DOD INSTRUCTION 5154.30
A
RMED FORCES MEDICAL EXAMINER SYSTEM (AFMES)
OPERATIONS
Originating Component: Office of the Under Secretary of Defense for Personnel and
Readiness
Effective: December 29, 2015
Change 1, Effective: December 21, 2017
Releasability: Cleared for public release. This instruction is available on the
Directives Division Website at http://www.esd.whs.mil/DD/.
Reissues and Cancels: DoD Instruction 5154.30, “Armed Forces Institute of Pathology
Operations,” March 18, 2003
Incorporates and Cancels: DoD Directive, 5154.24, “Armed Forces Institute of Pathology
(AFIP),” October 3, 2001
Directive-type Memorandum, 12-001, “Department of Defense
Executive Agent (DoD EA) for the Armed Forces Medical
Examiner System (AFMES) and the National Museum of Health
and Medicine (NMHM),” March 8, 2012, as amended
Approved by: Brad Carson, Acting Under Secretary of Defense for Personnel and
Readiness
Change 1, Approved by: Edward J. Burbol, Chief, Directives Division, Washington
Headquarters Services
Purpose: This issuance:
• Establishes policy, assigns responsibilities, and provides direction for forensic medicine
activities throughout DoD In accordance with the authority in DoD Directive (DoDD) 5124.02.
DoDI 5154.30, December 29, 2015
Change 1, December 21, 2017
• Provides for the continued operation and governance of AFMES, a component of the
Defense Health Agency (DHA) under DoDD 5136.13, in carrying out assigned functions,
including those under Section 1471 of Title 10, United States Code (U.S.C.).
DoDI 5154.30, December 29, 2015
Change 1, December 21, 2017
TABLE OF CONTENTS 3
TABLE OF CONTENTS
SECTION 1: GENERAL ISSUANCE INFORMATION .............................................................................. 4
1.1. Applicability. .............................................................................................................. 4
1.2. Policy. ......................................................................................................................... 4
1.3. Summary of Change 1. ............................................................................................... 4
SECTION 2: RESPONSIBILITIES ......................................................................................................... 5
2.1. Under Secretary of Defense for Personnel and Readiness (USD(P&R)). .................. 5
2.2. Assistant Secretary of Defense for Health Affairs (ASD(HA)). ................................. 5
2.3. Director, DHA............................................................................................................. 5
2.4. AFME. ........................................................................................................................ 6
2.5. DoD Component Heads. ............................................................................................. 7
2.6. Secretaries of the Military Departments. .................................................................... 8
SECTION 3: OPERATIONS ................................................................................................................. 9
3.1. Forensic Pathology Investigations and Autopsies ...................................................... 9
a. Authority. ........................................................................................................... 9
b. Basis for Investigation. ...................................................................................... 9
c. Determination of Justification. ......................................................................... 10
d. Limitation in Concurrent Jurisdiction Cases.................................................... 10
e. Processes. ......................................................................................................... 10
f. Other Forensic Pathology Cases. ...................................................................... 11
3.2 AFRSSIR. .................................................................................................................. 11
3.3. Other AFMES Functions. ......................................................................................... 12
GLOSSARY ..................................................................................................................................... 13
G.1. Acronyms. ................................................................................................................ 13
G.2. Definitions. ............................................................................................................... 13
REFERENCES .................................................................................................................................. 15
DoDI 5154.30, December 29, 2015
Change 1, December 21, 2017
SECTION 1: GENERAL ISSUANCE INFORMATION 4
SECTION 1: GENERAL ISSUANCE INFORMATION
1.1. APPLICABILITY. This issuance applies to OSD, the Military Departments, the Office of
the Chairman of the Joint Chiefs of Staff and the Joint Staff, the Combatant Commands, the
Office of the Inspector General of the Department of Defense, the Defense Agencies, the DoD
Field Activities, and all other organizational entities within the DoD (referred to collectively in
this issuance as the “DoD Components”).
1.2. POLICY.
a. DoD maintains forensic medicine capabilities to support DoD and other
external stakeholders.
b. The AFMES is established as a subordinate element of the DHA to:
(1) Perform forensic pathology investigations in accordance with Section 1471 of Title
10, U.S.C.
(2) Exercise DoD scientific authority for the identification of remains of DoD-affiliated
personnel in deaths from past conflicts and other designated conflicts as provided in Section
1509 of Title 10, U.S.C.
c. DoD maintains expertise and capabilities in current and emerging forensic medicine
disciplines, including but not limited to, forensic pathology, forensic anthropology, forensic
odontology, DNA sciences, forensic toxicology, and mortality surveillance.
1.3. SUMMARY OF CHANGE 1. The changes to this issuance are administrative and update
organizational titles and references for accuracy.
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Change 1, December 21, 2017
SECTION 2: RESPONSIBILITIES 5
SECTION 2: RESPONSIBILITIES
2.1. UNDER SECRETARY OF DEFENSE FOR PERSONNEL AND READINESS
(USD(P&R)). The USD(P&R)):
a. Establishes policy and provides overall guidance for the AFMES.
b. Develops, in coordination with the Under Secretary of Defense for Policy, identification
and laboratory policy in accordance with the AFMES and Section 1509 of Title 10, U.S.C.
c. Develops, in coordination with the Under Secretary of Defense for Acquisition,
Technology, and Logistics, forensic medicine policy in accordance with DoDD 5205.15E.
2.2. ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS (ASD(HA)).
Under the authority, direction, and control of the USD(P&R), the ASD(HA):
a. Develops policy for, provides policy oversight of, and monitors the implementation of this
issuance to ensure effective and efficient forensic medicine activities throughout DoD.
b. Directs that forensic medicine activities are appropriately reflected in the Defense Medical
Programming Guidance and in the DoD budget.
c. Receives technical advice from the Armed Forces Medical Examiner (AFME) through the
Director, DHA, and advises the USD(P&R) on execution of the responsibilities for forensic
medicine disciplines.
2.3. DIRECTOR, DHA. Under the authority, direction, and control of the USD(P&R) through
the ASD(HA), the Director, DHA:
a. Exercises authority, direction, and control over the AFME.
b. Monitors daily operations, provides administrative support, and maintains operational and
functional oversight, including responsibility to administer the budget, personnel, information
technology, facilities, and other resources required to support the missions and functions of
the AFMES.
c. Appoints a forensic pathologist certified by the American Board of Pathology as the
AFME from among nominees from the Army, Navy, and Air Force.
d. Appoints a forensic pathologist certified by the American Board of Pathology to the
Defense POW/MIA Accounting Agency (DPAA) to:
(1) Exercise scientific identification authority as provided in Section 1509 of
Title 10, U.S.C.
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SECTION 2: RESPONSIBILITIES 6
(2) Establish identification and laboratory procedures in accordance with the AFMES.
(3) Advise the DPAA Director on forensic science disciplines.
e. Assures the ability of the AFME to carry out authorities under Section 1471 of
Title 10, U.S.C.
f. Coordinates with the DoD Component heads to identify requirements for forensic
medicine activities.
2.4. AFME. Under the authority, direction and control of the Director, DHA, the AFME:
a. Serves as:
(1) The Chief, AFMES, and leads the AFMES organization.
(2) The DoD scientific authority for the identification of remains of DoD-affiliated
personnel in current deaths and of other deceased individuals for whom a death certificate has
not been issued.
(3) The DoD scientific authority for the identification of remains of DoD-affiliated
personnel in deaths from past conflicts and other designated conflicts, in accordance with Section
1509 of Title 10, U.S.C.
b. Delegates his or her authority under Section 1471 of Title 10, U.S.C., to the Deputy
Armed Forces Medical Examiner, Deputy Medical Examiners, Regional Medical Examiners, and
other board-certified forensic pathologists under the cognizance of the AFME when professional
credentials are verified.
c. Develops and establishes appropriate standards, processes, and procedures to fulfill
requirements for forensic medicine disciplines in accordance with DoDDs 1300.22E, 5205.15E,
6490.14; and Department of Defense Instruction (DoDI)) 5505.10, and 1300.18.
d. Develops, establishes, and maintains laboratory accreditation; training and professional
certification; and research, development, test and evaluation programs.
e. Ensures the medical examiner whose primary duties include identification of remains in
support of DPAA for past conflicts and other designated conflicts in accordance with Section
1509 of Title 10, U.S.C., is fully informed in order to establish identification and laboratory
policy consistent with the AFMES.
f. Oversees:
(1) The identification of remains in accordance with Title 10, U.S.C., and
DoDD 1300.22E.
(2) The operation of the central forensic toxicology laboratory for the DoD Drug Testing
Program in accordance with DoDIs 1010.01 and 1010.16.
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SECTION 2: RESPONSIBILITIES 7
(3) The operation of the Armed Forces DNA Identification Laboratory (AFDIL) to
perform DNA testing for identification of human remains from peacetime casualties and from
current and past conflicts and other designated conflicts. As authorized by the Director, DHA or
ASD(HA), the AFDIL may perform DNA testing for other federal agencies on a
reimbursable basis.
(4) The operation of the Armed Forces Repository of Specimen Samples for the
Identification of Remains (AFRSSIR) in accordance with DoD Directive 5400.11 and DoD
5400.11-R to collect and store specimen samples for the identification of the human remains of
any Service member, DoD civilian employee, or contractor personnel supporting military forces
in accordance with this instruction.
(5) The operation of a DoD medical mortality registry to archive pertinent medical
records, autopsy reports, and investigative reports on every Service member death. The AFME
identifies medical, circumstantial, epidemiologic, and prevention issues for military deaths, and
makes recommendations for improvements in personnel protective equipment. Military
mortality information is reviewed annually with the Director, DHA.
(6) Forensic pathology investigative services rendered to non-DoD entities on a cost
reimbursable basis and in accordance with DoDD 1100.20 and DoDI 3025.21.
(7) Consultation (including, as required, diagnostic and consultative services and
medico-legal opinions, testimony, and evidence) on medico-legal investigations and related
matters to the judge advocates and criminal investigative agencies of the Military Services and
other federal agencies.
(8) Medico-legal investigations, including autopsies and DNA studies for identification,
to support eligible organizations outside DoD, in accordance with Section 2012 of Title 10,
U.S.C. and DoDD 1100.20. Such support is provided on a reimbursable basis, unless providing
support serves a valid military training purpose and the support is incidental to the training, in
accordance with DoDD 1100.20.
g. Reviews at least annually, with the Director, DHA, the AFMES accomplishments,
mission and organization changes, and budget execution.
h. Issues and maintains federal death certificates in cases subject to AFME’s authority under
Section 1471 of Title 10 and for all cases requiring an overseas death certificate.
i. Maintains an official seal and attests to the authenticity of official records under that seal.
2.5. DOD COMPONENT HEADS. The DoD Component heads:
a. Annually review the forensic medicine services provided by the AFMES for effectiveness
and efficiency in meeting their requirements and make appropriate recommendations for
improvement to the Director, DHA.
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SECTION 2: RESPONSIBILITIES 8
b. Ensure a DNA reference sample is sent to the AFRSSIR from individuals entering
Military Service and all Service members have a sample on file with the AFRSSIR.
c. In accordance with DoDIs 3020.41, 6025.19, and 6490.03, require that Service members,
DoD civilian employees, and contractor personnel who accompany military forces are not
deployed without collection of a DNA reference specimen, collected in accordance with
applicable procedures, to be used for identification of remains. The specimen will be forwarded
to the AFRSSIR. No duplicate specimen samples will be held separately from the AFRSSIR.
d. Notify the AFME of the deaths of all Service members on active duty and inactive duty
for training, including those retired due to disability within 120 days of death, if the death was
the result of an injury or illness incurred while such a member was on a period of active duty.
Allow the AFME to review all pertinent medical and dental records, investigative reports,
photographs, evidence, x-rays, and retained pathologic materials on any autopsy performed in a
DoD medical facility. Medical, casualty, mortuary, law enforcement, and other similar
personnel of the DoD Component shall expeditiously report all such deaths to the AFME.
2.6. SECRETARIES OF THE MILITARY DEPARTMENTS. The DoD Component heads:
In addition to the responsibilities in Paragraph 2.5., the Secretaries of the Military Departments
each nominate a forensic pathologist certified by the American Board of Pathology to serve as
the Armed Forces Medical Examiner as requested.
DoDI 5154.30, December 29, 2015
Change 1, December 21, 2017
SECTION 3: OPERATIONS 9
SECTION 3: OPERATIONS
3.1. FORENSIC PATHOLOGY INVESTIGATIONS AND AUTOPSIES
a. Authority. Under the authority, direction, and control of the AFME and in accordance
with Section 1471 of Title 10, U.S.C., a medical examiner may conduct a forensic pathology
investigation to determine the cause or manner of death of a deceased person if such an
investigation is determined to be justified under circumstances described in Paragraph 3.1.b. The
investigation may include an autopsy of the decedent’s remains.
b. Basis for Investigation. A forensic pathology investigation of a death under this Section
is justified if at least one of the circumstances in Paragraph 3.1.b.(1) and one of the
circumstances in Paragraph 3.1.b.(2) exist:
(1) Justification under this Paragraph is a circumstance under which:
(a) It appears the decedent was killed or that the cause of death was unnatural;
(b) The cause or manner of death is unknown;
(c) There is reasonable suspicion the death was caused by unlawful means;
(d) It appears the death resulted from an infectious disease or from the effects of a
hazardous material that may have an adverse effect on the military installation or community
involved; or
(e) The identity of the decedent is unknown.
(2) Justification under this Paragraph is a circumstance under which:
(a) The decedent was found dead or died at an installation garrisoned by units of the
Military Services that is under the exclusive jurisdiction of the United States;
(b) The decedent was a Service member on active duty or inactive duty for training;
(c) The decedent was recently retired in accordance with Chapter 61 of Title 10,
U.S.C., as a result of an injury or illness incurred while a member on active duty or inactive duty
for training;
(d) The decedent was a civilian dependent of a Service member and was found dead
or died outside of the United States;
(e) In any other authorized DoD investigation of matters which involves the death, a
factual determination of the cause or manner of the death of the decedent is necessary; or
(f) In any other authorized investigation being conducted by the Federal Bureau of
Investigation, the National Transportation Safety Board, or any other federal agency, an
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SECTION 3: OPERATIONS 10
authorized official of such agency with authority to direct a forensic pathology investigation
requests the AFME conduct such an investigation.
(3) Consent of the next-of-kin is not required for any forensic pathology investigation
carried out under Paragraph 3.1.b.(2) or any other applicable compulsory authority.
c. Determination of Justification.
(1) Subject to Paragraph 3.1.c.(2), the determination that a circumstance exists under
Paragraph 3.1.b.(1) will be made by the AFME.
(2) A commander may, after consultation with the AFME, make the determination that a
circumstance exists under Paragraph 3.1.b.(1) and require a forensic pathology investigation
under this Section without regard to a determination made by the AFME if:
(a) In a case involving circumstances described in Paragraph 3.1.b.(2)(a), the
commander is the commander of the installation where the decedent was found dead or died; or
(b) In a case involving circumstances described in Paragraph 3.1.b.(2)(b), the
commander is the commander of the decedent’s unit at a level in the chain of command
exercising summary court-martial convening authority.
d. Limitation in Concurrent Jurisdiction Cases.
(1) The exercise of authority under this Section is subject to the exercise of primary
jurisdiction for the investigation of a death:
(a) In the case of a death in a State (including for this purpose the District of
Columbia, the Commonwealth of Puerto Rico, and Guam), by the State or a local government of
the State; or
(b) In the case of a death in a foreign country, by that foreign country under any
applicable treaty, status of forces agreement, or other international agreement between the United
States and that foreign country.
(2) Paragraph 3.1.d.(1) does not limit the authority of the AFME to conduct a forensic
pathology investigation of a death that is subject to the exercise of primary jurisdiction by
another sovereign nation if the investigation by the other sovereign nation is concluded without a
forensic pathology investigation that the AFME considers complete. A forensic pathology
investigation is incomplete if the investigation does not include an autopsy of the decedent.
e. Processes. For a forensic pathology investigation under this Section, the AFME will:
(1) Designate one or more qualified pathologists to conduct the investigation.
(2) To the extent practicable and consistent with responsibilities under this Section, give
due regard to any applicable law protecting religious beliefs.
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SECTION 3: OPERATIONS 11
(3) As soon as possible, notify the decedent’s person authorized to direct disposition of
human remains (PADD), as defined in DoDI 1300.18, if known, that the forensic pathology
investigation is being conducted.
(4) As soon as practicable after the completion of the investigation, authorize release of
the decedent’s remains to the person authorized to direct disposition of human remains,
if known.
(5) Promptly report the results of the forensic pathology investigation to the official
responsible for the overall investigation of the death.
f. Other Forensic Pathology Cases. In other cases in which the AFME does not have
jurisdiction under Paragraph 3.1.b., but where the AFME believes a medico-legal investigation is
needed with respect to a death for which DoD has an interest in a forensic pathology
investigation, the AFME will seek the assistance and cooperation of authorities who exercise
jurisdiction for conducting such investigation. In all aircraft mishap investigations where the
local medico-legal authority has retained jurisdiction, OAFME may provide assistance as
requested by the investigation board.
3.2 AFRSSIR. The AFRSSIR will:
a. Be operated under rules and procedures that ensure, in accordance with DoDD 5400.11
and DoD 5400.11-R, the protection of privacy of the specimen samples and any DNA analysis of
those samples.
b. Maintain specimens in accordance with applicable standards. Specimen samples
maintained by the AFRSSIR may only be used for:
(1) The identification of human remains.
(2) The identification of any member of the Military Services, DoD civilian employee, or
contractor personnel supporting military forces, who is suspected of being missing in action, a
prisoner of war, unaccounted for, or detainee, and any other purpose for the benefit of such a
member or person as authorized by the ASD(HA).
(3) Internal QA activities to validate processes for collection, maintenance and analysis
of samples.
(4) A purpose for which the donor of the sample, a surviving primary next-of-kin as
defined in DoDI 1300.18, or, in the case of a contractor or other civilian personnel, the legal
next-of-kin, provides consent.
(5) A purpose as provided in Section 1565a of Title 10, U.S.C., when all of the following
conditions are met:
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SECTION 3: OPERATIONS 12
(a) The responsible DoD official has received a valid order of a federal court or
military judge. For this purpose, the Chief of the Trial Judiciary of each of the Military
Departments is the military judge authorized to issue such an order.
(b) The specimen sample is needed for the investigation or prosecution of a felony or
any sexual offense.
(c) The specimen sample can be provided in a manner that does not compromise the
ability of the AFRSSIR to maintain a sample for the purpose of identification of remains.
(d) No other source for obtaining a specimen for DNA profile analysis is
reasonably available.
c. Establish and maintain a procedure for destruction of samples. A routine destruction
schedule will be followed, under which samples will be retained for not more than 50 years.
(1) Individual specimen samples will be destroyed at the request of the donor following
the conclusion by the donor of completed military service or other applicable relationship
to DoD.
(2) On receipt of such a request, the AFRSSIR will destroy the sample within 180
calendar days and send notification to the donor.
(3) If the donor is deceased, destruction may be requested by the applicable primary or
legal next-of-kin.
3.3. OTHER AFMES FUNCTIONS. Consultation (including, as required, diagnostic and
consultative services and medico-legal opinions, testimony, and evidence) on medico-legal
investigations will, absent extraordinary circumstances as determined by the AFME, be provided
under the standard operating procedures of the AFMES.
a. Consultation will include accession of the material into the AFMES case repository as a
Government medical record, internal QA review, and the availability of the consulting
pathologist to all interested parties with a need to know or authorization for access.
b. AFMES pathologists are normally unavailable for nomination or assignment by
convening authorities or military judges as defense consultants or members of the defense team,
or other position requiring protection of communications and submitted case materials as
privileged attorney-client communications.
DoDI 5154.30, December 29, 2015
Change 1, December 21, 2017
GLOSSARY 13
GLOSSARY
G.1. ACRONYMS.
AFDIL Armed Forces DNA Identification Laboratory
AFME Armed Forces Medical Examiner
AFMES Armed Forces Medical Examiner System
AFRSSIR Armed Forces Repository of Specimen Samples for the Identification
of Remains
ASD(HA) Assistant Secretary of Defense for Health Affairs
DHA Defense Health Agency
DNA deoxyribonucleic acid
DoDD DoD Directive
DoDI DoD Instruction
DPAA Defense POW/MIA Accounting Agency
QA quality assurance
U.S.C. United States Code
USD(P&R) Under Secretary of Defense for Personnel and Readiness
G.2. DEFINITIONS. These terms and their definitions are for the purpose of this issuance.
autopsy. An examination and dissection of a dead body by a physician for the purpose of
determining the cause, mechanism, or manner of death, or the seat of disease, confirming the
clinical diagnosis, obtaining specimens for specialized testing, retrieving physical evidence,
identifying the deceased or educating medical professionals and students.
completed military service. Includes active duty service, all service as a member of the
Selected Reserve, the Individual Ready Reserve, the Standby Reserve, the Retired Reserve, or
the Retired Regular Permanent.
forensic medicine disciplines. Those forensic disciplines supporting the DoD’s medical
missions. They include but are not limited to, forensic pathology, forensic anthropology,
forensic odontology, DNA sciences, forensic toxicology, and mortality surveillance.
forensic pathology. The branch of medicine concerned with determining the cause and manner
of death and identifying the deceased through medical and scientific means, including the
autopsy process.
forensic pathology investigation. A systematic process of gathering, recording, and preserving
evidence and information for purposes of positive identification of the deceased, documentation
of trauma and preexisting conditions, and investigative correlations to include an interpretation
of injury patterns. The goal of a forensic pathology investigation is to determine a cause and
DoDI 5154.30, December 29, 2015
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GLOSSARY 14
manner of death compatible with the scene of death, terminal events, and the background of the
deceased and to assist with criminal and safety-board investigations. For the purposes of this
instruction, the terms forensic pathology investigation and medico-legal death investigation
are synonymous.
person authorized to direct disposition of human remains. Defined in DoDI 1300.18.
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REFERENCES 15
REFERENCES
DoD Directive 1100.20, “Support and Services for Eligible Organizations and Activities Outside
the Department of Defense,” April 12, 2004
DoD Directive 1300.22E, “Mortuary Affairs Policy,” October 30, 2015, as amended
DoD Directive 5124.02, “Under Secretary of Defense for Personnel and Readiness
(USD(P&R)),” June 23, 2008
DoD Directive 5136.13, “Defense Health Agency (DHA),” September 30, 2013
DoD Directive 5205.15E, “DoD Forensic Enterprise (DFE),” April 26, 2011, as amended
DoD Directive 5400.11, “DoD Privacy Program,” October 29, 2014
DoD Directive 6490.14, “Defense Suicide Prevention Program,” June 18, 2013, as amended
DoD Instruction 1010.01, “Military Personnel Drug Abuse Testing Program (MPDATP),”
September 13, 2012, as amended
DoD Instruction 1010.16, “Technical Procedures for the Military Personnel Drug Abuse Testing
Program (MPDATP),” October 10, 2012, as amended
DoD Instruction 1300.18, “Department of Defense (DoD) Personnel Casualty Matters, Policies,
and Procedures,” January 8, 2008, as amended
DoD Instruction 3020.41, “Operational Contract Support,” December 20, 2011, as amended
DoD Instruction 3025.21, “Defense Support of Civilian Law Enforcement Agencies,”
February 27, 2013
DoD Instruction 5505.10, “Criminal Investigations of Noncombat Deaths,” August 15, 2013
DoD Instruction 6025.19, “Individual Medical Readiness (IMR),” June 9, 2014
DoD Instruction 6490.03, “Deployment Health,” August 11, 2006, as amended
DoD 5400.11-R, “Department of Defense Privacy Program,” M ay 12, 2007
United States Code, Title 10
