Rule2023-01410
Implementation of HAVANA Act of 2021
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
January 25, 2023
Effective
January 25, 2023
Issuing agencies
State Department
Abstract
This rule finalizes the initial implementation by the Department of State (the Department) of the HAVANA Act of 2021. The Act provides authority for the Secretary of State and other agency heads to provide payments to certain individuals who have incurred qualifying injuries to the brain. As noted in the interim final rule (IFR) published in June 2022, this rulemaking covers current and former Department of State employees, and dependents of current or former employees. This final rule responds to public comments and amends four provisions in the IFR, adding two additional certification Boards for physicians who can sign the Form DS-4316; clarifying the definition of "qualifying injury to the brain;" and adding approval for Social Security Insurance (SSI) benefits as one of the eligibility criteria for a Base Plus payment.
Full Text
<html>
<head>
<title>Federal Register, Volume 88 Issue 16 (Wednesday, January 25, 2023)</title>
</head>
<body><pre>
[Federal Register Volume 88, Number 16 (Wednesday, January 25, 2023)]
[Rules and Regulations]
[Pages 4722-4727]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-01410]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF STATE
22 CFR Part 135
[Public Notice: 11951]
RIN 1400-AF52
Implementation of HAVANA Act of 2021
AGENCY: Department of State.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: This rule finalizes the initial implementation by the
Department of State (the Department) of the HAVANA Act of 2021. The Act
provides authority for the Secretary of State and other
[[Page 4723]]
agency heads to provide payments to certain individuals who have
incurred qualifying injuries to the brain. As noted in the interim
final rule (IFR) published in June 2022, this rulemaking covers current
and former Department of State employees, and dependents of current or
former employees. This final rule responds to public comments and
amends four provisions in the IFR, adding two additional certification
Boards for physicians who can sign the Form DS-4316; clarifying the
definition of ``qualifying injury to the brain;'' and adding approval
for Social Security Insurance (SSI) benefits as one of the eligibility
criteria for a Base Plus payment.
DATES: Effective date: This final rule is effective January 25, 2023.
FOR FURTHER INFORMATION CONTACT: Jenifer Moore, Advisor, Health
Incident Response Task Force, email: <a href="/cdn-cgi/l/email-protection#eca4a5beb8aa9f988d8a8a899e9fac9f988d9889c28b839a"><span class="__cf_email__" data-cfemail="bef6f7eceaf8cdcadfd8d8dbcccdfecdcadfcadb90d9d1c8">[email protected]</span></a>, telephone
number: 202-647-5010.
SUPPLEMENTARY INFORMATION: This rule implements the Helping American
Victims Affected by Neurological Attacks (HAVANA) Act of 2021, Public
Law 117-46, codified in 22 U.S.C. 2680b(i), which (among other things)
required Department heads to publish implementing rules. The Department
published an IFR on June 30, 2022 (87 FR 38981), which laid out the
process for HAVANA Act claimants in a new 22 CFR part 135, and provided
that physicians certified by the American Board of Psychiatry and
Neurology (ABPN) could certify the Form DS-4316, Eligibility
Questionnaire for HAVANA Act Payments. The IFR provided for 30 days of
public comment. Based on some of the prevalent comments, the Department
published a supplemental IFR on August 9, 2022 (87 FR 48444), which
provided that physicians certified by the American Board of Physical
Medicine and Rehabilitation (ABPMR) could certify the Form DS-4316.
Both the IFR and supplemental IFR were effective August 15, 2022.
Further background is contained in the preamble to the IFR.
Responses to Comments
The Department received a total of 69 public comments in response
to the IFR. Comments provided feedback under nine general categories:
clinician criteria; date of injury restriction; imaging/magnetic
resonance imaging scan (MRI) studies; ``other incident;'' length of
qualifying medical treatment; payment eligibility criteria; qualifying
injury definition; personal experience; and other. Many comments
provided input on multiple subjects. Such comments were assigned to
multiple categories. All comments are addressed in the aggregate below.
1. Clinician criteria: Thirty comments challenged the clinician
certification required to determine a qualifying injury to the brain.
They stated that the requirement to be diagnosed by a board-certified
neurologist from the American Board of Psychiatry and Neurology (ABPN)
was too narrow, and that other certifications and physician specialties
should be considered.
As noted above, the Department accepted these comments and
submitted a supplementary IFR to modify the provision of the IFR
relating to the Board certification of the physician who is required to
assess and diagnose an individual's qualifying injury to the brain and
complete the Form DS-4316. In addition to the ABPN and the ABPMR,
through this final rule, the Department provides that physicians
currently certified by the American Osteopathic Board of Neurology and
Psychiatry (AOBNP) and the American Osteopathic Board of Physical
Medicine and Rehabilitation (AOBPMR) may certify the Form DS-4316. The
regulatory text (Sec. 135.3) and the DS-4316 are being amended
accordingly.
2. Date of Injury Restriction: Fifteen comments focused on the date
of injury, all expressing a belief that people who were affected by an
anomalous health incident (AHI) earlier than January 1, 2016, should be
eligible for a payment. The Department is unable to accept this
suggestion. The HAVANA Act specifies that payments are for incidents
occurring on or after January 1, 2016. The Department may not broaden
the eligibility date without an amendment to the HAVANA Act or
additional legislative action authorizing additional eligibility
timeframes.
3. Imaging/MRI Studies: Nine comments raised objections to what was
perceived as a blanket requirement for imaging/MRI studies that
supported a diagnosis of ``acute injury to the brain.'' This perception
is not correct. An individual may submit an MRI or other imaging
studies to the certified physician to demonstrate an acute injury to
the brain, but that is not the only way to demonstrate a qualifying
injury under the IFR. The IFR also permits individuals to submit
electroencephalogram (EEG) results, physical examination results, or
other appropriate testing results to their certified physician for use
in their physician's assessment. The Department is adding an ``or''
between ``EEG'' and ``physical examination'' in the definition of
``Qualifying injury to the brain'' (Sec. 135.2), between paragraphs
(2)(i) and (ii), to clarify the language, and is also amending Question
3 on the Form DS-4316 accordingly.
4. ``Other Incident'': Seven comments noted that the language of
the HAVANA Act regarding the occurrence of the injury (``in connection
with war, insurgency, hostile act, or other incidents designated by the
Secretary of State'') was very broad. With regard to ``other
incidents'', the commenters stated that this language makes the
determination subjective and not measurable, and asked how those who
would be denied would know that the decision was made using objective
criteria. One commenter expressed concern over who would determine that
an ``attack'' had occurred.
The definition of ``other incident'' in the IFR is: ``A new onset
of physical manifestations that cannot otherwise be readily
explained.'' For each request for payment, the Department will review
available information on the reported incident, including any
investigations that may have been conducted. If the reports and the
results of investigations do not provide a credible alternate
explanation for the incident, that incident will be recommended for
designation by the Secretary of State or their designee. Incidents for
which an explanation has been identified will not be recommended for
designation.
The list of reported incidents will be administratively controlled
and will not be made public in order to ensure privacy for everyone who
has reported an AHI. The IFR refers to only those from 2016 to the
present because, as defined in the Act, only incidents that occurred on
or after January 1, 2016, are eligible for payment. The Department
maintains a list of all reported incidents; that list is not time-
limited.
In the event of an adverse decision on a request for payment under
the HAVANA Act, the Department has established an appeals process by
which an individual may request further consideration.
5. Length of Qualifying Medical Treatment: Nine comments provided
feedback on the length of qualifying medical treatment criteria. All
comments disagreed that 12 months of qualifying medical treatment
should be a requirement, with several suggesting that the time period
be shorter--for example, three months instead of 12 months. Some
proposed that the 12 months of treatment be replaced with other
criteria, citing examples such as, receiving prescription medication or
therapy for brain injury-related conditions such as migraines, vertigo,
vision problems, and hearing loss.
[[Page 4724]]
Another commenter suggested that the required 12 months of medical
treatment be replaced with language that the ``demonstrated effect of
injury'' was expected to last more than 12 months. The same comment
expressed concern that covered employees who have been evaluated, but
not yet had access to treatment, would not qualify otherwise and are
excluded.
Individuals may be eligible for a HAVANA Act payment if they meet
one of three criteria under the definition of ``qualifying injury to
the brain'': (1) an acute injury to the brain, such as, but not limited
to, a concussion or penetrating injury, or as a consequence of an event
that leads to permanent alterations in brain function as demonstrated
by confirming correlative findings on imaging studies (to include
computer tomography scan (CT) or MRI) or EEG; or (2) a medical
diagnosis of a traumatic brain injury (TBI) that required active
medical treatment for 12 months or more; or (3) acute onset of new
persistent, debilitating 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.
Of those three criteria, only (2) and (3) require 12 months of
treatment, which would demonstrate that the individual suffers from a
chronic condition.
Even if a covered individual has not yet received 12-months or more
of treatment as outlined in (2) or (3), the covered individual may
nevertheless qualify at a later time if treatment lasts for twelve
months or more. Such individuals are not excluded but will have to meet
the criteria to be eligible for a payment.
6. Payment eligibility criteria: Thirty-three comments discussed
various aspects of the payment eligibility criteria. The majority of
the comments expressed concern about who was eligible for payments.
Another subset of comments questioned how eligibility is to be (or can
be) determined without a clear definition or known cause of AHI. An
additional comment raised a question about adequate funding for
payments under the Act. The Department anticipates that resources will
be available to provide payments to those who meet the eligibility
criteria. One commenter asked what would happen if the Department
underestimated the costs needed to pay all eligible requesters. The
Department anticipates that resources will be available to provide
payments to those who meet the eligibility criteria.
Fourteen comments stated that the payment eligibility criteria
should be expanded, challenged the scope of ``covered individuals''
defined in the Act, and specifically mentioned unpaid interns and
Embassy Science Fellows as examples of persons who should be included.
The Department agrees that the payment eligibility criteria should be
expanded to include unpaid interns and will consequently insert
``students providing volunteer services under 5 U.S.C. 3111'' after
``Temporary Appointments'' in the definition of ``covered employee.''
The Department believes that Embassy Science Fellows are also covered
under the definition of ``covered employee'', unless they are an
employee of another Federal agency. In the latter case, the employing
agency would be responsible for making a determination for payment and
making a payment if qualified under that agency's rules. Additionally,
the definition of covered employee has no reference to nationality, and
employees who are citizens of other countries may qualify if they
otherwise meet the criteria for payment.
The State Department drafted the IFR in close coordination with the
interagency and National Security Council. As contemplated by Congress,
other Federal agencies will need to prepare their own rules for
implementation of the HAVANA Act.
Another comment questioned the objective capability of the
Department to determine eligibility and award payment and suggested
that a neutral outside board do so instead. The Department disagrees.
For each request for payment, the Department will rely on the
submission from the independent board-certified physician who completed
the Form DS-4316, as well as available information on the reported
incident, including any investigations that may have been conducted.
One comment stated that bodily injuries caused by AHI should be
eligible for payments under the Act. The Department notes that the
HAVANA Act of 2021 specifically authorizes payments for qualifying
``injuries to the brain,'' not ``bodily injuries''.
Another comment shared a belief that the Department should make
HAVANA Act payments posthumously to family members who had died because
of mental health issues, arguing that not enough investigation has been
done into the impacts of AHI on mental health illness. The Department
notes that the HAVANA Act of 2021 specifically authorizes payments for
qualifying ``injuries to the brain,'' not for mental health illnesses.
Several comments pointed out that there was no definition for or
known cause of AHI and asked how it would be possible to determine who
would qualify under the HAVANA Act, which they viewed as too broad and
susceptible to abuse. Conversely, multiple comments expressed concern
that the medical requirements to show an injury to the brain were too
stringent. In response, the Department notes that, recognizing that the
nature of AHI includes a lack of consensus by the medical and
scientific communities, the definition of ``qualifying injury to the
brain'' in the IFR was written to be comprehensive, respect
congressional intent, and allow the physician completing the Form DS-
4316 to consider appropriate medical information and context.
Two comments proposed alternate/additional payment eligibility
criteria under Sec. 135.3, Eligibility for payments by the Department
of State, including allowing covered employees who have a Department-
approved reasonable accommodation to be eligible for a Base Plus HAVANA
Act payment. One comment said that a medical retirement from the
Department should be sufficient to qualify for a Base Plus HAVANA Act
payment.
In response to these two comments, the Department notes that it
developed the eligibility criteria for a Base Plus payment under Sec.
135.3 of the rule to cover individuals who have no employment potential
with or without a reasonable accommodation. The Department believes
that the four separate options for meeting the criteria in Sec.
135.3(e)(2) represent a fair and consistent approach to determining
Base Plus payments. In addition, the Department has added approval for
Social Security Insurance (SSI) benefits as one of the eligibility
criteria for a Base Plus payment.
7. Qualifying Injury: The Department received 24 comments related
to qualifying injury. Several comments noted that the IFR's definition
of ``qualifying injury to the brain'' was not an actual definition, was
too broad, and was open to ``vast'' interpretation. They asked if
multiple sclerosis, idiopathic tics, dementia, epilepsy, Parkinson's,
and several other medical conditions would qualify as an eligible
injury. Other comments pointed out that traditional imagery is not
likely to accurately identify changes to the brain, and that other
documentation should be accepted or required, including vestibular
tests. Likewise, some comments asserted a belief that TBI was a
required diagnosis to qualify (which is inaccurate). Others expressed
fraud and
[[Page 4725]]
abuse concerns as taxpayers on the potential monetary scope of payments
under the Act. They stated their belief that AHIs were not real and
noted that there is no International Classification of Diseases, Tenth
Revision (ICD-10), diagnosis code for AHI. Therefore, there would be no
way to ensure that prospective recipients had been affected by an AHI,
as opposed to other causative factors.
Recognizing that the nature of AHI includes a lack of consensus by
the medical and scientific communities, the definition of ``qualifying
injury to the brain'' in the IFR was written to be comprehensive,
respect congressional intent, and allow the physician completing the
Form DS-4316 to consider appropriate medical information and context.
``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 . . .'' recognizes that the board-certified physician who
completes the Form DS-4316 may exercise their professional judgment as
to what elements are relevant. An ICD-10 diagnosis code specifically
for AHI is not necessary as payments are for qualifying injuries to the
brain, which will have one or more relevant ICD-10 codes.
Another comment specifically focused on children of affected
covered employees, who reportedly did not receive evaluation of a
possible AHI when their parent(s) were medically evacuated as the
result of a suspected AHI. The comment states the writer's belief that
dependents of AHI-affected employees should automatically qualify for a
HAVANA Act payment without medical documentation, based on their
parent(s)' injury. The Department notes that eligibility for a HAVANA
Act payment under the IFR requires a currently board-certified
physician to make a determination based in part on medical
documentation submitted to the physician by the requester, and to
complete the Form DS-4316 for each requester. Children of affected
covered employees who may not have been evaluated at the time of the
parent(s)' medevac may qualify for a payment if they meet the
eligibility criteria.
The Department also notes that imagery is one of several means by
which requesters can establish eligibility for payment, and that the
certifying physician will consider all available medical documentation
when assessing the requester's condition. A diagnosis of a TBI is a
non-exclusive criterion to potentially demonstrate eligibility under
the HAVANA Act, and there are other ways in which an individual may
meet the medical requirement, as listed in the definition. Regarding
the concern that the injury may have been caused by factors other than
an AHI, the physician must certify that they do not ``have evidence or
otherwise believe that the [requester's] symptoms can be attributed to
a pre-existing condition.''
8. Personal Experience: Three comments shared detailed accounts of
individual experiences. One comment expressed frustration that the
Department of Defense has not implemented its policy or procedures
regarding the HAVANA Act. Another comment shared the commenter's
experiences related to clinician care for AHI. The third shared the
commenter's AHI experience. The Department of State respects and
recognizes the service of persons from numerous departments, agencies,
and institutions, public and private, who are working or have worked to
advance the interests of the United States. The Department's IFR only
covers persons who were employed by the State Department and dependents
of those persons when the reported AHI occurred. Other U.S. Federal
Government agencies will need to complete their own rulemaking process
to evaluate payment eligibility.
9. Other: The Department received three comments that provided
input on issues that are outside the scope of this rulemaking,
including recommendations/comments on compensating employees for lost
career growth as a result of an AHI; a belief that the Department must
work with the Department of Labor (Federal Employees' Compensation Act
(FECA)) on FECA requirements for TBI; and speculation about directed
energy weapons. One commenter took the opportunity to address another
comment with which they disagreed. The Department also received an
email from an individual who felt that the Department's ``product'' was
linking to their family's devices.
The Department has a process to compensate employees for
demonstrated lost career growth as a result of an AHI. It was given
this authority under previous legislation. The Department also works
closely with the Department of Labor on FECA claims filed by its
employees, but the Department of Labor sets the requirements for
eligibility for FECA benefits.
Regulatory Analysis
Administrative Procedure Act
This rule is being published as a final rule. Because this rule is
a matter relating to public benefits, it is exempt from the
requirements of 5 U.S.C. 553. See 5 U.S.C. 553(a)(2). Since the rule is
exempt from the entirety of section 553 pursuant to section 553(a)(2),
the provisions of section 553(d) do not apply and the rule will be in
effect upon publication.
Congressional Review Act
The Office of Information and Regulatory Affairs (OIRA) in the
Office of Management and Budget (OMB) has determined that this rule is
not a major rule as defined by 5 U.S.C. 804 for the purposes of
congressional review of agency rulemaking under the Small Business
Regulatory Enforcement Fairness Act of 1996 (5 U.S.C. 801-808).
Unfunded Mandates Reform Act of 1995
This rule will not result in the expenditure by State, local, or
tribal governments, in the aggregate, or by the private sector, of $100
million in any year; and it will not significantly or uniquely affect
small governments. Therefore, no actions were deemed necessary under
the provisions of the Unfunded Mandates Reform Act of 1995.
Executive Order 13175--Consultation and Coordination With Indian Tribal
Governments
The Department has determined that this rulemaking will not have
tribal implications, will not impose substantial direct compliance
costs on Indian tribal governments, and will not pre-empt tribal law.
Accordingly, the requirements of Executive Order 13175 do not apply to
this rulemaking.
Regulatory Flexibility Act: Small Business
The Department of State certifies that this rulemaking will not
have an impact on a substantial number of small entities. A regulatory
flexibility analysis is not required under the Regulatory Flexibility
Act (5 U.S.C. 601, et seq.).
Executive Order 12866 and Executive Order 13563
The Department of State has provided this final rule to OMB for its
review. OIRA has designated this rule as ``significant'' under
Executive Order 12866. Potential causes of AHI are being investigated
but remain unknown. Given the nature of the incidents, it is difficult
to accurately estimate future incidents and numbers of individuals
[[Page 4726]]
affected. The Department approved/obligated funds for five cases
totaling $796,025 by the expiration of Fiscal Year (FY) 2022 on
September 30. This is below our previous FY 22 estimate of $1,545,225
primarily because we did not begin accepting requests for payment until
45 days before the end of the fiscal year. For FY 2023, the estimated
numbers are up to $7.3 million for 47 people. The Department has also
reviewed the rule to ensure its consistency with the regulatory
philosophy and principles set forth in Executive Order 12866 and finds
that the benefits of the rule (in providing mechanisms for individuals
to obtain compensation for certain injuries) outweigh any costs to the
public, which are minimal. The Department of State has also considered
this rulemaking in light of Executive Order 13563 and affirms that this
regulation is consistent with the guidance therein.
Executive Order 12988
The Department of State has reviewed this rule in light of
Executive Order 12988 to eliminate ambiguity, minimize litigation,
establish clear legal standards, and reduce burden.
Executive Orders 12372 and 13132
This rule will not have substantial direct effect on the states, on
the relationships between the National Government and the states, or on
the distribution of power and responsibilities among the various levels
of government. Therefore, in accordance with Executive Order 13132, it
is determined that this rule does not have sufficient federalism
implications to require consultations or warrant the preparation of a
federalism summary impact statement. Executive Order 12372, regarding
intergovernmental consultation on Federal programs and activities, does
not apply to this regulation.
Paperwork Reduction Act
This rulemaking is related to an information collection for the
Form DS-4316, ``Eligibility Questionnaire for HAVANA Act Patients,''
OMB Control Number 1405-0250. This collection was approved under an
emergency authorization. After OIRA approved the changes, the DS-4316
has been revised in accordance with the supplemental IFR and this final
rule. The Department published a 60-day notice on September 9, 2022 (87
FR 55456). No public comments were received. The Department published a
30-day notice on November 21, 2022 (87 FR 70887) and OIRA approved the
information collection on January 13, 2023.
List of Subjects in 22 CFR Part 135
Federal retirees, Government employees, Health care.
Accordingly, for the reasons stated in the preamble, the interim
rules adding and amending 22 CFR part 135, which were published on June
30, 2022 (87 FR 38981), and August 9, 2022 (87 FR 48444), are adopted
as final with the following changes:
PART 135--IMPLEMENTATION OF THE HAVANA ACT OF 2021
0
1. The authority citation for part 135 continues to read as follows:
Authority: 22 U.S.C. 2651a; 22 U.S.C. 2680b.
0
2. Amend Sec. 135.2 as follows:
0
a. By revising paragraph (2) of the definition of ``Covered employee''
and paragraph (2) of the definition of ``Qualifying injury to the
brain''; and
0
b. By placing the definition of ``Other incident'' into alphabetical
order.
The revisions read as follows:
Sec. 135.2 Definitions.
* * * * *
Covered employee. * * *
(2) The following are considered employees of the Department (see
procedures in 3 FAM 3660 and its subchapters) for the purposes of this
part: 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; Temporary
Appointments; students providing volunteer services under 5 U.S.C.
3111; 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.
* * * * *
Qualifying injury to the brain. * * *
(2) The individual must have:
(i) 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
(ii) A medical diagnosis of a traumatic brain injury (TBI) that
required active medical treatment for 12 months or more; or
(iii) 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.
0
3. Amend Sec. 135.3 by revising paragraphs (a) through (c) and (e)(2)
to read as follows:
Sec. 135.3 Eligibility for payments by the Department of State.
(a) The Department of State may provide a payment to covered
individuals, as defined in this part, if the qualifying injury to the
brain was assessed and diagnosed in person by a currently board-
certified physician from the American Board of Psychiatry and Neurology
(ABPN), the American Osteopathic Board of Neurology and Psychiatry
(AOBNP), the American Board of Physical Medicine and Rehabilitation
(ABPMR), or the American Osteopathic Board of Physical Medicine and
Rehabilitation (AOBPMR); occurred on or after January 1, 2016; and
while the individual was a covered employee of the Department.
(b) The Department of State may provide a payment to covered
employees, as defined in this part, if the qualifying injury to the
brain was assessed and diagnosed in person by a currently board-
certified physician from the ABPN, AOBNP, ABPMR, or AOBPMR; occurred on
or after January 1, 2016; and while the employee was a covered employee
of the Department.
(c) The Department of State may provide a payment to a covered
dependent, if the qualifying injury to the brain was assessed and
diagnosed in person by a currently board-certified physician from the
ABPN, AOBNP, ABPMR, or AOBPMR; occurred on or after January 1, 2016;
and the dependent's sponsor was a covered employee of the Department at
the time of the dependent's injury.
* * * * *
(e) * * *
(2) 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 either
Social Security Disability Insurance or Supplemental Security Insurance
(SSI) benefits; or the requester's ABPN, AOBNP, ABPMR, or
[[Page 4727]]
AOBPMR board-certified physician 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.
* * * * *
Kevin E. Bryant,
Deputy Director, Office of Directives Management, U.S. Department of
State.
[FR Doc. 2023-01410 Filed 1-24-23; 8:45 am]
BILLING CODE 4710-10-P
</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>Indexed from Federal Register on January 25, 2023.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.