Reserve Incapacitation Benefit Appeal Process

BACKGROUND

Per Chapter 6 of the Reserve Policy Manual; COMDTINST M1001.28 (series), Commandant (CG-13) is the appeal authority for Reserve Incapacitation Benefits (RIBs). RIBs include Medical Hold orders, Active Duty for Health Care (ADHC) orders, Notice of Eligibility (NOE), and Incapacitation Pay. Should a member disagree with RPM’s determination concerning their RIB request, the member should submit an appeal as outlined below.

NOTE: The appeal process for RIBs differs from the appeal process for Line of Duty (LOD) determinations. The appeal process for LOD determinations is addressed in Chapter 7 of the Administrative Investigation Manual; COMDTINST M5830.1 (series).

APPEAL PROCESS

Member:

  1. Appeals must be submitted within 30 days of RPM’s original decision.
    1. Appeals must be in standard Coast Guard memo format, indicate appeal in the memo subject line and it must be addressed to CG-13 via the chain of command, including District(dxr), DOL-1 or PAC-13, as appropriate, and RPM.
    2. The memo must clearly state the justification for the appeal and include supporting documentation.

Command:

  1. Endorse the appeal memo (recommending approval or denial) and provide a copy to the member. However, the final determination will be made by CG-13. Once the member submits an appeal, it must be routed through appropriate entities to CG-13 for final determination.
  2. Forward the appeal along with the endorsement to the District(dxr), DOL-1 or PAC-13, as appropriate, within 3 business days of the member submitting the appeal memo. Commands should ensure there are no unnecessary administrative or operational delays submitting the appeal.

District(dxr), DOL-1 or PAC-13 (as appropriate):

  1. Within 3 business days, endorse the appeal memo accordingly and forward to RPM with a copy to the command and the member.

CG PSC-RPM:

  1. RPM reviews the appeal package and the original decision to deny or terminate benefits. Within 10 calendar days, endorse the appeal accordingly and forwarded to CG-13 with a copy to the District(dxr), DOL-1 or PAC-13, as appropriate, the command, and the member.

Commandant (CG-13):

  1. Reviews the case and issues a final determination to approve or deny the appeal request. Determination will be made within 30 calendar days of CG-13 receiving the appeal package. Response will be given via standard Coast Guard memo to the member and all required entities