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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

LOD coverage is separate from any other TRICARE coverage received including:2

  • 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.

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.3 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-Step4

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

Sources

1"Reserve Component Incapacitation System Management, Instruction 1241.2" [PDF 39KB], Department of Defense. Published May 30, 2001.
2"Line of Duty Care," TRICARE. Last accessed June 17, 2013.
3"How to Forward a Line of Duty Determination (LOD) to MMSO" [PDF 268KB], TRICARE. Last accessed June 17, 2013.
4"TRICARE Fundamentals Course Participant Guide (Module 7: National Guard and Reserve)" [PDF 6.5MB], TRICARE. Last accessed July 10, 2013.

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