AGENCY OVERSEAS MEDICAL PROGRAM

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP72-00310R000200200002-2
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 2
• Document Creation Date: December 20, 2016
• Document Release Date: November 15, 2006
• Sequence Number: 2
• Publication Date: November 23, 1970
• Content Type: MF

Approved For Release 2006/11/15: CIA-RDP72-00310R000200200002-2
MEMORANDUM FOR: Director of Personnel
.5 C HAS REVS W C` 23 November 1970
SUBJECT: Agency Overseas Medical Program
REFERENCE: Memo fr D/MS to D/Pers dtd 10 Sept 70;
Subject: Extent of Overseas Medical
Benefits for Dependents- -Case of Son of
1. The referent memorandum was forwarded to this office
for consideration of the legal aspects. The Director of Medical
Services points out that he cannot state that the son's illness in this
case was clearly caused by residence abroad. On the other hand,
he does conclude that overseas residence contributed to the illness.
In such a situation, therefore, the Director of Medical Services finds
difficulty in approving a waiver of treatment at Government expense
beyond a period of 120 days since the statute concerned and our
regulation I provide that the waiver can only be granted
if the Director of Medical Services determines in writing "that the
illness or injury is clearly caused by the fact that the dependent is
or has been located abroad. "
2. Since the Agency authority in this area was adopted by the
Agency from State Department's statutory authority, we looked at
their regulations implementing the statute. Their regulation, 3'FAM
685. 2c, provides that the Medical Director has the authority to extend
treatment at Government expense beyond 120 days in those cases in
which he determines the illness or injury is "clearly caused or
materially aggravated by the fact that the patient is or has been located
abroad. " The regulation further included what might be called a
"but for" rule saying that "such determination shall be made the basis
of whether it may be reasonably assumed that the patient would not
have incurred the illness or injury had he remained in the U. S. "
OGC 70-1964
Y.Gii (! I i y a:,'
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3. In our view the above regulatory wording is extremely
important in determining how far the Director of Medical Services
may go in making his determination. While at first look it may
appear that such wording broadens the statutory language, we have
found through research that analogous statutory words have been
interpreted rather broadly by numerous courts in attempting to do
equity in particular fact situations consistent with the spirit of the
legislation involved. Consequently, it is our view that if this Agency
had the same regulatory provisions as does the State Department,
and if the Director of Medical Services can determine that overseas
residence contributed to the illness, he could appropriately approve
a waiver of the 120-day period.
4. The question has also been raised whether the Agency may
in any way limit the reimbursement of medical expense once it does
grant a waiver. The statute which we adopted provides that "the
Secretary may, in accordance with such regulation as he may prescribe,
pay .... " In our view, the Agency may, by appropriate regulation and
policy decision, limit the maximum amount of benefits whether or not
waiver is granted. It certainly would not be unreasonable to provide
for periodic review of Government payment of benefits after the initial
waiver, leaving in a designated official the authority to reduce or
discontinue benefits, utilizing some reasonable standards in making
such determination.
5. In the absence of formalized regulations establishing Agency
policy to include (a) the State Department regulatory provisions and
(b) limitations on benefits after waiver of the 120-day period, there
would be no legal objection to the Deputy Director for Support, as the
approving authority for regulations, affirming that these matters are
and were intended to be a part of the Agency policy in administering
the overseas medical program. After such affirmation, there would
be no legal objection in applying such policy to cases arising prior to 25X1
this date.
Deputy G neral Counsel
cc: OMS
/bGC Subject - MEDICAL
OGC Chrono
OGC:JSW:mks
Approved For Release 2006/11/15: CIA-RDP72-0031 OR000200200002-2