ALCOAST 204/24 - MAY 2024 CHANGES TO MEDICAL SCREENING REQUIREMENTS FOR DEMOBILIZING RESERVISTS, REQUIREMENTS FOR SEPARATION OR RETIREMENT PHYSICALS, AND VETERANS AFFAIRS SEPARATION HEALTH ASSESSMENT ENHANCEMENTS

R 022015Z MAY 24 MID120001073203U
FM COMDT COGARD WASHINGTON DC
TO ALCOAST
BT
UNCLAS
ALCOAST 204/24
SSIC 6000
SUBJ: CHANGES TO MEDICAL SCREENING REQUIREMENTS FOR DEMOBILIZING
RESERVISTS, REQUIREMENTS FOR SEPARATION OR RETIREMENT PHYSICALS,
AND VETERANS AFFAIRS SEPARATION HEALTH ASSESSMENT ENHANCEMENTS
A. National Defense Authorization Act For Fiscal Year 2022, S.1605
B. Activation Of The Reserve Component, COMDTINST 3061.2A
C. Reserve Policy Manual, COMDTINST 1001.28D
D. Coast Guard Medical Manual, COMDTINST 6000.1F
E. The Separation History And Physical Examination (Shpe) For The
Dod Separation Health Assessment (Sha) Program, DODI 6040.46
F. 10 U.S.C. Section 1145(a)(5)(a) and 1074n
G. Medical Guidance For Completion Of The Separation Health
Assessment, HSWLSCTD 2020-015
H. Medical Guidance For Demobilization Of Active Duty Members And
Reservists In Support Of Contingency (Non-Expeditionary)
Operations And Continuous Duty (Non-Contingency), HSWLSCTD 2019-021
I. Travel To Obtain Health Care (Ttohc) For Oconus Units,
HSWLSCTD 2020-004
J. Joint Travel Regulations
1. IAW REF (A) Section 717, this ALCOAST announces policy which
supersedes REFs (B), (C), (D), (E), (F) and (G). This ALCOAST also
provides new guidance surrounding Department of Veterans' Affairs
disability claims which applies to some service members (SMs).
2. Section 717 of REF (A) incorporates a noteworthy change to the
requirement for a reservist to receive a physical examination and
Mental Health Assessment (MHA) upon Release from Active Duty (RELAD)
following an involuntary mobilization.
3. Due to these changes, members who are not being retired,
discharged, or dismissed from SELRES within 90 days of the end of
orders are no longer required to complete a Separation History and
Physical Exam (SHPE) and MHA unless requested by the member.
4. Reserve members requesting a SHPE should schedule the exam at
least 30 days prior to RELAD. If the SHPE cannot be completed prior
to RELAD, members should be issued MEDHOLD orders IAW with Title 10
U.S.C. 12301(h) and Personnel Service Center procedural guidance
with the applicable contingency code for which they were
involuntarily recalled (in order to complete the SHPE).
5. If a reserve member elects not to complete a SHPE, a Limited
Health Assessment (LHA) must be completed, as per REF (H).
Telehealth may be utilized to complete an LHA. Members reporting
new health concerns may require an in-person evaluation.
6. A SHPE or LHA does not meet the annual requirement for a PHA.
Members must maintain a current PHA in addition to any SHPE or LHA
completed as part of the demobilization process.
7. Commands are reminded that expeditionary deployments have
additional requirements per REFs (B), and (D), and should coordinate
in advance with their servicing clinics to ensure these requirements
are met.
8. REF (F) requires the completion of a SHPE and MHA for most
service members (SMs) ending a period of active duty service except
as noted in Paragraphs 2 and 3. REF (B) provides policy for the
completion of the SHPE.
9. All SMs who file a disability claim with the VA prior to
separation, via the Veterans Affairs (VA) Benefits Delivery at
Discharge (BDD) program, will receive a VA-provided Separation
Health Assessment (SHA). This ALCOAST authorizes the use of the
VA SHA to meet the requirements for a military SHPE and MHA.
10. Under the VA BDD program, SMs must file their VA disability
compensation claim between 90 and 180 days prior to separation.
This provides time for VA to schedule the SHA and other exams,
review treatment records, and evaluate the claim before separation.
Most claimants receive their decision the day after leaving active
duty service.
11. To begin the claims process, SMs should submit their
application, service treatment records, and other required documents
online through eBenefits:
(Copy and Paste URL Below into Browser)

https://www.va.gov/disability/how-to-file-claim/

or in person with a Veterans Service Organization (VSO) or a VA
representative at a military installation. The SM must be available
within 45 days for scheduling their SHA and other required
examinations. More details on the BDD claims process and program
eligibility may be found at:
(Copy and Paste URL Below into Browser)

https://benefits.va.gov/BENEFITS/separation-health-assessment.asp

12. Upon completion of their SHA, separating SMs must immediately
notify their supporting Coast Guard Clinic of the completed SHA. The
clinic will review the SHA to ensure it meets the requirements of
the SHPE and MHA and will document it in the health record.
13. SMs who decide not to participate in the BDD program or who are
unable to meet the timelines in paragraph ten may still file a
regular disability claims with the VA. In this case, the SM will
receive a decision regarding their disability claim as per normal VA
disability claim timelines. These SM must still complete a SHPE at a
Coast Guard or Department of Defense Military Treatment Facility
(DoD MTF) prior to separation or retirement.
14. OCONUS CG SMs who are planning to file a VA disability claim
using the BDD program who are not within 100 miles of a VA physical
examination locations are entitled to Travel to Obtain Health Care
(TTOHC) to defray the financial expenses surrounding travel to and
from VA physical examination locations, IAW REFs (I) and (J). This
includes travel to and from locations where VA-required
supplementary medical exams, tests, and studies are to be performed.
SMs should work with their VA or VSO representative, as well as with
the supporting CG clinic, to minimize the total number of trips
necessary to complete all required evaluations. CONUS SMs may be
entitled to health care-related travel benefits per the Joint Travel
Regulations REF (J).
15. The following recommendations are applicable to all SMs,
regardless of when they decide to file a disability claim with the
VA:
     a. Make and obtain a personal copy of the CG health record prior
to separation or electronic copy of the CG health record is
recommended.
     b. Personally ensure all care notes from health care providers
that do not work within a CG clinic are provided to the respective
health record custodian for inclusion in the CG health record.
     c. Contact a Veteran's Service Organization for assistance in
navigating the VA claims process.
16. PSC Reserve Personnel Management will release procedural
guidance for requesting MEDHOLD SHPE Procedural guidance may be
found at:
(Copy and Paste URL Below into Browser)

https://uscg.sharepoint-mil.us/sites/psc_spo/psc-rpm/rpm3/
RPM-3medical/SitePages/Medical-Hold-Process.aspx

17. HSWL SC will release an updated Technical Directive that
provides procedural guidance for the completion of the SHA, with
MHA. Expect it to be promulgated within the year. The HSWLSC TD
may be found at:
(Copy and Paste URL Below into Browser)

https://uscg.sharepoint-mil.us/sites/hswlsc/Shared%20Documents/Forms
/AllItems.aspx?RootFolder=%2Fsites%2Fhswlsc%2FShared%20Documents%2FH
SWLSCTD&FolderCTID=0x012000DD90827048485549AA8A2EA48A325443&View=%7B
DEFD64A2%2DA876%2D4468%2D8274%2DF60FC0CB31E3%7D#InplviewHashdefd64a2
-a876-4468-8274-f60fc0cb31e3=

18. POC: LCDR Bridget A. Metcalf, COMDT (CG-1K21), 202-757-5183,
Bridget.A.Metcalf@uscg.mil.
19. RADM Miriam L. Lafferty, Assistant Commandant for Reserve
(CG-R), and RADM Dana L. Thomas, Assistant Commandant for Health,
Safety, and Work-Life (CG-1K), send.
20. Internet release is authorized.