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Acknowledgement of Awareness of Line of Duty Act Benefits


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Section 9.1-400 408, of the Code of Virginia, is the Line of Duty (LODA) Act (“the Act”). The Act provides eligible public safety employees, recognized volunteers and their spouses and dependent children with certain benefits if the eligible public safety officer dies or is disabled in the line of duty. Benefits include a death benefit and payment of health insurance premiums. There is a five year statute of limitations under Virginia law to file that applies to claims for LODA benefits.

A copy of the Act is attached for your records.



Acknowledgement of Awareness of Line of Duty Act Benefits
I hereby acknowledge that I have received and read a copy of the Line of Duty Act and understand that a five year statute of limitations applies to claims for LODA benefits. Questions regarding LODA should be directed to the Commonwealth’s Department of Accounts at (804) 786-1856. Another LODA resource is www.valoda.org.

________________________________ ______________________________

Employee/Volunteer Signature Date

________________________________ ______________________________

Employee/Volunteer Name (Print) Witness

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Employee/Volunteer Spouse Signature Date

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Employee/Volunteer Spouse Name (Print) Witness


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