There is a pilot program and a revamp of the ARC LOD process. It allows final determination do be done at the Wing level...which is in line with AD. Historically...for Guard members it could be a year or two before an AD validated LOD goes to the ARC side for approval.
The interesting thing that i see is the language stating that it is the members responsibility to not only get seen and report the illness but to "Request an LOD Determination:You can request an LOD determination within 180calendardays of completing your qualified duty status when you have an injury, illness or disease; otherwise, the Air Force considers you fit for duty. Certain latent onset conditionslike post-traumatic stress disorder are an exception and are permitted to be requested more than 180calendardaysafter completing your qualified duty status."
36-2910 has stated for years that once you are seen for an issue, it is the treating providers responsibility to initiate an LOD within 5 days of being seen and they must close out and route their portion within 30 days. To me...this is an interesting and unfair development.
The information below is a sloppy edit job...but i wanted to get it out there. I'm still unpacking the info and will report back within the week
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The interesting thing that i see is the language stating that it is the members responsibility to not only get seen and report the illness but to "Request an LOD Determination:You can request an LOD determination within 180calendardays of completing your qualified duty status when you have an injury, illness or disease; otherwise, the Air Force considers you fit for duty. Certain latent onset conditionslike post-traumatic stress disorder are an exception and are permitted to be requested more than 180calendardaysafter completing your qualified duty status."
36-2910 has stated for years that once you are seen for an issue, it is the treating providers responsibility to initiate an LOD within 5 days of being seen and they must close out and route their portion within 30 days. To me...this is an interesting and unfair development.
The information below is a sloppy edit job...but i wanted to get it out there. I'm still unpacking the info and will report back within the week
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ARC service memberssubmit documentation based on the type of qualified duty status they were when the medical condition occurred or was aggravated:1.Determine the qualified duty status: Inactive Duty for Training (IDT), Annual Tour (AT), Military Personnel Appropriation (MPA), Reserve Personnel Appropriation (RPA), or DD 1610 (TDY)2.Submit the appropriate qualified duty status documentation:a.If on orders: Pre-certification; All modifications; Close-out if availableb.If on IDT: i.Certif ied/approved AF 40A (AFRC) or ANG105S(ANG)c.If on IDT, and AF 40A or ANG105Snot available, ARC service member can visit FSS/MPF/CSS to obtain one of the following:i.Memorandum for Record,Participation Report, Unit Training Assembly Process System (UTAPS)/AROWS export, or Participation History f rom UTAPS4.Should ARC service membersexpect to receive a briefing on the LODdetermination?Yes. Within fivecalendardays of the LOD determination, a commander conducts an in-person or telephone briefing to the ARC service memberon the decision, rationale, and eligibility for benef itsif In Line of Duty and options to appeal the decision if Not in Line of Duty.AFRC and ANG units can utilize the electronic LOD system to generate an automatic memorandum notif ying the member of the LOD decision.5.What benefits can ARC service membersaccess after receiving an In Line of Duty
2USAF Invisible Wounds Initiative | Learn more at www.woundedwarrior.af.mil/Airmen-Veterans/Invisible-Wounds-InitiativeARC LOD REFORMLOD FREQUENTLY ASKED QUESTIONSMAY 2021determination?Once the immediate commander makes their LOD recommendation, it serves as an interim LOD determination. If the interim LOD determination is In Line of Duty, the ARC service membermay access healthcarefor the In Line of Duty conditionthrough TRICARE services,and may apply for Medical Continuation (MEDCON) or Incapacitation (INCAP) Pay. The interim LOD determination is valid for up to 60 days or until the date of the final LOD determination, whichever is earlier.See AFI 36-2910, Line of Duty (LOD) Determination, Medical Continuation (MEDCON), and Incapacitation (INCAP) Pay,paragraph5.2 for MEDCON eligibility and paragraph6.2 for INCAP PayEligibility and Qualification Determination.6.Can ARC service membersappeal a Not in Line of Dutydetermination?Yes. ARC service memberscanappeal a Not in Line of Duty determination.ARC service membersmust notify their LOD Program Manager and provide the reason for the appeal in writing within 30 days of being notified of the LOD determination.Follow the appeal process in AFI 36-2910.7.If an LOD appeal is denied, is there any other avenue for service membersto address a potential error with an LOD determination?Yes. Any further claims must be addressed to the Air Force Board for Correction of Military Records (AFBCMR) in accordance with AFI 36-2603, Air Force Board for Correction of Military Records.8.What resources and support can ARC service membersuse to make an LODrequest?The Line of Duty Process: Airman’s/Guardian’sRights, Responsibilities, and Eligibility explains how to initiate anLOD request, and defines the rightsARC service membersareafforded by the LOD determination program, and the responsibilities ARC service membersmustfulfill to access healthcareand secondarybenefits. Commanders9.What options do immediate commandershave in the informal LOD determination process?Immediate commanders make the LOD recommendation to the wing commander, and the wing commander makesthe final LOD determination. Immediate and wing commanders make one of the three following decisions on the evidence and information obtainedduring their review in the process. 1.In Line of Duty 2.Not in Line of Duty-Existed Prior to Service-Not Service Aggravated (Other than Misconduct)3.Route the case for formal LOD processing10.What is the“Presumption of In Line of Duty?” The Air Force presumesall injuries, illnesses, diseases and deaths during a qualified duty status are In Line of Duty. To make a Not in Line of Duty determination, sixevaluation criteria questions determine if there is evidence in the submitted forms to overcome the presumption of In Line of Duty.Below are the sixevaluation criteria questions and guidance to inform the LOD determination. Question 1: Did member sign the Member LOD Initiation Form certifying the information to be true?•YESroceed to question #2. The member certified by signing the form•NO:Consider engaging with the member to determine why the form is not certified. If the member indicated in writing they are not willing to certify the form, route the case for formal LOD processingQuestion 2: Is there a written diagnosis from a medical provider that supports the claimed condition?•YES
3USAF Invisible Wounds Initiative | Learn more at www.woundedwarrior.af.mil/Airmen-Veterans/Invisible-Wounds-InitiativeARC LOD REFORMLOD FREQUENTLY ASKED QUESTIONSMAY 2021•NO:Consider engaging with the medical provider. If the medical provider confirms there is no diagnosis for the claimed condition, make a Not in Line of Duty determinationQuestion 3: Did the member request the LOD within 180 days of completing the qualified duty status, or is the diagnosis a latent onset condition, e.g., post-traumatic stress disorderand other mental, behavioral, neurodevelopmental conditions?•YESeny LOD request. Member did not submit LOD request within required timeframeQuestion 4: Was the injury incurred or aggravated during a time period covered by the qualified duty status?•YES:Make an In Line of Duty determination. The date of the injury reported inthe Member LOD Initiation Form or Medical Provider Form is within the qualified duty status time period •NO:Make a Not in Line of Duty determination. The date of the injury reported in the Member LOD Initiation Form or Medical Provider Form is not withinthe qualified duty status time periodQuestion 5: Is there medical evidence the illness or disease existed prior to the qualified duty status time period?•YES: Proceed to #6. Thisis a pre-service condition. The military medical provider obtains diagnostic testing showing condition was incurred or diagnosed before the qualified duty status time period. Refer toTable 12: Diagnostic Tests that Inform Disease/Illness Timeline1for diagnostic tests and information that can inform when the disease or illness came into being•NO:Make an In Line of Duty determination. The military medical provider does not obtain diagnostic testing showing condition was incurred or diagnosed before the qualified duty status time period, or the military medical provider confirms the diagnosis is a condition within ICD 10 F series: Mental/Behavioral/Neurodevelopmental Disorder (e.g., PTSD)2Question 6:Is there medical evidence that activities during the qualified duty status worsenedthe pre-service condition beyond its natural progression?•YES:Make an In Line of Duty determination. Medical provider in the Medical Provider Form or AF Form 348 indicate the condition is worsened beyond its natural progression •NO: Make a Not in Line of Duty determination. Medical provider in the Medical Provider Form or AF Form 348 does not indicate the condition is worsened beyond natural progression11.When do commanders conduct an LOD determination?Af ter an ARC service membersubmits a certified Member LOD Initiation Form and a copy of the orders from the qualified duty status, the GMU/RMU coordinator initiatesthe LOD process. A qualif ied duty status includes any of the following: •Any active service or authorized training inthe military service;•Traveling directly to or from the place where the ARC service memberperforms active duty;•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. For example, commanders should initiate an LOD request for an ARC service memberwho experiences an ankle injury in of f-duty hours during Unit Training Assembly12.Does the Air Force provide target completion timelines for the informal LOD process?Yes. After an ARC service membersigns the Member LOD Initiation Form to initiate the 1See Commander’s Guide, 3.2.2.1 Diagnostic Tests that Inform Disease/Illness Timeline2If the member certifies the Member LOD Initiation Form, the unit obtains an ICD 10 F series diagnosis, there is no suspected misconduct, then the commander has no evidence the condition was Not in Line of Duty.
4USAF Invisible Wounds Initiative | Learn more at www.woundedwarrior.af.mil/Airmen-Veterans/Invisible-Wounds-InitiativeARC LOD REFORMLOD FREQUENTLY ASKED QUESTIONSMAY 2021process, ARC units complete tasks within the targeted completion time in the table below:RoleTaskCompleted WithinRMU/GMU CoordinatorUpload Documentation5 WorkdaysMilitary Medical ProviderProvide Medical Input30 Workdays or next UTAImmediate CommanderRecommend LOD 10 Workdays(OPTIONAL) Staff Judge AdvocateReview/Recommend LOD5 WorkdaysWing CommanderFinalize Inf ormal LOD10 WorkdaysTotal: 60 Workdays13.How does the Air Force evaluate LOD process performance?Wing Commanders appoint an LOD Program Manager who reports LOD determination perf ormance across the wing to the Wing Commander. LOD Program Managers submit a monthly program status report on timeliness of completed LODs and in-progress LODs andsubmit a written audit report based on a 10 percent evaluation of LOD determination accuracy and timeliness.14.How much time do commanders have to make an informal LOD determination?Commanders are required to finalize an LOD determinationor forward the LOD for FormalLOD processingwithin 60 days of receiving an LOD request from an ARC service member.15.How can commanders verify the duty status of the ARC service member during which the medical condition occurred or was aggravated?Commanders refer to the copy of the ordersthe member submits with their completed Member LOD Initiation Formto confirm receipt of the appropriate qualified duty status documentation.•Member Status: Inactive Duty for Training (IDT), Annual Tour (AT), Military Personnel Appropriation(MPA), Reserve Personnel Appropriation(RPA), DD 1610(TDY)•If on orders: Pre-certification; All modifications; Close-out if available•If IDT: Certif ied/approved AF 40A (AFRC) or ANG105S(ANG)•If AF 40A or ANG105Snot availableRef er to the Point Credit Accounting and Reporting System (PCARS) Report f rom the Military Personnel Data System (MilPDS)attached for the memberoConf irm PCARS reflectsthe date of injury, illness or disease to accurately calculate Total Active Federal Military Service (TAFMS)oDetermine if TAFMSreads more than 080000 (YYMMDD)
5USAF Invisible Wounds Initiative | Learn more at www.woundedwarrior.af.mil/Airmen-Veterans/Invisible-Wounds-InitiativeARC LOD REFORMLOD FREQUENTLY ASKED QUESTIONSMAY 202117.What is a “Prior Service Condition,” and what actions should commanders take if they suspect an LOD casemay meet “Prior Service Condition” criteria?A “Prior Service Condition” is defined as a condition that:1) occurs or originates from previous service in another Service Branch or Component; and 2) has no evidence of service aggravationwhile performing duty in the current Service Component(Note: If there is any medical evidencepresented by the civilian or military medical provider that the condition was aggravated while the ARC service member performed duty with the current Service Component, the wing commander should finalize the LOD determination). To qualify as a “Prior Service Condition,” a diagnosis, or symptoms correlating to the official diagnosis received after leaving the prior service, must be documented in the service treatment record.If “Prior Service Condition” criteria applies, the wing commander should return the LOD determination to the military medical provider, who will route the case to the ARC LOD Board (AFRC) or to NGB/SGPS (ANG)for a “Prior Service Condition” determination.Following the “Prior Service Condition” determination, should the condition be severe enough to warrant entrance into theIntegratedDisability Evaluation System(i.e., unfitting), a positive determination would qualify the ARC service memberf or entrance into the compensable pathway, the Medical Evaluation Board and Integrated Disability Evaluation System.18.Is the Staff Judge Advocate’s approval step required for an informal LODdetermination?No. Wing Commanders use their discretion to obtainlegal inputs from Staff Judge Advocate within the sixty-day process.Military Providers19.What medical evidence must a Military Medical Provider present to recommend a disease or illness existed prior to service and was not aggravated? All illnesses and diseases in qualified duty status are presumed In Line of Duty. Criteria for conditions thatexisted prior to service and were not service aggravatedmay include: 1.The ARC unit obtains previous medical history records, a diagnostic test or written medical inputfrom a credentialed providerthat concludes the condition existed before the qualif iedduty status;and2.The militaryprovider,or civilian provider who made the diagnosis,indicates there is no medical evidence the pre-service condition worsened beyond its naturalprogression20.What evidence informs the Military Medical Provider’s inputs?Military Medical Providers provide input based on the medical evidence obtained at the time of their review. If the ARC service memberreceives a diagnosis from a credentialed civilian provider, themilitary medical provider reviews and documents findings from relevant medical documentationand the diagnosis; confirms whether the existing medical evidence supports the illness, injury or diseaseclaimed by the member based on medical principles;and determines if the condition existed prior to service or was service aggravated
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