All requests for ADHC orders must include the items below and be routed through the Command and District(dxr)/DOL-1/PAC-13 RFRS to CGPSC-RPM-3 via email to: ARL-SMB-CGPSC-RPM-Reserve-Medical@uscg.mil. All personnel involved in this process shall ensure proper precautions are taken to protection Personally Identifiable Information (PII) and Protected Health Information (PHII), especially when transmitting information electronically.
Initial requests must include ALL of the documents listed below. Incomplete request packages will be returned without action.
NOTE 1: A formal LOD investigation is only required when the command has reason to believe that the injury, illness or disease was not incurred in the line of duty or occurred as a result of misconduct or gross negligence.
NOTE 2: The CG-4614 is obsolete, The Letter of Incident Report (LIR) should be utilized in its place.
Member's on ADHC orders are required to submit monthly supporting documentation to continue their benefits. Failure to submit the required monthly documentation below may result in early termination of benefits. All documents shall be submitted through the member's command and District(dxr)/DOL-1/PAC-13 RFRS to: ARL-SMB-CGPSC-RPM-Reserve-Medical@uscg.mil
ADHC orders may not be extended beyond the original date authorized by PSC-RPM-3 without prior approval from PSC-RPM-3. All extension requests must include the documentation below and be submitted to PSC-RPM-3 via email at: ARL-SMB-CGPSC-RPM-Reserve-Medical@uscg.mil