Q. Who is eligible to submit a request to the Department of Commerce for a HAVANA Act- authorized payment for a qualifying injury to the brain?

Current and former Department of Commerce (DOC) employees and dependents of current or former employees who reported that they experienced a potential Anomalous Health Incident (AHI) on or after January 1, 2016, while they were an employee of the Department, may submit a request for a HAVANA Act-authorized payment for a qualifying injury to the brain. 

Q. How do I initiate a request for a HAVANA Act-authorized payment for a qualifying injury to the brain?

We recommend that you begin by reviewing the DOC webpage covering the HAVANA Act, including Form CD-350, Eligibility Questionnaire for HAVANA Act Payments. Completion of Form CD-350 by a physician currently certified with the American Board of Psychiatry and Neurology (ABPN), the American Board of Physical Medicine and Rehabilitation (ABPMR), the American Osteopathic Board of Neurology and Psychiatry (AOBNP), or the American Osteopathic Board of Physical Medicine and Rehabilitation (AOBPMR), following in-person examination, is a requirement for all payment requests. After you and your physician complete Form CD-350, the reviewing physician’s office will submit it directly to the DOC Care Team by secure means, and we will begin our review of your request for payment. If we require any additional information from you, we will contact you at the email address listed on your completed Form CD-350, so please ensure that it is filled out accurately.

If you require a copy of Form CD-350 or have any additional questions related to requesting a HAVANA Act-authorized payment, you may contact [email protected]. We are here to support you, but to protect your information, please do not send or share any medical information with us at this email address.

Q. Does HAVANA Act-authorized payment eligibility only apply to those who served in Cuba or China?

No. The HAVANA Act places no geographic restrictions on the country where a qualifying injury to the brain occurred. You may request payment regardless of where you sustained an AHI.

Q. How do I know if my incident has been designated?

The HAVANA Act only covers qualifying injuries that “have occurred in connection with” one of five things: “war, insurgency, hostile act, terrorist activity, or other incidents.”  The Secretary of State or the Secretary of Commerce may make a designation of an “other incident” with respect to DOC employees and their dependents. If you have questions about your incident designation, please contact [email protected].

Q. Why are pre-2016 incidents not being considered?

The HAVANA Act of 2021 applies only to covered individuals who incurred qualifying injuries to the brain on or after January 1, 2016. We must abide by the legislation’s provisions.   

Q. Why is a “qualifying injury to the brain” a condition of eligibility for a HAVANA Act-authorized payment?

The HAVANA Act of 2021 specifically states that the payments it authorizes are intended only for those who experienced a qualifying injury to the brain.

Q. What is the definition of a “qualifying injury to the brain” that the Department is relying on to review requests for payments?

DOC’s regulations implementing the HAVANA Act of 2021 define a qualifying injury to the brain in part as:

(i) An acute injury to the brain such as, but not limited to, a concussion or 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), EEG, or physical exam, or other appropriate testing, and that required active medical treatment for 12 months or more; and

(iv) The qualifying injury to the brain must have occurred on or after January 1, 2016, in connection with certain hostile acts, including war, terrorist activity, or other incidents designated by the Secretary of State, and must not have been the result of the willful misconduct of the recipient. Other incident is defined as a new onset of physical manifestations that cannot otherwise be readily explained.

Q. Why require review of brain imaging when the injury was not apparent in brain imaging for many individuals who experienced an AHI?

A lack of apparent brain injury in imaging or lack of brain imaging does not preclude an individual from qualifying for a HAVANA Act-authorized payment. We request that clinically indicated, available brain imaging be reviewed for two reasons. First, it is a potential way to establish that a qualifying injury to the brain occurred. And second, it is a means for the reviewing physician to better assess an individual’s diagnostic picture, care, and treatment plan.

Q. What does “twelve months of active medical treatment” mean and why require it for consideration of eligibility?

The HAVANA Act specifies its intent to provide a monetary payment to individuals who experienced a qualifying injury to the brain, and to consider the severity of the injury. In applying the terms “qualifying injury to the brain” and “severity of injury,” the Department, in consultation with interagency partners, determined that a brain injury that resulted in the need for continued, active treatment for symptoms for over one year establishes that a qualifying injury of substantial severity occurred.

Q. Why require specific accreditations of physicians submitting the health questionnaire (Form CD-350)?

The Department requires that a physician with current certification by the American Board of Psychiatry and Neurology (ABPN), the American Board of Physical Medicine and Rehabilitation (ABPMR), American Osteopathic Board of Neurology and Psychiatry (AOBNP), or American Osteopathic Board of Physical Medicine and Rehabilitation (AOBPMR) review your medical history and submit a completed Form CD-350 to ensure the integrity of the request submission process. Physicians with these accreditations are practicing specialized medicine at an industry-recognized high level and are best positioned to provide a thorough, complete review of a requester’s diagnostic history, symptom picture, imaging history when appropriate, and overall treatment plan regarding brain injuries.

Q. Should I have my physician include additional information pertinent to my medical condition?

Your physician may reference whatever information they believe is relevant when completing the Eligibility Questionnaire Form CD-350.  However, in the interest of ensuring the decision-making process is impartial, fair, objective, and consistent for every individual who requests a HAVANA Act payment, the DOC requires only a completed Eligibility Questionnaire Form CD-350. No additional medical information should be submitted to the DOC, so please do not include any information outside of what is requested by the Eligibility Questionnaire Form CD-350.

Q. Will family members who experienced AHIs and are approved for payment receive the same payment as employees?

Yes. The employment category of a requester (individuals employed in eligible categories or family members of those employees) will not affect the amount of an approved benefit payment.

Q. If multiple family members have been affected by an AHI, can they submit one request for payment as a family?

Each individual family member must submit a separate Eligibility Questionnaire Form CD-350 and have their case reviewed independently.  In addition, please submit a copy of your relevant travel orders so that we may verify your family member(s)’ eligibility status.  If you are submitting for a dependent, you will be required to provide proof of your relationship.

Q. Can I get an update on the status of my request?

Yes.  Please contact [email protected] with update requests.  If you have received confirmation of the receipt of your HAVANA Act submission, please allow eight weeks to elapse before requesting a status update.

Q. Are Workers’ Compensation and HAVANA Act funding interrelated? Does applying for one preclude eligibility for the other?

The Office of Workers' Compensation Programs and the HAVANA Act Program provides different benefits based on the applicable laws. The Department of Labor manages the Workers' Compensation program for Federal employees and stated in FECA Bulletin No. 22-03 that it does not consider payment under the HAVANA Act to offset workers' compensation benefits.

Q. How do I apply for Workers’ Compensation

To apply for workers’ compensation, you must initiate a claim using the Employees’ Compensation Operations & Management Portal (ECOMP).  The DOC Workers’ Compensation Management Program is managed by the Office of Occupational Safety and Health (OOSH) and claim services are provided by Managed Care Advisors (MCA).

If you have experienced a work-related injury or illness, please immediately notify your supervisor and follow these steps to file a workers’ compensation claim using ECOMP. If you have any questions, please contact your bureau’s WC manager or MCA.

MCA is available 8:30 AM to 8:00 PM EST, Monday through Friday. You can reach MCA at

1-844-DOC-CLAIM (1-844-362-2524), (202) 684-3081, or [email protected].

Q. How do I apply for reimbursement for my Anomalous Health Incident-related medical expenses?

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 a qualifying injury. The Department of State, Bureau of Medical Services (MED) is responsible for processing claims for reimbursement of the costs of diagnosing and treating qualifying injuries, in coordination with Charleston Global Financial Systems.

For covered employees and individuals, please note that MED only accepts and reviews these reimbursement claims after:

• you have filed a complete application with the Department of Labor’s (DOL) Federal Employees’ Compensation Act (FECA), also known as “Workers’ Compensation;”
• your complete FECA application has been denied, including a final decision from DOL’s Office of Workers’ Compensation Programs;
• your private insurance provider has also declined coverage.

If you are applying for reimbursement of a dependent’s qualifying injury costs, you must provide proof that your primary health insurance provider denied your claim and subsequent appeal. Covered dependents are not eligible for FECA.

If the covered employee, covered individual, and/or covered dependent qualify for reimbursement from MED, the following documentation is required:

• a copy of travel orders showing assignment and travel, on or after January 1, 2016, to a duty station in Cuba, China, or another foreign country designated by the Secretary of State;
• copies of the Explanation of Benefits (EOB) or other bills from your private insurance that show the diagnosis codes from your claim; and
• documentation of your out-of-pocket expenses, and documentation that you paid them.

Please do not send copies of your medical history or records. Medical reimbursement claims must be submitted via email to [email protected].

3 FAM 3664 contains a comprehensive overview of the reimbursement process.

Q. What leave options are available for AHI-affected employees who are seeking medical diagnosis and treatment for their AHI-related symptoms?

The primary option for leave assistance related to an Anomalous Health Incident is Workers’ Compensation.  Please see the ECOMP tutorials or contact MCA on how you can apply.

DOC offers a variety of leave programs that may also assist you. For information on your bureau’s leave options, consult your Bureau’s Human Resources Office.

Q. What type of support is available to AHI victims and their family members?

Current employees and their family members are encouraged to use the Employee Assistance Program (EAP).  Service providers vary based on your bureau and work location. Contact your human resources office and you will be directed to the appropriate EAP service provider.

Current and former employees may also seek assistance from their current healthcare provider.

Q. What is the “Base” payment and how would I qualify for it?

The Base payment will be a one-time, non-taxable, lump sum payment equivalent to 75% of maximum pay rate established by Executive Schedule Level III (EX-III). Eligibility for a Base payment is established by submission of a completed Form CD-350 indicating that you sustained a qualifying injury to the brain on or after January 1, 2016, and confirmation that your injury occurred in connection with war, insurgency, hostile act, terrorist activity, or that your report of an AHI was designated as an “other incident” by the Secretary of State or their designee.

Q. What is the “Base Plus” payment and how would I qualify for it?

A base plus payment is a one-time, non-taxable, lump sum payment equivalent to the maximum pay rate established by Executive Schedule Level III (EX-III). Eligibility for a Base Plus payment is established by submission of a completed Form CD-350 indicating that you sustained a qualifying injury to the brain on or after January 1, 2016, and confirmation that your injury occurred in connection with war, insurgency, hostile act, terrorist activity, or your report of an AHI was designated as an “other incident” by the Secretary of State or their designee.

Additionally, a requester must establish at least one of the following to qualify for a Base Plus payment:

- The requestor requires a full-time caregiver for activities of daily living, as defined by the Katz Index of Independence of Daily Living; or

- The Department of Labor (Office of Workers' Compensation Programs) determined that the requester has no reemployment potential; or

- The Social Security Administration approved the requester for Social Security Disability Insurance (SSDI): or

-The Social Security Administration approved the requester for Supplementary Security Insurance.

Please contact us at [email protected] if you believe that you qualify for a Base Plus payment.

Q. What if my request is denied?

An appeal process has been established, with final decision-making authority resting with the Deputy Assistant Secretary for Administration.  If your request has been denied and you wish to request reconsideration of the decision, please contact [email protected] for further instructions. 

Q. How long will it take to get paid once I am approved?

Typically, payments are made within 60 days of approval.

Q. I understand that HAVANA Act payments are tax-free.  Will we receive any paperwork confirming that?

In terms of specific documents, you will receive the IRS 1099 Form(s) from the U.S. Department of Agriculture, National Finance Center, showing no taxes being withheld.  While we cannot give any advice on the tax ramifications (federal, state, or otherwise) of these types of payments, we can refer you to the Department’s rule, which states “Payment for a qualifying injury to the brain will be a non-taxable, one-time lump sum payment.”  If you have any questions or concerns with the taxability of a payment, you may wish to contact your own tax advisor.

Q. I reported multiple, separate incidents to the Department. Will I receive HAVANA Act payments for each incident I experienced/reported?

Each individual may request and, if eligible, receive one HAVANA-Act authorized payment. Experiencing and/or reporting multiple incidents does not allow an individual to qualify for more than one payment.

However, an approved individual who received a Base payment may later apply for the monetary difference between a Base and Base Plus payment, if they later qualify at the Base Plus level.

Q. When will HAVANA Act payments be made?

Qualifying requestors under the Department’s HAVANA Act Program should know that payment funding is identified and available, and approved individuals will receive details when the payments will be processed.