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PREFACE

BY ORDER OF THE COMMANDER

DRAFT OFFICIAL:

JOHN F. BAHRENBURG
Major General, New York Guard
Commander

1. Purpose. This publication sets forth format and procedures to govern the Line of Duty
Determination, Hospitalization, Medical Care and Deceased Personnel.

2. Application

a. Format and procedures to be followed in completing duty status investigations in

connection with injury, disease or death of individuals ordered to state active duty.

b. This publication is a mandatory directive.

3. Scope. This publication describes procedures to be followed in completing duty status

investigations in connection with injury, disease or death of individuals ordered to state active
duty. Although the procedures are similar to those guidelines furnished for federal LOD (Line of
Duty) investigations, all SAD LOD investigations must be in accordance with this Directive.

New York State Consolidated Laws, Chapter 36, Military, Article X, Pay and
4. Basis.
Allowances, § 216 Pay and care when injured or disabled in service.

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TABLE OF CONTENTS

CHAPTER PAGE

I POLICY…………………………………………………………………….………….. I-1

II RESPONSIBILITIES…………………………………………………………………… II-1
1. Individual Concerned….……………………………………………………….. II-1
2. Commanders of New York Guard Components .……………………………….. II-1
3. Headquarters New York Guard………………………………….…………….. II-1

III. PROCEDURES……..……………….………………..……………………………… III-1

1 Authorizing Authority……..……………………..……………………………… III-1
2. Procedures…………………………………………………………….……….. III-1
3. Reviewing Authority. ……..…………………………………………………… III-1
4. Line of Duty Injuries and Investigations. ……….………………..…………… III-1
5. In an emergency: …….…………………………..……………………………… III-2
6. Commanders: ……..……………………………..……………………………… III-2
7. Individuals: ……..……………………………….……………………………… III-2
8. LOD investigations: …………………………….……………………………… III-3
9. Evidence Collection: …………………………….………………………………III-3

APPENDIX A…………………………………………………………………………… A-1

1. MEDICAL RELEASE STATEMENT………………………………………….. A-1
2. STATEMENT OF UNDERSTANDING CIVILIAN HEALTH CARE……….. A-2
3. MEMORANDUM FOR Commander …………….…………….…………….. A-3

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CHAPTER I

POLICY

A duty status investigation is a command responsibility. The investigation is a review process,

which is used to determine an individual's eligibility for benefits as a result of an injury, disease
or death. Elements of duty status investigations and reports are:

a. The status of the individual at the time the injury was incurred or the disease was
contracted.

b. Medical evidence that an injury or disease was incurred contracted or aggravated by the
performance of duty.

c. Evidence of death.

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CHAPTER II

RESPONSIBILITIES

1. It is each individual's responsibility to make known his need for medical care as a result of
injury or disease incurred in state active duty status.

2. It is incumbent upon commanders and/or Administrative Officers to promptly initiate

necessary action.

3. Headquarters NYG will monitor that Line of Duty Investigations will be prepared in all cases
involving civilian/military health care in connection with injuries/illnesses contracted while
performing SAD. This applies to all NYG -SAD forces. LOD investigations will be completed
regardless of civilian medical cost.

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CHAPTER III

PROCEDURES

1. Authorizing Authority:

a. The appointing authorities for all SAD forces mobilized into state active duty is the
Commander NYG or designated representative

b. The appointing authority will issue orders appointing such officers as may be necessary to
conduct duty status investigations and reports.

2. Reviewing Authority. The reviewing authority in all cases is The Adjutant General or his
designated representative. Duty status investigation and reports will be submitted promptly,
through channels, to the NYG J1.

3. Line of Duty Injuries and Investigations. Upon being ordered into state active duty, each
unit will include in its accompanying library the appropriate medical Line of Duty forms listed in
Appendix A.

a. The procedures and formats prescribed in this chapter will be followed in every instance
of an injury incurred or a disease contracted during state active duty.

b. If an individual has been hospitalized during a portion of the active duty period, or is still
hospitalized at the close of the active duty period, the investigating officer will procure a clinical
summary for the period up to the time of submitting the duty status report.

c. This summary should indicate the number of days hospitalized, diagnosis, results of X-
rays and all other tests and treatment given, together with an accounting of the expense incurred.

4. In an emergency: Unit commanders may authorize hospitalization or medical treatment for

an individual without prior approval of this Headquarters. In such instances, details of the case,
together with a request for hospitalization or medical care, will be submitted to the NYG J1.

a. It is a command responsibility to provide prompt medical care to a member in need of

such care.

b. The respective unit commander will make the location of aid stations and hospital
facilities known to all personnel. It is a command responsibility that required medical care is
available to the individual without delay. Commanders must continually be aware of the general
physical and health conditions of personnel in their command.

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c. Treatment beyond the capabilities of the command will be accomplished at the nearest
civilian medical treatment facility. Use of military and federal medical treatment facilities (MTF)
is not authorized except for life threatening situations. Commanders will ensure that these
facilities are provided with the proper billing procedures, necessary vouchers and billing address.

5. Commanders: Will ensure that LOD investigations are initiated promptly as outlined. An
Initial Incident Report, will be completed and submitted to NYG J1 immediately. Additional
information and status updates should be forwarded with the periodic strength reports.
Commanders will ensure that all LODs are forwarded to Headquarters NYG J1 within 20 days of
the date of occurrence. If the DMNA Operation Center is not in operation, LODs will be
submitted to MNSG. Certain LOD investigations may require investigating officers to be placed
on SAD to complete the investigation.

6. Guide for commanders:

a. Commanders are responsible for appointing an investigating officer for each formal line of
duty.

b. An investigation is essentially a fact process to gather sufficient evidence to determine if a

soldier's disease, injury, condition, or death was due to the soldier's intentional misconduct or
willful negligence or was incurred during a period of unauthorized absence.

c. Unless reputed by substantial evidence, the soldier's disease, injury, condition, or death is
presumed to have been incurred In the Line of Duty (ILD).

d. The investigating officer must be free from bias or prejudice as to the cause of the
soldier's disease, injury, condition, or death or the outcome of the investigation. The I0 must also
be free of all other duties. Promptness is crucial since any delay may result in failure to secure
important information.

7. Instructions For The Investigating Officer.

a. You have been appointed as an Investigating officer (I0) to conduct an official Line of
Duty Investigation concerning the disease, injury, condition, or death of a NYG soldier, or a
group of soldiers. Your investigation, the documents you gather, and the way you present the
facts and the circumstances (tell the story) will be the basis for the NYG-DMNA to make
decisions that may impact on the soldier and soldier's family. Therefore it is imperative that you
read these instructions and refer to NYG Directives for further guidance if necessary, review the
source documents gathered thus far, and begin the investigation.

b. When advice or assistance is required, consult the experts, such as your local Judge
Advocate; Medical Treatment Facility Patient Administrator; Physicians; Mental Health Officers;
PM; CID; and appointing authority.
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8. Individuals: Hospitalized at the time of relief from state active duty. Within 24 hours after
demobilization, each unit commander as applicable, will submit the following information to the
NYG J1 pertaining to individuals remaining in the hospital at the time the unit or individual is
relieved from state active duty

a. Grade, name, SSN, branch of service

b. Name and location of hospital
c. Estimated length of stay in hospital
d. Brief diagnosis of disease or injury

9. LOD investigations: Will be completed for, but are not limited to, the following
circumstances:

a. When medical treatment may be extended beyond the period of authorized training or
follow-up medical care will be required.

b. Cases in which incapacitation pay may be entitled as a result of the incident.

c. Pre-existing injuries.

d. Diseases.

e. Injuries/death incurred while traveling directly to or from authorized duty status.

f. The injury or disease which may have resulted from the member’s own misconduct.

g. Self-inflicted wounds or injuries.

h. The injury or disease may have been received or contracted during a period of
unauthorized absence, or during a period that existed prior to authorized SAD.

i. An injury incurred while engaged in authorized SAD, which appears not to be in the line
of duty.

10. Evidence Collection: Required for a State Active Duty Line of Duty Investigation.

a. The Investigating Officer (IO) must be free from bias or prejudice while conducting the
investigation. The IO should never begin the investigation with predetermined ideas as to the
cause of the injury, disease or death. To make a thorough and impartial investigation, the IO
should determine the actual facts, not as reported, but as they actually occurred; as far as
possible. The IO should be able to make an intelligent and accurate determination. Delays often
result in the failure to secure important information.

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b. The preparation of the line of duty requires attention to detail. The investigation will
ascertain dates, places, persons and events definitely and accurately. The Appointing Authority
must ensure that the investigation contains sufficient pertinent information and data to enable
later reviews to be made without additional information.

c. All finding of fact will be supported by evidential exhibits, copies of military and
civilian reports, clinical records, emergency room reports, hospital admission and discharge
summaries, operative notes, laboratory reports, and other findings.

d. Preparation of witness statements will be thorough and provide an accurate account of

the situation. When there are no witnesses available, the unit commanders must present
sufficient comment as to why no witnesses were available. Does the individual’s
schedule/activities/mission coincide with witness statements? If the injured member was under
the supervision of a superior, the superior’s account of the situation must be obtained. The
investigating officer must determine if negligence or misconduct was involved. Pre-existing
conditions must be identified during the investigation.

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APPENDIX A - FORMS
DIVISION OF MILITARY AND NAVAL AFFAIRS
330 Old Niskayuna Road
Latham, New York 12110-2224

MEDICAL RELEASE STATEMENT

I, _____________________________, hereby authorize release of all

NAME / SSN

Medical documents relative to my medical care during the period

Through to the Division of Military and Naval Affairs,

Headquarters New York Guard.

_____________________________________
Name (TYPED)

_____________________________________
SSN

_____________________________________
SIGNATURE

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STATEMENT OF UNDERSTANDING
CIVILIAN HEALTH CARE

I, _______________________________, UNDERSTAND THAT AS A MEMBER OF

NAME AND RANK OF INSURED SOLDIER

________________________________, WHO INCURRED OR AGGRAVATED AN INJURY

COMPONENT

OR DISEASE WHILE IN A STATE ACTIVE DUTY STATUS AM ENTITLED TO HEALTH

CARE AND THAT EMERGENCY CIVILIAN HEALTH CARE MAY BE AUTHORIZED BY

COMMANDING OFFICER TO SAVE LIFE, LIMB, EYE SIGHT OR TO PREVENT UNDUE

SUFFERING, AND THAT THE J-1 OF THE EMERGENCY OPERATIONS CENTER MUST

PROVIDE APPROVAL FOR ANY ADDITIONAL NON-EMERGENCY CIVILIAN HEALTH CARE

AT GOVERNMENT EXPENSE.

I FURTHER UNDERSTAND THAT IF I DO NOT OBTAIN APPROVAL FROM THE J-1 OR

MNBF FOR NON-EMERGENCY CIVILIAN HEALTH CARE, I WILL BE RESPONSIBLE FOR

THE TOTAL COST INCURRED BY ME FOR MY MEDICAL TREATMENT.

ADDITIONALLY, I UNDERSTAND THAT IF THE LOD INVESTIGATION IS FOUND TO

BE “NOT IN THE LINE OF DUTY”, I MAY BE HELD LIABLE.

______________________________ _______________________________
MEMBER’S SIGNATURE WITNESS SIGNATURE

______________________________ _______________________________
MEMBER’S NAME/SSN (TYPED) WITNESS NAME/SSN (TYPED)

______________________________ _______________________________
TIME/DATE SIGNED TIME/DATE WITNESSED

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MEMORANDUM FOR Commander, New York Guard, ATTN: NYSG-J1 (LOD),

330 Old Niskayuna Road, Latham, New York 12110-2224

SUBJECT: Notice of Emergency Medical Treatment (NET)

1. LAST NAME, FIRST, MI GRADE SSN

2. CIVILIAN EMPLOYMENT - NAME & ADDRESS - JOB DESCRIPTION

HOME OF RECORD –
HOME PHONE NUMBER -

3. NAME OF THE PERSON AUTHORIZING CIVILIAN MEDICAL CARE

4. TYPE OF DUTY BEING PERFORMED IDT, AGR, AT, ADSW, Other

5. LOCATION OF TRAINING SITE WHERE INCIDENT OCCURRED:

6. DATE OF OCCURENCE: DIAGNOSIS:

7. LINE OF DUTY STATUS (check one): [ ] IN LINE OF DUTY,

[ ] NOT IN LINE OF DUTY,
[ ] PENDING INVESTIGATION

8. SOLDIER IS AUTHORIZED MEDICAL CARE UNDER THE PROVISIONS

OF AR 135-381.

9. INCLUSIVE DATES OF TRAINING: FROM TO:

10. NAME AND FULL MAILING ADDRESS OF MEDICAL FACILITY UTILIZED.

11. BRIEF AND COMPLETE SUMMARY OF EVENTS LEADING UP TO AND

SURROUNDING THE INCURRENCE OF INJURY, ILLNESS OR DISEASE:

** The line of duty investigation must be completed and forwarded within 35 days of the
occurrence of the injury, illness or disease. Commanders are reminded that all soldier
entitlements are based on the line of duty investigation. Follow-up health care, Payment of
Medical Bills and Incapacitation all
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