It is the purpose of the National EMS Memorial Service (NEMSMS) to recognize and honor our nation’s Emergency Medical Services (EMS) providers and deliverers who make the supreme sacrifice in the line-of-duty. Each submission for recognition will be considered on a case-by-case basis to determine whether the potential honoree’s death occurred as a direct and proximate result of his/her service as an EMS provider or deliverer. The provisions detailed herein will assist in making such determination but do not constitute an exclusive set of qualifying circumstances. When in doubt, individuals are strongly encouraged to submit potential honorees for consideration.
LINE-OF-DUTY DEATH DEFINED
The National EMS Memorial Service defines line-of-duty death (LODD) as when “an individual’s life is cut short as a direct result of his/her service.” Synonymous with ‘ultimate’ or ‘supreme sacrifice,’ it is something more than dying on-duty or in uniform from a cause unrelated to duty. More specifically, in order for a death to be considered line-of-duty, a cause and effect relationship must be determined to exist between an individual’s EMS service and the injury or illness that led to his/her death.
DIRECT AND PROXIMATE RESULT OF AN INJURY SUSTAINED IN THE LINE-OF-DUTY
For a death to qualify as ‘line-of-duty,’ it must be a direct and proximate result of an injury (including illness, heart attack, stroke, etc.) sustained in the line-of-duty. For an injury to be sustained in the line-of-duty, it must be sustained in the course of:
1) Performance of line-of-duty activity or line-of-duty action;
2) During qualified duty-specific commuting; or
3) Convincing evidence demonstrates that such injury resulted from the injured party’s status – current or prior – as an EMS worker or member of his/her respective EMS agency.
It should be noted that an individual dying on-duty or in uniform of a cause unrelated to his/her duty does not constitute a line-of-duty death. Similarly, a death that occurs while a member is driving a department issued vehicle off-duty or while engaged in activity unrelated to departmental business even while on-duty also does not necessarily constitute a LODD.
The following subsections provide additional clarification and set parameters pertinent to specific causes or circumstances of injury that could qualify as LODD pursuant to these guidelines. Again, these specific provisions and examples do not constitute an exclusive set of circumstances recognized as LODD by NEMSMS.
HEART ATTACK, STROKE and VASCULAR RUPTURE – A heart attack, stroke or vascular rupture is considered a line-of-duty injury if it occurs as a result of duty. However, since it is difficult to identify a specific catalyst for such an injury with certainty, the NEMSMS follows guidelines for presumption established for Public Safety Officers’ Benefits purposes pursuant to the Hometown Heroes Act of 2003 and the Dale Long Act of 2012. Generally, such an injury is presumed to have occurred in the line-of-duty if:
- The injury occurred (or symptoms significantly manifested) within 24-hours of non-routine physically stressful or strenuous line-of-duty activity; and
- Such presumption is not overcome by compelling medical evidence to the contrary – meaning more than the mere presence of cardiovascular risk factors.
NOTE: Activities of a clerical or non-manual nature do not qualify. Also, death does not need to occur within the 24-hour period. If the injury (or significant manifestations of symptoms) occurs within that period and death occurs as a direct and proximate result thereof, regardless of timing, such presumption would apply.
PHYSICAL FITNESS TRAINING – Injuries suffered during ‘physical fitness training’ or while ‘working out’ during duty or non-duty hours do not qualify as line-of-duty except potentially in the following circumstances:
- Such activity is part of a formal training exercise such as a component of in-service training
- Such activity is incumbent on the individual or a workgroup the individual belongs to pursuant to official agency policy and participation is tracked and monitored by the agency. Additionally, if occurring outside regular duty hours, the individual must receive some sort of formal consideration for participation – such as release from duty for a specific period, incentive pay, etc.
COMMUTING
An EMS worker’s commute to/from a duty assignment for a regular shift is not unique to EMS duty and is therefore not considered an extension of duty – even if traveling in a vehicle provided by the agency. A commute is considered duty-related, however, even in a personal vehicle if traveling to/from any mandatory extra-duty activity such as being ‘called in’ pursuant to an emergency or traveling between one work situs and another when required to do so in the course of duty. Travel to/from training and court appearances could also be considered as such if they are duty-related, mandatory and occur outside the scope of one’s normal duties. Commuting to/from an overtime or ‘extra’ shift would not qualify.
The return leg of a qualified commute (as outlined above) will also be considered an extension of duty as long as the individual is returning home, to the location from which the commute began, or to another location which would make the individual ‘whole’ – meaning that the return leg of the commute would be ‘qualified’ if it was determined that he/she was traveling to the location he/she would have been at that time had it not been for the call to duty.
However, the return segment will no longer be considered an extension of duty if the EMS worker engages in a ‘frolic’ or ‘detour.’ In other words, if the individual deviates from his/her normal course to a location as described above – such as stopping for a non-duty related activity or his/her path indicates travel to another location, it will no longer be considered an extension of duty.
INITIATION OF ACTIVITY OFF-DUTY – If an EMS provider renders emergency medical aid within the scope of his/her training and qualification while off-duty and suffers an injury as a direct and proximate result thereof, such injury could be deemed to have occurred in the line-of-duty.
DISENTITLING FACTORS – Deaths that would otherwise qualify can be denied for recognition by the NEMSMS if any of the following factors are present:
- Death was caused by the EMS worker’s intentional misconduct
- Death was caused by the EMS worker’s intent to bring about his/her own death
- The EMS worker was voluntarily intoxicated
- The EMS worker performed his/her duties in a grossly negligent manner
- Actions of a potential beneficiary of LODD benefits substantially contributed to the EMS worker’s death
NOTE: These factors are not absolute causes for denial. The circumstances of each submission will be considered on a case-by-case basis.