Casualty Assistance

On Thursday at 1500 the phone rings in the Headquarters Marine Corps (HQMC) Casualty Section with the II Marine Expeditionary Force casualty cell informing that LCpl Marine has been killed in action in Al Anbar Province, personnel casualty report (PCR) to follow. Based on this call the Casualty Section opens a case file, retrieves information from the record of emergency data, and identifies family members to be notified. LCpl Marine was married, and his spouse resides at Camp Lejeune. His parents live in Albany, NY.

LCpl Marine was a 2d Marine Division (2d MarDiv) Marine, and the HQMC Casualty Section coordinates with the 2d MarDiv casualty cell to identify the casualty assistance calls officer (CACO) for the spouse. The Casualty Section will also identify the closest Marine Corps unit to the parents, in this case Inspector-Instructor (I&I), Company F, 2d Battalion, 25th Marines, Albany, and task the unit to provide a CACO for the parents.

The CACO is the direct representative of the Commandant. Once CACOs are assigned they contact HQMC for follow-on instructions, which include contact information for other assigned CACOs. The CACOs prepare for the task, but no action is taken until receipt of the PCR at HQMC.

When the PCR is received, the CACOs are provided the confirmed information and proceed with notification. Coordination between the CACOs and HQMC is continuous to make sure the CACOs have the latest information. Notifications are done simultaneously to avoid one next of kin (NOK) potentially having to notify the other. Notifications are made to LCpl Marine’s spouse by the CACO who is accompanied by a chaplain from the unit.

The CACO offers to make any calls to local family/friends for support before the notification team departs. LCpl Marine’s parents are notified by the I&I who accompanies the CACO and also offers to assist in arranging local support. Prior to departure the CACOs provide the family a business card with current contact numbers for the CACO (to include cell phone number) so that they can get help whenever they need it.

The CACOs ensure that the family knows that they will be returning the next day with more information and to discuss escorting LCpl Marine’s remains home. After departure the CACOs contact HQMC Casualty Section to confirm notification, update NOK personal information, and address any immediate concerns.

On Friday CACOs coordinate with HQMC for updated information (supplemental PCRs, location of remains, etc.). The Camp Lejeune CACO contacts Mrs. Marine and arranges an appropriate time for a followup visit to discuss the memorial service and funeral arrangements and to assist in completion of death gratuity forms. The death gratuity is $100,000 (normally paid to the spouse) for immediate living expenses.

The CACO conveys her decision on burial to Dover Port Mortuary and Navy Mortuary Affairs representatives. After this visit the principal focus is on Mrs. Marine’s desires regarding LCpl Marine’s funeral arrangements and preparation of invitational travel arrangements to the gravesite for eligible family members (spouse, children, parents, siblings, and the person authorized to direct disposition of the remains).

After the funeral the CACO arranges a time to meet with Mrs. Marine to explain benefits and entitlements to include payment of Servicemembers Group Life Insurance (SGLI) (up to $400,000), arrears of pay, housing entitlements, etc. The CACO also coordinates with outside agencies (such as the Department of Veterans Affairs (VA), Social Security Administration, etc.) to arrange for Mrs. Marine to meet with their benefits experts. Each casualty assistance case is unique; care and concern for the family’s well-being and desires dictate the CACO’s actions.

In this case Mrs. Marine desires to move to Atlanta, GA. The CACO at Camp Lejeune assists in this move and coordinates with the HQMC Casualty Section for assignment of a gaining CACO in the Atlanta area to provide continuity of assistance to Mrs. Marine.

After relocation and any local assistance needed from the Atlanta CACO, Mrs. Marine is contacted by the HQMC Long-Term Assistance Program (LTAP) coordinator to determine any residual issues and to identify to Mrs. Marine a continuing point of contact at HQMC for any subsequent problems that may arise. The LTAP coordinator works with the assigned CACO to ensure a smooth transition from immediate to long-term support. The transition between CACO and LTAP is situational but usually occurs within 3 to 6 months.

The above vignette illustrates the actions that take place as Marines support the family of a fallen Marine. When a Marine is injured, becomes seriously ill, or is killed, the expression “taking care of our own” takes on an extended meaning and a new sense of urgency.

The Marine Corps Casualty Assistance Program is designed to meet those needs and is continuously evolving as those needs change and other challenges are identified. Although centered at the Casualty Section, HQMC, casualty assistance is a responsibility of the headquarters, commands, other agencies and, most especially, the CACO assigned. Providing families the most timely and accurate information and assisting them in this time of need is the task for this dedicated professional team.

Making Notifications
Key to our casualty process are the several thousand trained CACOs located at bases, stations, and Reserve centers across the country. CACOs are handpicked by their commanding officers based upon their experience, professional maturity, and commitment to assisting surviving family members. CACOs receive a foundational block of classroom training provided by the Casualty Section on the responsibilities of their solemn duty as part of a recurring “train-the-trainer” effort at the bases, stations, and Marine Forces Reserve. Additionally, CACOs receive a supplementary Internet-based training module available through MarineNet.

The training covers subjects such as the casualty notification and assistance program, benefits and entitlements, how to deliver emotionally charged news, and how to use reference materials, such as the Casualty Assistance Calls Officers Guidebook to Benefits and Entitlements and the Department of Defense’s (DoD’s) A Survivor’s Guide to Benefits.

These guides contain details of the benefits and entitlements provided by the Marine Corps, the Federal Government, and benevolent or philanthropic organizations. When assigned as a CACO, the designated Marine is also in direct contact with the Casualty Section, HQMC that is available to review procedures and provide any assistance required by the CACO.

After the initial notification, the CACO makes followup contact with survivors within 24 hours to start funeral planning and to arrange payment of death benefits, such as the death gratuity and proceeds from the Marine’s SGLI policy. The CACO conducts numerous personal visits to the NOK throughout the casualty assistance process.

During these visits the CACO works with the NOK to process all actions associated with disposition of remains and burial services, travel arrangements to the burial, and applications for the numerous benefits and entitlements that the survivors may be eligible to receive. Each notification is unique, and there is no predetermined or set number of required visits or time limit on how long a CACO is available to the survivors.

When investigations into the circumstances surrounding the death of the Marine are conducted, CACOs immediately advise the NOK and assist in obtaining copies of the completed investigation. In instances where technical expertise is necessary (such as an aircraft mishap), CACOs facilitate a personal presentation of the investigative findings to the NOK by qualified personnel.

Survivor Benefits
The benefits and entitlements provided by the military are restricted, by law in most cases, to specific family members. The death gratuity payment ($100,000) is usually made to the family within 24 to 48 hours in the form of an electronic funds transfer and is intended to remove a potential financial stressor. The CACO works with the survivors to complete the forms necessary for payment of up to $400,000 of SGLI proceeds, which are typically completed within a few days.

CACOs are not intended to be subject matter experts on benefits from the VA, the Social Security Administration, or TRICARE. Rather, they act as enablers who ensure that the NOK completes required benefits applications, and they arrange contact with the designated experts from these and many other agencies who can more appropriately explain specific benefits or entitlements directly to the NOK.

There are numerous charitable organizations available to assist the family. One is the Marine Corps-Law Enforcement Foundation that provides educational bonds to children of fallen Marines and financial aid to eligible survivors. Another is the Marine Corps Scholarship Foundation that provides scholarships to children of fallen Marines.

Yet another is the Injured Marine Semper Fi Fund that provides services and financial support to injured Marines during recovery. The CACO provides the survivors with a list of these and other credible benevolent and philanthropic agencies that support Marines and their families with special needs or unique circumstances and assists them in obtaining the services/support available to them.

LTAP
Depending on the needs of the individual case, but normally 3 to 6 months after the Marine’s death, the primary NOK is introduced to the LTAP team in the Casualty Section that works with the family to answer any additional questions and resolves residual issues. LTAP is a new capability within the Marine Corps. Over the last several years it became apparent that our peacetime support process did not meet our wartime needs.

Young surviving spouses moved home and CACOs (and units) deployed, leaving a gap where the spouse did not know where to turn for help. LTAP was established to fill that gap and to provide a continuing point of contact within the Marine Corps. A representative from the LTAP typically calls the NOK as the CACOs direct involvement diminishes to ensure that all benefits and entitlements have been filed for and to follow up on any remaining matters.

The LTAP also sends a letter to the primary NOK about a year after the death of the Marine to check on their welfare and to reaffirm and remind them that the Marine Corps is available to support them indefinitely. To improve the support provided to survivors, members of the LTAP solicit feedback from them via the family member survey. This survey enables family members to share their experiences and have direct input toward further development of the Marine Corps Casualty Assistance Program. LTAP representatives also participate in quarterly survivor group forums sponsored by the DoD and the VA and routinely communicate with our sister Service’s long-term assistance providers to identify best practices.

Review of Casualty Procedures
There has been much attention by Congress, the media, and HQMC regarding military casualty procedures and investigation of potential friendly fire casualties. The Commandant directed a review by the Inspector General of the Marine Corps on command reporting and investigative reporting/processing of Marine Corps casualties. This review identified both human and system errors that required immediate remedial action to preclude future reporting inaccuracies.

The Commandant promulgated a White Letter, and a subsequent Marine Corps bulletin followed that directed review and compliance with current Marine Corps orders. Other changes included the institution of monthly reporting requirements for operational commanders on the initiation, status, completion, and findings of all investigations and formalization of more rigorous predeployment casualty reporting and notification training.

An operational planning team comprised of HQMC and Operating Forces personnel involved with casualty reporting reviewed the initial implementation of the changes in February and will further monitor to ensure that the procedures continue to meet the Commandant’s intent. As a result the Marine Corps casualty assistance order (Marine Corps Order P3040.4E) is currently under revision. Recent changes to law, DoD, and Department of the Navy policy, as well as the previously mentioned findings of the bottom-up review, will be addressed in the new order.

Increased Staffing
On 1 January the Casualty Section assumed the overall centralized responsibility for notification of primary NOK for all wounded and seriously injured/ill Marines. This notification will continue to be performed telephonically to ensure speed of notification. The Casualty Section, HQMC will continue to assist family members with travel to bedside by issuance of individual travel orders as they do now. Contract billeting at Bethesda, Walter Reed, and Brook medical centers will continue in order to relieve families of the burden of paying for their billeting and later having to request reimbursement via a travel settlement.

Improving CACO Training
The critical role of the CACO in the notification and assistance process is obvious to all. Enhancement of CACO training has been a major focus of the DoD over the past year. In accordance with the fiscal year 2006 (FY06) and FY07 National Defense Authorization Acts (NDAAs), a new CACO training policy has been developed that requires specific training on grief and trauma, release of information, overview of benefits and entitlements, points of contact, and the Privacy Act.

Of these specific new requirements, the Marine Corps is training on all topics with the exception of grief and trauma pending the implementation of a comprehensive multimedia training package that will be completed during FY08. In addition to meeting the requirements of the NDAA, the updated CACO training program will also require annual casualty assistance training and certification for CACOs and increase our training formats and availability of training to designated CACOs.

The Casualty Section, HQMC is currently providing casualty assistance training to Marine units through train-the-trainer classroom methods and to all CACOs with online training. In collaboration with Training and Education Command, a Casualty Assistance Distance Learning Course has been developed. This online course is intended to supplement existing classroom training provided on a scheduled basis to Marine Corps commands.

Survivor Binders
One comment heard from our surviving families was that the information provided by the CACO and other agencies came like water from a fire hose at a time when they were truly not able to absorb the subjects and details. In response to this concern and working with the other Services and Military OneSource, the Casualty Section developed a “Days Ahead” binder.

This binder is usually delivered within a few days of the Marine’s death by the CACO and provides organized storage for documents, benefits claims forms, and reference materials that the CACO provides to the family so that this information is readily available when needed in the future. Included in this binder are business cards for VA and Social Security points of contact and a copy of the DoD’s A Survivor’s Guide to Benefits that provides a DoD-level review of benefits and includes a unique Marine Corps section.

Also provided are relevant reference materials from Military OneSource on grieving and trauma. Included with the binder is a copy of Military Widow: A Survivor Guide—a highly acclaimed book cowritten by Joanne Steen, the widow of a fallen Navy pilot. Since its implementation in the spring of 2007, the binder has been well received by the family members and instrumental in keeping their affairs in order.

Conclusion
Providing timely, accurate notification and assistance to Marine families in the case of death, injury, or illness is challenging with today’s high-speed communications from the battlefield. However, it is fundamental to taking care of our own. Marine CACOs are the face of the system and the point of main effort in discharging that duty. CACOs are supported by Marine commands that relay updated information and by the Casualty Section, HQMC that focuses all support to the CACO.

Our casualty notification processes have adjusted to the needs of our families and the 21st century Corps. Marine Corps leadership is committed to taking care of our own. All Marines and their families must feel confident that if they become ill, injured, wounded, or fallen angels, the Marine Corps family will take care of them.