanders in understanding the diagnosis, prognosis, and treatment plan for the Soldier and whether the injury, illness, or disease was caused or aggravated through military service while in a duty status or was EPTS. This responsibility includes making a definitive diagnosis that has not been accomplished by the initial treating MTF, initial civilian treatment facility, or Veterans Administration MTF.

g. For ARNG, the State surgeon’s office is responsible for assisting commanders in understanding the diagnosis, prognosis, and treatment plan for the Soldier and whether the injury, illness, or disease was caused or aggravated through military service while in a duty status or was EPTS. This responsibility includes making a definitive diagnosis that has not been accomplished by the initial treating MTF, initial civilian treatment facility or Veterans Administration MTF. The State health services specialist (HSS) or State administrator has access to forward LOD to the State surgeon’s office through eMMPS. Unit commanders who require assistance will need to forward LOD to the State HSS or State administrator in order to receive a State surgeon opinion….

5–4. Entitlement to medical care, pay and allowances for Soldiers who incur an injury, illness, disease, or incur aggravation in the line of duty

This guidance establishes criteria for initiating and processing LODs to ensure access to care and a timely resolution of their medical condition(s).

a. Soldiers will have up to 180 days following the completion of their qualified duty to request consideration for a line of duty determination, absent special circumstances. Special circumstances are those in which the covered condition predates the 180 day period, for example, latent onset symptoms of post-traumatic stress and unreported Sexual Assault in accordance with AR 600–8–4, paragraph 4–4c.

b. LOD determinations for injury, illness, or disease that have no lasting effect, defined as not requiring follow on care ultimately affecting a Soldier’s overall health or career will not be accepted in accordance with AR 600–8–4, paragraph2–2 (a)(1). LODs where the diagnoses are listed as, abrasions, scratches, pain, headache (not associated with BH), hernia, and pregnancy, are injuries or illness that leave no lasting effect on the Soldier or require hospitalization for further treatment.

c. A Soldier requiring treatment for an emergency medical or dental condition while in a qualified duty status is authorized an interim line of duty determination for initial medical care only. This authorizes emergent care, unless clear and unmistakable evidence shows the condition was the result of the member’s gross negligence or misconduct. An interim LOD must be initiated within 10 days following completion of qualified duty to continue treatment, if indicated, for covered conditions. The appropriate Defense Health Agency (DHA) office will serve as the MMA for approval and authorization of emergency medical and dental treatment with a civilian provider. The interim LOD will be adjudicated within 30 days of completion of the qualified duty status to continue further medical and/or dental treatment.

d. The LOD determination is required to authorize immediate medical and dental treatment for the covered condition(s). Under no circumstances, will care be authorized after one year from diagnosis without being identified for referral to the Disability Evaluation System (DES). A Soldier must be referred to the DES when the criteria for referral is met in accordance with DODI 1332.18.

e. Should the approval authority, at any time, find that the injury, illness, or disease was not incurred or aggravated in a qualified duty status or was the result of gross negligence or misconduct, all authorizations for medical and dental treatment, incapacitation pay, travel and transportation allowances provided related to in line of duty determination must be terminated immediately. The Soldier is financially responsible for all treatment to include emergency treatment for non-covered condition(s), if a finding such as described above is rendered.

5–5. Reserve Component line of duty procedures for sexual assault

Members of the RCs, whether they file a restricted or unrestricted report, shall have access to medical treatment and counseling for injuries, illness, and/or diseases incurred from a sexual assault inflicted upon a Soldier when performing active service, as defined in 10 USC section 101(d)(3), and inactive duty training.

a. Medical entitlements remain dependent on a LOD determination as to whether or not the sexual assault incident occurred in an active service or inactive duty training status. However, regardless of their duty status at the time that the sexual assault incident occurred, or at the time that they are seeking SAPR services, Soldiers can elect either the Restricted or Unrestricted Reporting options and have access to the SAPR services of a SARC and a SAPR VA.

Comment: SAPR stands for sexual assault prevention and response. SARC stands for sexual assault response coordinator.

b. Any alleged collateral misconduct by a Soldier victim associated with the sexual assault incident will be excluded from consideration as intentional misconduct or gross negligence under the analysis required by 10 USC section 1074a(c) in LOD findings for healthcare to ensure sexual assault victims are able to access medical treatment and mental health services.

c. The following LOD procedures shall be followed by Reserve Component commanders.

(1) To safeguard the confidentiality of Restricted Reports, LOD determinations may be made without the victim being identified to Department of Defense law enforcement or command, solely for the purpose of enabling the victim to access medical care and psychological counseling, and without identifying injuries from sexual assault as the cause.

(2) For LOD determinations for sexual assault victims, the Chief, Army National Guard and Chief, Army Reserve shall designate individuals within their respective organizations to process LODs for victims of sexual assault when performing active service, as defined in 10 USC section 101(d)(3) and inactive duty training….

(3) For LOD purposes, the victim’s SARC may provide documentation that substantiates the victim’s duty status as well as the filing of the Restricted Report to the designated official.

(4) If medical or mental healthcare is required beyond initial treatment and follow-up, a licensed medical or mental health provider must recommend a continued treatment plan.

(5) Reserve Component members who are victims of sexual assault may be retained or returned to active duty in accordance with DODI 6495.02, Table 1 and 10 USC Section 12323….