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jdlancas519,
I am an Army Reserve 1SG going through the LOD and INCAP process. I injured my right knee while on 23 day ADT orders. Reading your initial posting you mentioned that you have a LOD or DA 2173. I take it that you are near a military treatment facility as you have been seen by a military doctor and that doctor is requesting surgery. I had braces, surgery, and now going through physical therapy all paid for and coordinated by the Army. I have not been at work since September 18, 2017. AR 135-381 (INCAP for Guard and Reserve Soldiers) says if you are within 50 miles of a MTF, then that MTF has to provide your care. In my case I am within the 50 miles and I receive my care at the nearest military hospital. To your discretion you can ask the MTF to refer you to a civilian doctor to perform your surgery and to take care of any follow-ups with additional specialists. However, very important, you'll need request an authorization/referral through the MTF to see an in-network/non-network Tricare doctor from the Tricare website. This is a must! The MTF will be your primary care manager. It is good to already have a specialist in-network specialist from the Tricare directory in mind so that way you can tell them at time of the request. In order to insure your bills will be paid through Tricare whether seeking treatment through the MTF or authorized civilian provider referred by the MTF, you'll need to register yourself in their hospital system by going to the BCAC office Beneficiary Counseling and Assistance Coordinator. They will assist you in registering your in their system, providing care, and advising on how to get your bills paid. You can go to
https://tricare.mil/bcacdcao. Ensure to tell them that you are a reservist needing LOD care. I am surprised the military doctor that you seen did not inform you of such.
If you are outside a 50 mile radius or not near a MTF then all of your medical care needs to be requested through MEDCHART system in the LOD section. You or your unit will need to go to DHA website(Defense Health Agency) and fill out worksheet 1 and worksheet 2 (can be uploaded at the same time) and submit in MEDCHART along with all your supporting documentation. This is only if you live outside a 50 mile radius or not near a MTF. All of your care will be coordinated by DHA through this website
https://health.mil/GreatLakes. They will generate all your authorization/referrals. So again if you have a doctor you want to see and they are in the Tricare network/non-network directory then make sure whomever is entering your information into MEDCHART notate such. Otherwise they will send you to some random doctor. They will not pay your bill if you did not seek a referral for the needed services.
INCAP Process
In order for you to claim INCAP pay, you first need a LOD investigation initiated to determine if your injury was incurred in the line of duty and was not due to negligence or misconduct. In order for you to do this all Army Reserve and National Guard units has to have their UA or designated person to enter all supporting documentation to include doctor's medical notes from your initial visits and any subsequent visits thereafter in a system called MEDCHART in the LOD section (VERY IMPORTANT). Once entered into the system, your company commander has to digitally sign and approve this action in that system. It then gets routed to your respective RSC Health Services Department for review. The regulation says the determination should take 30 days but that depends on what their workload is like. Once approved you'll receive an official memo stating that the Army Reserve Command concurs that your injury happened in the line of duty. The DA 2173 and this memo is needed to start your INCAP claim in the MEDCHART system under the INCAP section. Should they deny your LOD then all medical treatments will cease and you'll been the hook for continued care. Receiving INCAP pay requires a lot of documents. You'll need to be seen at least once a month by the doctor in the month you are claiming lost income in order to be paid. You cannot be working your civilian job and you have to be deem not fit for military duty and/or not fit for civilian duty per the 2 7574-1 that you have. Now either have to deemed fit for military duty and not fit for civilian duty or not fit for military duty and civilian duty. Either way you cannot work your civilian job or attend battle assemblies if not fit for military duty. Other documents needed are(at minimum if applicable):
-7574 (completed every month: has to be dated after the last day of the month that you are trying to claim)
-7574-2 (completed every month: has to be dated after the last day of the month that you are trying to claim)
-Commander's Memo (completed every month: has to be dated after the last day of the month that you are trying to claim)
-all doctors notes to include x-ray reports and MRI reports if available (provide monthly)
-W-2 forms or last years tax returns
-pay stubs from your job for that month(if you some income for that month they'll deduct that amount from your military INCAP pay)
-civilian job description
-military treatment plan from civilian or military doctor(for the recovery time and dates have your doctor to either list the maximum recover period or say unknown, otherwise you'll have to have it updated if the months you are attempting to claim fall outside the months your doctor indicates)
88th RSC INCAP/LOD POC:
[email protected]
ADME Orders
NO ONE can deny you from wanting to go on active duty for treatment, not even your BN Commander. It is not left up to him. You'll need to submit an application to go on orders (preferred route; I wished I would have taken this route because the INCAP pay process takes months before you are paid). I have attached what you need. I am in the 81st RSC region but the process is the same for all RSCs. For both programs, you need a military profile. Its a simple form that you and your doctor needs to fill out and then you'll need to email that form to the Army Reserves Medical Command. Profiles can only be granted for 90 days. So 14 days before 90 days expires from your previous profile you'll need to submit another profile request. No supporting medical documentation is needed to be submitted other than your 2173. It normally takes about 2-3 days for them to issue you a profile and they will email you when its available in MEDPROS. If you are unable to access MEDPROS have someone at your unit to forward it to you.
Attached you will find the ADME/MRP2 packet and checklist. Please note the first page is Form 8 (you will not use this form). You will use Form 4, and complete all that applies on the checklist. I have also attached a fillable DA FM 4187, ensure that either ADME/MRP2 is circled. Commander's
memo(indicated as Unit Cover Letter on checklist...same thing) must be on Unit Letterhead. The Soldier needs to have a current Treatment Care Plan (on the attending Physician/medical office letterhead), Profile for the condition and an approved LOD uploaded in MEDCHART(can be submitted prior to approval of LOD determination). Upon completion of the packet, submit packet in one (1) pdf file, with the
checklist being the first document, to the respective mailbox below.
Forward WTU Entry Packets to:
[email protected]
[email protected]
[email protected]
[email protected]
Army Profile
You'll need to fill out the first two forms. Ignore the 3rd form, MEDCOM 756, and have your doctor to fill out the last forms (SF 600). Again, no supporting documentation is needed. If they need any additional information they will email you. If you need another 90 day profile in the future then you only have to submit SF 600. You can send from your civilian email. Email to the Army Reserves Medical Command using the following example:
Email completed documentation to usarmy.usarc.usarc‐
[email protected]
a. SUBJECT LINE: “Profile Request”, Last name, First name and Last 4 of SSN
example- PROFILE REQUEST: Snuffy, Joe 1234
Lastly,
If you can take care of stuff yourself then I would advise you to do so. Make sure you follow directions very closely and do not miss a step. Most units do not know of this process and they will screw you. Now you cannot have access to the MEDCHART system so I would stay on whomever in your unit to make sure they are looking out for you. You can email the 88th RSC ADME/WTU and the 88th RSC INCAP/LOD POCs for more information. Feel free to file an IG complaint or congressional if things are moving slowly. Let me know if you need any additional assistance. I have access to MEDCHART and can check your progress if needed.
