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What Line of Duty Determinations Mean to Guard and Reserve Members

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Photo by Kari Hawkins, Redstone Rocket Staff

Note: Line of Duty (LOD) is a term used by the Army, Air Force, Navy and Marine Corps. The Coast Guard uses the term “Notice of Eligibility” (NOE). For simplicity, this article uses “LOD” for both terms.

“It is Department of Defense policy to provide medical and dental care to Reserve component members for an injury, illness or disease incurred or aggravated in the line of duty.”1

Guard and Reserve members returning from mobilization and combat duty encounter new challenges once they demobilize, especially if injuries or illnesses such as combat-related psychological health issues require further or additional medical care.

Once demobilized, if Reserve and National Guard members have an injury or illness that occurred on active duty, they must receive a Line of Duty (LOD) determination from their service branch. The LOD documentation is used to establish, manage and authorize civilian health care for eligible Reserve and National Guard members.2 (Note: LOD coverage is not available for family members.)

Line of Duty Medical Care

Transitional Assistance Management Program

The Transitional Assistance Management Program (TAMP) offers transitional TRICARE coverage to certain separating active duty members and their eligible family members during the LOD process. The 180-day TAMP period begins upon separation from active duty. Under TAMP, service members do not have copayments, cost-shares or deductibles for treatment services. Service members should check with their service personnel departments on whether they are eligible. TAMP eligibility is determined by the Services and documented in the Defense Enrollment Eligibility Reporting System (DEERS). Find out more about conditions for eligibility.

LOD coverage is separate from any other TRICARE coverage received including:3

  • Benefits provided under the Transitional Assistance Management Program
  • Coverage provided under TRICARE Reserve Select
  • Coverage provided under TRICARE Retired Reserve

The LOD determination is extremely important for Reserve and Guard members for two reasons: first, so they do not incur out-of-pocket expenses for medical care; and second, so those seeking care for physical and psychological concerns will receive needed attention.

Reserve and Guard members should first contact their chain-of-command. If the service member is within 50 miles of a military treatment facility (MTF), the unit medical representative will coordinate care. If the member lives more than 50 miles from a MTF, the unit medical representative can authorize the member to be evaluated by civilian medical personnel, with the government reimbursing the expense.

Transitional Care for Service-Related Conditions Program

The Transitional Care for Service-Related Conditions (TCSRC) Program extends TRICARE coverage beyond the regular 180-day TAMP period for certain service-related conditions approved by a DoD provider.

Once the member has been evaluated, the information is forwarded to the chain-of-command or medical unit representative which, if applicable, initiates the LOD process. With the medical evaluation, the chain-of-command or medical unit representative forwards the information to its personnel headquarters, which issues the LOD, if applicable.

  • If the Reserve or Guard member lives within 50 miles of a military treatment facility, the LOD should be sent to that MTF’s TRICARE office.
  • If the Reserve or Guard member lives more than 50 miles to a military treatment facility, the LOD is sent to the Military Medical Support Office.4 Follow these steps to forward a LOD to the MMSO [PDF 268KB].

If your service issues a LOD, it is the Reserve or Guard member’s responsibility to ensure the LOD documentation is on file at either a MTF or the MMSO.2 When a Guard/Reserve member is issued an LOD, he or she receives primary medical care at the military treatment facility, and an assigned primary care manager manages that care. MTFs may also refer National Guard and Reserve members to civilian TRICARE providers.

Line of Duty Determination Step-by-Step5

For Reserve and National Guard service members:

Within 50 miles of Medical Treatment Facility

Greater than 50 miles to Medical Treatment Facility

1. Contact chain-of-command

1. Contact chain-of-command

2. Unit medical representative initiates LOD determination

2. Unit medical representative initiates LOD determination

3. MTF evaluates member.

3. After authorization, evaluated by civilian medical personnel.

4. Personnel HQ issues LOD (if applicable).

4. Personnel HQ issues LOD (if applicable).

5. MTF will provide and manage care.

6. MMSO will coordinate care with unit medical representative.

6. No out-of-pocket costs for routine or specialty care received at the MTF.

7. There are no out-of-pocket costs for covered routine care.

7. No out-of-pocket costs for referred and authorized specialty care.

7. There are no out-of-pocket costs for referred and authorized specialty care.

Additional Resources

Military Medical Support Office

The Military Medical Support Office (MMSO) manages civilian health care for Reserve and National Guard members who reside more than 50 miles away from a military treatment facility and must receive care through civilian health care systems.

Sources

1Reserve Component Incapacitation System Management, Instruction 1241.2, Department of Defense. Published May 30, 2001.
2Line of Duty Care, Beneficiary Home-Special Programs Overview, TRICARE. Last accessed May 12, 2011.
3Line of Duty Care, TRICARE. Last accessed May 12, 2011.
4How to Forward a Line of Duty Determination (LOD) to MMSO [PDF 268KB], MMSO Process Guide. Last accessed May 12, 2011.
5The National Guard and Reserve (Module 4) Participants Guide [PDF 606KB], TRICARE Fundamentals Course. Last accessed May 12, 2011.

Average: 3 (2 votes)
Last Reviewed: 06/01/11
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