3 FAM 3660
COmpensation for certain injuries
(CT:PER-1158; 10-02-2023)
(Office of Origin: GTM/ER; MED)
3 FAM 3661 AUTHORITY AND PURPOSE
(CT:PER-1158; 10-02-2023)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Pursuant to Public Law 116-94, Division J, Title IX, section 901 (22 U.S.C. 2680b), Congress allows the Secretary of State or the head of any other Federal agency to pay benefits to certain Department of State or other Federal agency personnel under Chief of Mission authority who incurred a qualifying injury and are receiving benefits under section 8105 or 8106 of Title 5, United States Code. It further authorizes the Secretary of State to pay for the costs of diagnosing and treating a qualifying injury of a covered employee, as defined in 3 FAM 3662, that are not otherwise covered by chapter 81 of Title 5, United States Code (the Federal Employees Compensation Act (FECA)) or other provision of Federal law; and to pay the costs of diagnosing and treating a qualifying injury of a covered individual or covered dependent, as defined in 3 FAM 3662, that are not otherwise covered by Federal law.
b. The Department of State’s Bureau of Global Talent Management (GTM), and other Federal agencies, as appropriate, administer this program.
c. Under this program, covered employees, as defined in 3 FAM 3662, may qualify for a monthly monetary benefit if they are receiving benefits under section 8105 or 8106 of Title 5, United States Code.
d. Under this program, a covered employee, covered individual, or covered dependent, as defined in 3 FAM 3662, may qualify for reimbursement for the costs of diagnosing and treating a qualifying injury which are not otherwise covered by Federal law.
e. Under the Helping American Victims Afflicted by Neurological Attacks (HAVANA) Act of 2021, covered employees, covered dependents and covered individuals as defined in 3 FAM 3667 may be eligible to receive a one-time monetary award. HAVANA Act benefits are described in 3 FAM 3667.
f. Payments made under this provision are not considered workers’ compensation payments. Nothing in this provision shall limit, modify, or otherwise supersede chapter 81 of title 5, United States Code, the Defense Base Act (42 U.S.C. 1651 et seq.), or section 19A of the Central Intelligence Agency Act of 1949 (50 U.S.C. 3519b).
g. To avoid duplicate or otherwise improper payments, the Secretary of Labor, the Secretary of State, and, as appropriate, the head of any other Federal agency paying benefits, shall exchange information about the amounts paid for treatment of qualifying injuries.
3 FAM 3662 DEFINITIONS
(CT:PER-1158; 10-02-2023)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
Covered employee: For purposes of 3 FAM 3663, Monthly Monetary Benefits, an employee of the Federal government who, on or after January 1, 2016, becomes injured by reason of a qualifying injury and was assigned to a duty station in the Republic of Cuba, the People's Republic of China, or another foreign country as designated by the Secretary of State or designee under 3 FAM 3666, not including an individual receiving compensation under section 19A of the Central Intelligence Agency Act of 1949 (50 U.S.C. 3519b).
(1) For purposes of 3 FAM 3663, the following career-type employees are considered "employees of the Department of State" to whom this benefit may apply: Department of State Foreign Service Officers, Department of State Foreign Service Specialists, and career Department of State Civil Service employees working overseas on detail or a Limited Non-Career Appointment (LNA).
The following are not considered "employees of the Department of State" for purposes of 3 FAM 3663: retired employees and employees of other agencies; employees on limited appointments including LNAs (except as discussed above), Family Member Appointments (FMA), Foreign Service Family Reserve Corps (FSFRC), Expanded Professional Associates Program (EPAP), and Consular Affairs - Appointment Eligible Family Member (CA-AEFM) Adjudicator positions. Employees hired on a Personal Services Agreement (PSA) or Personal Services Contract (PSC) are also not employees under this section.
(2) For purposes of 3 FAM 3664, the following employees are considered "employees of the Department of State" to whom this benefit may apply: Department of State Foreign Service Officers; Department of State Foreign Service Specialists; Department of State Civil Service employees; employees on Limited Non-Career Appointments (LNA), Family Member Appointments (FMA), Foreign Service Family Reserve Corps (FSFRC), Expanded Professional Associates Program (EPAP), and Consular Affairs - Appointment Eligible Family Member (CA-AEFM) Adjudicator positions.
The following are not considered "employees of the Department of State" for purposes of 3 FAM 3664: employees hired on a Personal Services Agreement (PSA) or Personal Services Contract (PSC); retired employees, and employees of other agencies.
Covered individual: An individual who, on or after January 1, 2016, becomes injured by reason of a qualifying injury and is:
(1) detailed to a duty station in the Republic of Cuba, the People's Republic of China, or another foreign country designated by the Secretary of State or designee under 3 FAM 3666; or
(2) affiliated with the Department of State, as determined by the Secretary of State.
(3) Per Memorandum signed April 24, 2020, the Under Secretary for Management has determined that other agency employees under Chief of Mission authority are "affiliated with the Department of State."
Covered dependent: A family member of a Federal employee who, on or after January 1, 2016:
(1) is accompanying the employee to an assigned duty station in the Republic of Cuba, the People's Republic of China, or another foreign country designated by the Secretary of State or designee under 3 FAM 3666; and
(2) becomes injured by reason of a qualifying injury.
Family member: An individual who is an "Eligible Family Member" as defined in 14 FAM 511.3.
Qualifying injury: The term "qualifying injury" means the following:
(1) With respect to a covered dependent, an injury listed in (3) below incurred:
(a) during a period in which a covered dependent is accompanying an employee to an assigned duty station in the Republic of Cuba, the People's Republic of China, or another foreign country designated by the Secretary of State or designee under 3 FAM 3666;
(b) in connection with war, insurgency, hostile act, terrorist activity, or other incident designated by the Secretary of State or designee; and
(c) that was not the result of the willful misconduct of the covered dependent.
(2) With respect to a covered employee or a covered individual, an injury listed in (3) below incurred
(a) during a period of assignment to a duty station in the Republic of Cuba, the People's Republic of China, or another foreign country designated by the Secretary of State or designee under 3 FAM 3666;
(b) in connection with war, insurgency, hostile act, terrorist activity, or other incident designated by the Secretary of State or designee; and
(c) that was not the result of the willful misconduct of the covered employee or covered individual.
(3) Recognized and eligible qualifying injuries, as of June 26, 2018, based on the University of Pennsylvania-identified criteria, include the following: sharp localized ear pain; dull unilateral headache; tinnitus in one ear; vertigo, visual focusing issues; disorientation; nausea; extreme fatigue; cognitive problems, including difficulty with concentration, working memory, and attention; recurrent headache; high-frequency unilateral hearing loss; sleep disturbance; and imbalance walking.
3 FAM 3663 MONTHLY MONETARY BENEFIT
(CT:PER-1158; 10-02-2023)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
a. The Secretary of State or the head of any other Federal agency may pay an additional monthly monetary benefit to a covered employee who is receiving benefits under section 8105 or 8106 of Title 5, United States Code (FECA), and may determine the amount of each monthly monetary benefit amount by taking into account -
(1) the severity of the qualifying injury;
(2) the circumstances by which the covered employee became injured; and
(3) the seniority of the covered employee, particularly for purposes of compensating for lost career growth.
b. The Bureau of Global Talent Management, Office of Employee Relations Care Coordination team (GTM/ER/Care Coordination) is responsible for processing applications for the monthly monetary benefit for employees of the Department of State, in coordination with the Office of Performance Evaluation (GTM/PE), the Bureau of the Comptroller and Global Financial Services (CGFS), and the Office of the Under Secretary for Management (M). Heads of other Federal agencies may designate an appropriate office to process applications for monthly monetary benefits for their employees.
c. Eligibility for the monthly monetary benefit is limited to covered employees, as defined in 3 FAM 3662. Employees on non-career-type limited appointments are not eligible for this benefit, which was designed to address lost career growth due to qualifying injury.
d. Eligible employees may apply for the monthly monetary benefit if they believe they have sustained lost career growth (e.g., promotion) due to a qualifying injury. Employees of the Department of State who wish to apply for this benefit must submit the documentation listed in 3 FAM 3665.1 via email to the Senior Care Coordinator (MMBquery@state.gov). Employees of other Federal agencies should contact the appropriate office in that agency.
e. Additionally, employees on FECA leave without pay (LWOP) receiving full wage loss compensation under section 8105 of chapter 81 of Title 5 may submit a claim for a monthly monetary benefit in the amount of any missed step increase that they would have been eligible to receive if they had been working and performing in a satisfactory fashion.
3 FAM 3664 MEDICAL COST REIMBURSEMENTS
(CT:PER-994; 05-28-2020)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Costs for Treating Qualifying Injuries. The Secretary of State may pay the costs of, or reimburse for diagnosing and treating:
(1) a qualifying injury of a covered employee for such costs, that are not otherwise covered by chapter 81 of Title 5, United States Code, or other provision of Federal law; or
(2) a qualifying injury of a covered individual, or covered dependent, for such costs that are not otherwise covered by Federal law.
b. The Department of State's Bureau of Medical Services (MED) is responsible for receiving and processing claims under this section for reimbursement of the costs of diagnosing and treating qualifying injuries, in coordination with CGFS and the covered individual’s sponsoring agency as appropriate.
c. Eligibility: Covered employees, covered individuals, and covered dependents as defined in 3 FAM 3662 may be eligible for payment or reimbursement of medical costs related to the qualifying injury.
d. Covered Employees: FECA remains the sole recourse for Federal employees for costs associated with diagnosing and treating a work-related injury. Employees must file a claim under FECA with respect to the qualifying injury before filing for payment or reimbursement from MED under this section. The Department may only pay the costs of or reimburse for diagnosing and treating a qualifying injury that are not otherwise covered under FECA, or other provision of Federal law.
(1) If an employee's claim under FECA for medical costs related to a qualifying injury is denied, the employee must supply information requested by the Department of Labor's Office of Workers' Compensation Programs and receive a final decision from OWCP. An OWCP decision that denies medical benefits on the ground that the employee failed to respond to inquiries and failed to submit any supportive evidence is insufficient to establish that the costs are not covered by FECA.
(2) If the employee's FECA claim and subsequent appeal are unsuccessful, the employee must then make a claim through their private health insurance If private health insurance denies the claim or does not pay it in full, the employee must file an appeal. After the appeal is completed, employees may then file a claim for reimbursement of the unreimbursed cost of treatment with MED, as provided in 3 FAM 3665.2.
(3) If the employee’s private health insurance specifically does not cover durable medical supplies for qualifying injuries (such as prescription eyeglasses for visual focusing issues or hearing aids for hearing loss), the employee should file a claim for reimbursement of the unreimbursed cost with MED, as provided in 3 FAM 3665.2 paragraph (1) (vi).
(4) An employee may file a claim for reimbursement with MED, as provided in 3 FAM 3665.2, only after completing the actions described in subparagraphs (1) and (2) above.
e. Covered individuals: FECA remains the sole recourse for Federal employees for costs associated with diagnosing and treating a work-related injury. Covered individuals who are Federal employees must file a claim under FECA with respect to the qualifying injury before filing for payment or reimbursement from MED under this section. The Department may only pay the costs of or reimburse for diagnosing and treating a qualifying injury that are not otherwise covered under FECA, or other provision of Federal law.
(1) If a covered individual's (who is a Federal employee) claim under FECA for medical costs related to a qualifying injury is denied, the individual must supply information requested by the Department of Labor's Office of Workers' Compensation Programs and receive a final decision from OWCP. An OWCP decision that denies medical benefits on the ground that the individual failed to respond to inquiries and failed to submit any supportive evidence is insufficient to establish that the costs are not covered by FECA.
(2) If the individual's FECA claim and subsequent appeal are unsuccessful, the individual must then make a claim through their private health insurance. If private health insurance denies the claim or does not pay it in full, the individual must file an appeal. After the appeal is completed, the individual may then file a claim for reimbursement of the unreimbursed cost of treatment with MED, as provided in 3 FAM 3665.2.
(3) If the individual’s private health insurance specifically does not cover durable medical supplies for qualifying injuries (such as prescription eyeglasses for visual focusing issues, or hearing aids for hearing loss), the individual should file a claim for reimbursement of the unreimbursed cost with MED, as provided in 3 FAM 3665.2 paragraph (1) (vi).
(4) A covered individual may file a claim for reimbursement with MED, as provided in 3 FAM 3665.2, only after completing the actions described in subparagraphs (1) and (2) above.
f. Covered dependents: Covered dependents with qualifying injuries, as defined in 3 FAM 3662, must first file a claim under their private health insurance.
(1) If private health insurance denies the claim or does not pay it in full, the dependent must file an appeal.
(2) If the claim is accepted, but not paid in full, the claim must be appealed. After the appeal is completed, the dependent may then file a claim for reimbursement of the unreimbursed cost of treatment with MED, as provided in 3 FAM 3665.2. Private insurance copays for dependents may be eligible for reimbursement by MED.
(3) If the dependent’s private health insurance specifically does not cover durable medical supplies for qualifying injuries (such as prescription eyeglasses for visual focusing issues, or hearing aids for hearing loss), the dependent should file a claim for reimbursement of the unreimbursed cost with MED, as provided in 3 FAM 3665.2 paragraph (1) (vi).
3 FAM 3665 RESPONSIBILITIES
3 FAM 3665.1 Covered Employees - Monthly Monetary Benefit
(CT:PER-1158; 10-02-2023)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Covered employees of the Department of State are responsible for assembling and submitting to MMBquery@state.gov the following required documentation for a monthly monetary benefit claim. Questions should be directed to MMBquery@state.gov.
(1) a copy of travel orders showing assignment and travel, that cover the period January 1, 2016, or after to a duty station in Cuba, China, or another foreign country designated by the Secretary of State or designee;
(2) copies of Department of Labor FECA claim and payment letters;
(3) a copy of the Department of Labor FECA letter that outlines the employee’s payment and computation of payment;
(4) a short statement from the employee describing possible harm to career growth; and
(5) any additional documentation or information requested by the GTM/ER Care Coordination Team.
b. Covered employees of other Federal agencies should contact the appropriate office in their agency regarding monthly monetary benefits.
3 FAM 3665.2 Covered Employees, Covered Individuals and Covered Dependents - Medical Cost Reimbursement
(CT:PER-1158; 10-02-2023)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
Covered employees, covered individuals, and covered dependents are responsible for:
(1) Assembling documentation required for submitting a claim for reimbursement of qualifying medical diagnosis or treatment costs. Covered employees and covered individuals may submit documentation for their covered dependents.
(a) The following documentation is required:
(i) a copy of travel orders showing assignment and travel, that cover the period January 1, 2016 or after, to a duty station in Cuba, China, or another foreign country designated by the Secretary of State or designee;
(ii) copies of the Explanation of Benefits (EOB) or other bills from private insurance that show the diagnosis codes from the claim;
(iii) copies of the insurance appeal denial letter, and if an employee, a copy of the OWCP’s final determination letter;
(iv) documentation of out-of-pocket expenses, and documentation of payment; and
(v) any additional documentation or information requested by the Medical Claims team.
(vi) If the claim is for unreimbursed costs for durable medical supplies for a qualifying injury that are not covered by the claimant’s private health insurance (such as prescription eyeglasses for visual focusing issues or hearing aids for hearing loss), the claimant should submit an excerpt from the health plan materials which lists the durable medical supply (e.g., glasses) as a non-covered item. The claimant does not have to submit an appeal to their private health insurance before claiming the costs of these durable medical supplies.
(b) Do not send copies of medical files or medical history.
(2) Submitting the documentation to MED via email to MEDCLAIMS@state.gov. The applicant should use the following email subject line: Last name, First name - 3 FAM 3664.
(3) Providing any additional relevant documentation to MED related to submitted claims, as requested.
3 FAM 3665.3 Bureau of Global Talent Management, Office of Employee Relations (GTM/ER)
(CT:PER-1158; 10-02-2023)
(State only)
(Applies to Foreign Service and Civil Service Employees)
The GTM/ER Care Coordination Team coordinates the monthly monetary benefit application process for the Department of State and has responsibility to:
(1) Process applications for the monthly monetary benefit from employees of the Department of State;
(2) Determine eligibility for the benefit, the amount of the benefit, and process payment of the benefit in coordination with the Bureau of Global Talent Management Performance Evaluation Office (GTM/PE), the Bureau of the Comptroller and Global Financial Services (CGFS), and the Office of the Under Secretary for Management (M);
(3) Make a recommendation to M to approve (or not approve) the application for the monthly monetary benefit; and
(4) Notify employees upon receipt of their applications and when a monthly monetary benefit decision is made.
3 FAM 3665.4 Bureau of Medical Services (MED)
(CT:PER-1158; 10-02-2023)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
The Bureau of Medical Services (MED) will receive applications for payment or reimbursement and has the responsibility to:
(1) Receive applications for reimbursement of diagnosis and treatment of qualifying injuries via email (MEDCLAIMS@state.gov);
(2) Process applications for reimbursement of diagnosis and treatment of qualifying injuries as defined in 3 FAM 3662;
(3) Notify employees of the status of their applications for the payment or reimbursement benefit; and
(4) Track and share information related to amounts paid for treatment of qualifying injuries, as defined in 3 FAM 3662, to Department of State employees and covered dependents as well as to covered individuals affiliated with the Department of State on a quarterly basis with the Department of Labor, to avoid duplicate or otherwise improper payments.
3 FAM 3665.5 Bureau of Global Talent Management Office of Performance Evaluations (GTM/PE)
(CT:PER-1158; 10-02-2023)
(State Only)
(Applies to Foreign Service and Civil Service Employees)
In coordination with the GTM/Office of Organization and Talent Analytics (OTA), GTM/PE has the responsibility to, upon request from GTM/ER, compile promotion statistical data for Department of State employees in the same cone or specialty and with similar lengths of service as the applicant and provide it to GTM/ER. GTM/ER will use the data to determine whether a covered employee applicant has likely suffered lost career growth based upon a comparison of the average promotion time for the similarly situated group and the applicant.
3 FAM 3665.6 Bureau of the Comptroller and Global Financial Services (CGFS)
(CT:PER-1158; 10-02-2023)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Upon receipt from GTM/ER, the Office of Global Compensation (CGFS/GC) will process all approved monthly monetary benefit payments for Department of State employees.
b. Upon receipt from MED, the Office of Claims (CGFS/F/C) will process payments for all approved claims for the Department of State employees and dependents, as well as covered individuals affiliated with the Department of State.
3 FAM 3665.7 Office of the Under Secretary of State for Management (M)
(CT:PER-1158; 10-02-2023)
(State Only)
(Applies to Foreign Service and Civil Service Employees)
The Under Secretary of State for Management will:
Upon receipt of an Action Memo from GTM/ER, review and make a final determination on a Department of State covered employee's monthly monetary benefit application.
3 FAM 3666 Secretary of State Country Designation
(CT:PER-1158; 10-02-2023)
(Uniform State/USAID/USAGM/Commerce/Foreign Service Corps-USDA)
(Applies to Foreign Service and Civil Service Employees)
a. Under Public Law 116-94, Division J, Title IX, section 901 (22 U.S.C. 2680b), the Secretary of State or designee may designate another foreign country for the purposes of this section, provided that the Secretary or designee reports such designation to the Committee on Foreign Relations of the Senate, and the Committee on Foreign Affairs of the House of Representatives, and includes in such report a rationale for each such designation.
b. The Secretary of State may not designate an added foreign country or duty station for the purposes of providing additional monetary benefit pursuant to 3 FAM 3663 or 3 FAM 3664 for a qualifying injury to covered employees, covered dependents, or covered individuals under this section unless the Secretary of State:
(1) provides to the Committee on Foreign Relations of the Senate and the Committee on Foreign Affairs of the House of Representatives 30 days' notice of the designation of a particular additional country or duty station and the rationale for such an addition; and
(2) provides no such additional monetary benefit pursuant to 3 FAM 3663 or 3 FAM 3664 to covered employees, covered dependents, or covered individuals for a qualifying injury until the 30-day notice period expires, unless there is written agreement by both the Chair and Ranking Members of both the Committee on Foreign Relations of the Senate, and the Committee on Foreign Affairs of the House of Representatives that there is no objection to proceeding with provision of such monetary benefit compensation in less than 30 days.
3 FAM 3667 HAVANA ACT OF 2021
(CT:PER-1158; 10-02-2023)
(State only)
(Applies to Foreign Service and Civil Service Employees)
Under section 3 of the Helping American Victims Afflicted by Neurological Attacks (HAVANA) Act of 2021, the Secretary of State or other Federal agency heads may provide a payment for a qualifying injury to the brain that occurred on or after January 1, 2016, to a covered employee, covered dependent, or covered individual as defined in 3 FAM 3667.1. The Secretary of State or other Federal agency heads may also provide a payment to a former covered employee, a former covered dependent, or a former covered individual who incurred a qualifying injury to the brain on or after January 1, 2016.
3 FAM 3667.1 Definitions
(CT:PER-1158; 10-02-2023)
(State only)
For purposes of the HAVANA Act, the following definitions apply:
Covered employee:
(1) An employee of the Department of State who, on or after January 1, 2016, becomes injured by reason of a qualifying injury to the brain.
(2) The following are considered employees of the Department for purposes of 3 FAM 3667: Department of State Foreign Service Officers; Department of State Foreign Service Specialists; Department of State Civil Service employees; Consular Affairs – Appointment Eligible Family Member Adjudicator positions; Expanded Professional Associates Program members; Family Member Appointments; Foreign Service Family Reserve Corps; employees on Limited Non-Career Appointments; students providing volunteer services under 5 U.S.C. 3111; Temporary Appointments; personnel on a Personal Services Contract; Locally Employed Staff, whether employed on a Personal Services Agreement, Personal Services Contract, or appointed to the position; and Embassy Science Fellows, unless they are an employee of another Federal agency.
(3) The following are not considered employees of the Department of State for purposes of 3 FAM 3667: employees or retired employees of other agencies.
Covered dependent: A family member of a Department of State current or former employee who, on or after January 1, 2016, becomes injured by reason of a qualifying injury to the brain while the dependent’s sponsor was an employee of the Department of State as defined in subparagraph two of the definition of covered employee.
Covered individual: A former employee of the Department of State who, on or after January 1, 2016, becomes injured by reason of a qualifying injury to the brain while they were a covered employee of the Department of State.
Family member: For purposes of determining “covered dependent”, a family member is defined as follows:
(1) Children who are unmarried and under 21 years of age or, regardless of age, are unmarried and due to mental and/or physical limitations are incapable of self-support. The term “children” must include natural offspring, step-children, adopted children, and those under permanent legal guardianship (at least until age 18), or comparable permanent custody arrangement, of the employee or spouse or domestic partner (as defined in 3 FAM 1610) when dependent upon and normally residing with the guardian or custodial party, and U.S. citizen children placed for adoption if a U.S. court grants temporary guardianship of the child to the employee and specifically authorizes the child to reside with the employee in the country of assignment before the adoption is finalized;
(2) Parents (including stepparents and legally adoptive parents) of the employee or of the spouse or of the domestic partner as defined in 3 FAM 1610;
(3) Sisters and brothers (including stepsisters or stepbrothers, or adoptive sisters or brothers) of the employee, or of the spouse when such sisters and brothers are at least 51 percent dependent on the employee for support, unmarried and under 21 years of age, or regardless of age, are physically and/or mentally incapable of self-support; and
(4) Spouse.
Qualifying injury to the brain is defined as follows:
(1) The injury must have occurred in connection with war, insurgency, hostile act, terrorist activity, or other incidents designated by the Secretary of State, and that was not the result of the willful misconduct of the covered employee, covered dependent, or covered individual; and
(2) The individual must have:
(a) an acute injury to the brain such as, but not limited to, a concussion, penetrating injury, or as the consequence of an event that leads to permanent alterations in brain function as demonstrated by confirming correlative findings on imaging studies (to include computed tomography scan (CT), or magnetic resonance imaging scan (MRI), or electroencephalogram (EEG); or
(b) a medical diagnosis of a traumatic brain injury (TBI) that required active medical treatment for 12 months or more; or
(c) acute onset of new persistent, disabling neurologic symptoms as demonstrated by confirming correlative findings on imaging studies (to include CT or MRI), or EEG, or physical exam, or other appropriate testing, and that required active medical treatment for 12 months or more.
Other incident is defined as a new onset of physical manifestations that cannot otherwise be readily explained.
3 FAM 3667.2 Payments under the HAVANA ACT of 2021
(CT:PER-1158; 10-02-2023)
(State Only)
For employees of the Department of State:
(1) Payment for a qualifying injury to the brain will be a non-taxable, one-time lump sum payment.
(2) The Department of State will determine the amount paid to each eligible person based on the following factors:
(a) the responses on the DS-4316, “Eligibility Questionnaire for HAVANA Act Payments”; and
(b) whether the Department of Labor (Workers’ Compensation) has determined that the requester has no reemployment potential; or the Social Security Administration has approved the requester for Social Security Disability Insurance, or Supplemental Security Insurance (SSI); or a neurologist or physician certified by the American Board of Psychiatry and Neurology (ABPN) or the American Board of Physical Medicine and Rehabilitation (ABPMR) or the American Osteopathic Board of Neurology and Psychiatry (AOBNP) or the American Osteopathic Board of Physical Medicine and Rehabilitation (AOBPMR) has certified that the individual requires a full-time caregiver for activities of daily living, as defined by the Katz Index of Independence of Daily Living.
(3) The award thresholds are based on Level III of the Senior Executive Schedule of the year in which the request for payment is approved: Base will be 75 percent of Level III pay, and Base Plus will be 100 percent of Level III pay.
(4) If the requester meets any of the criteria listed in paragraph (2)(b) above, the requester will be eligible to receive a Base Plus payment. Requesters whose board-certified physicians confirm that the definition of “qualifying injury to the brain” has been met but have not met any of the criteria listed in paragraph (2)(b) above, will be eligible to receive a Base payment. If a requester who received a Base payment later meets any of the criteria listed in paragraph (2)(b) above, the requester may apply for an additional payment that will be the difference between the Base and Base Plus payment.
3 FAM 3667.3 Responsibilities
(CT:PER-1158; 10-02-2023)
(State Only)
a. The Bureau of Global Talent Management administers this program for the Department of State. Eligible employees should contact the Care Coordination Team at HAProcessing@state.gov. Other agencies may designate appropriate offices for this purpose.
b. The Under Secretary of State for Management may approve payments of HAVANA Act benefits for Department of State employees. The Bureau of Global Talent Management (GTM) will notify individuals of the decision in writing and provide information about the appeals process.
c. An appeal of a decision made by the Under Secretary of State for Management may be directed to the Deputy Secretary of State for Management and Resources in writing. The Deputy Secretary of State for Management and Resources is the final appeal authority. GTM will notify individuals of the decision in writing.
d. The Department of State will, to the extent possible, consult with the appropriate officials in other Federal agencies to identify their current and former covered employees, and current and former dependents who reported an anomalous health incident while working under Chief of Mission authority. This consultation is solely to assist the other agencies in determining who might be initially eligible for payment under the HAVANA Act. The Department of State will not process payment for employees, former employees, or dependents of current or former employees of other agencies.
e. Under the HAVANA Act, the heads of other employing Federal agencies are responsible for prescribing regulations to carry out the HAVANA Act, including regulations for approving any payment.
3 FAM 3668 THROUGH 3669 UNASSIGNED