Navy Special Pay Guidance

[Gastrapathy]

Pages - default

https://www.med.navy.mil/bumed/Special_Pay/Documents/FY19 Special Pay Plans/Special Pays Briefing Card_181214.pdf


Out today. Very interesting. No renegotiating if you are Peds, Rads or Rad Onc. New 6 year retention bonuses for selected specialties. They recommend pushing your payment effective date to 2019 and (though they aren't saying it directly) your next payment to 2020 so that you wont pay taxes on both in 2019. This would add 3 months to most folks obligations!

17 Dec 2018: Please make sure to review the Medical Department Special Pays Admin Info, as well as each Corps pay guidance before submitting any requests as there are changes in FY19 from FY18, most within the eligibility for RB. The major changes have been highlighted in yellow in each Corps Pay Guidance.

Any request submitted with an effective of 1 Oct 2018, or later, both the request and endorsement are dated NET 7 Dec 2018, and NLT 7 Jan 2019, or they will be required to be retroactive. After 7 Jan 2019, any request for an effective date prior to 7 Dec 18 will require a retroactive submission.

The 2018 tax year cutoff is Friday 21 Dec 2018 to have any chance of being paid in 2018, which means it is highly unlikely we are going to get any special pays received, processed, and to DFAS in time for them to process and post the pay by the 2018 tax year cutoff, so it is recommended any RB submissions the effective date used should be 1 Jan 2019 to prevent two payments of RB in tax year 2019.

With a 1 Jan 2019 start date for RB, that is also the date the obligation for the RB will be established from. If an officer does submit for an effective date of 1 Oct 18 – 31 Dec 2018, you must inform the officer the likelihood of receiving two payments in tax year 2019, which could put them in a higher tax bracket. There is nothing that can be done for taxes if the member elects an effective date between 1 Oct – 31 Dec 2018, and is paid twice in 2019.

As a result of the changes in the eligibility for FY19, only retroactive requests for RB to FY18 where the justification for the delay was clearly unavoidable and can be supported by documentation, such as the officer submitted for an age waiver, or retired retained, in FY18, and had to wait on PERS approval, will be approved. No other unsupported retroactive requests for an effective date back to FY18 will be approved.

Also, with the possible Government shut down, if DOD does shut down, no special pays will be processed during the shutdown; however, anniversary payments due to be paid should still be released during the period, and paychecks, should still be paid, but with a shutdown there are no guarantees.

If there are any questions please direct them to your HRD/Admin/Special Pays Coordinator, or Specialty Leader, who will forward to BUMED inquiries they are unable answer at the command level, but no individuals should be bypassing their local command admin support, since they need to be able to understand the issues, and responses, to be able to better support the command.

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[pgg]

Out today. Very interesting. No renegotiating if you are Peds, Rads or Rad Onc. New 6 year retention bonuses for selected specialties. They recommend pushing your payment effective date to 2019 and (though they aren't saying it directly) your next payment to 2020 so that you wont pay taxes on both in 2019. This would add 3 months to most folks obligations!

FY19 MC Special Pay Guidance

The 6 year RB is new. The increase over the 4-year rate
- adds $15K/year for anesthesia, ER, gen surg, psych, pulm/cc
- adds $20K/year for ortho and subspec cat 1 (mostly subspecialist surgeons)
- adds $12K/year for FM

I'm not sure I understand the logic behind offering it. Anyone signing a 4-year RB has already decided to remain for a 20 year career. It's nice to see the lifers thrown a bit of a bone, though - in the same way it's nice to be eligible to transfer GI Bill benefits even if you already owe 4+ years.

It does feel a little weird to be reading this, knowing I'm in my final ADSO with an existing contract and none of it impacts me.

 

[cgk]

Pages - default

https://www.med.navy.mil/bumed/Special_Pay/Documents/FY19 Special Pay Plans/Special Pays Briefing Card_181214.pdf


Out today. Very interesting. No renegotiating if you are Peds, Rads or Rad Onc. New 6 year retention bonuses for selected specialties. They recommend pushing your payment effective date to 2019 and (though they aren't saying it directly) your next payment to 2020 so that you wont pay taxes on both in 2019. This would add 3 months to most folks obligations!

17 Dec 2018: Please make sure to review the Medical Department Special Pays Admin Info, as well as each Corps pay guidance before submitting any requests as there are changes in FY19 from FY18, most within the eligibility for RB. The major changes have been highlighted in yellow in each Corps Pay Guidance.

Any request submitted with an effective of 1 Oct 2018, or later, both the request and endorsement are dated NET 7 Dec 2018, and NLT 7 Jan 2019, or they will be required to be retroactive. After 7 Jan 2019, any request for an effective date prior to 7 Dec 18 will require a retroactive submission.

The 2018 tax year cutoff is Friday 21 Dec 2018 to have any chance of being paid in 2018, which means it is highly unlikely we are going to get any special pays received, processed, and to DFAS in time for them to process and post the pay by the 2018 tax year cutoff, so it is recommended any RB submissions the effective date used should be 1 Jan 2019 to prevent two payments of RB in tax year 2019.

With a 1 Jan 2019 start date for RB, that is also the date the obligation for the RB will be established from. If an officer does submit for an effective date of 1 Oct 18 – 31 Dec 2018, you must inform the officer the likelihood of receiving two payments in tax year 2019, which could put them in a higher tax bracket. There is nothing that can be done for taxes if the member elects an effective date between 1 Oct – 31 Dec 2018, and is paid twice in 2019.

As a result of the changes in the eligibility for FY19, only retroactive requests for RB to FY18 where the justification for the delay was clearly unavoidable and can be supported by documentation, such as the officer submitted for an age waiver, or retired retained, in FY18, and had to wait on PERS approval, will be approved. No other unsupported retroactive requests for an effective date back to FY18 will be approved.

Also, with the possible Government shut down, if DOD does shut down, no special pays will be processed during the shutdown; however, anniversary payments due to be paid should still be released during the period, and paychecks, should still be paid, but with a shutdown there are no guarantees.

If there are any questions please direct them to your HRD/Admin/Special Pays Coordinator, or Specialty Leader, who will forward to BUMED inquiries they are unable answer at the command level, but no individuals should be bypassing their local command admin support, since they need to be able to understand the issues, and responses, to be able to better support the command.

Is this for the army as well?

 

[Gastrapathy]

@pgg I think the logic is that a little more money might tip people over to staying and they didn't want to just bump up the 4 year. It doesn't overcome the changes to retirement though. Thanks for fixing the link.

The list of critical specialties for the accession bonus is also interesting. IM off the list but FP stays on. I think that specifically targets IM subspecialists who could have received the IM bonus otherwise it doesn't make any sense. The tone in the briefing card seems pretty argumentative. It defined Navy Medicine's mission pretty narrowly and argued that this wasn't a change (I feel like its a pretty big change since I remember SGs talking about Navy Medicine's many missions including humanitarian medicine, training doctors for future wars and caring for retirees).

I'm not sure why they took a gratuitous shot at Peds, Rads and Rad Onc but not IM subs, etc. Seems strange.

 

[pgg]

I'm not sure why they took a gratuitous shot at Peds, Rads and Rad Onc but not IM subs, etc. Seems strange.

I don't know if I'd read too much into that. IM subspecialties can be effectively force-shaped via the GMESB; IM generalists easily fit into operational billets, so there's really no reason to encourage internists to leave.

They also included some non-medical communities - general dentistry, endodontics, exodontia, public health dentistry, oral pathology, pediatric dentistry, pharmacy*, optometry*, pediatric nurse practitioner*, family nurse practitioners, and certified nurse midwife*.

* these groups also lost the 4-year RB option.

I didn't find the tone argumentative. Maybe a little defensive ("talking points") but even that I feel is a bit of a reach, as if looking for something soft to criticize. Overall, very little change compared to FY18 and what change there is, seems broadly in line with the variously declared intents and plans of the last year.

 

[backrow]

I personally love that their recommendation for not getting two bonuses in one calendar year and the subsequent tax issues (which is wholly their fault) is to sign up to serve for longer.

How does that pass for a good solution to anyone? Blows my mind.


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[Perrotfish]

I'm not sure I understand the logic behind offering it. Anyone signing a 4-year RB has already decided to remain for a 20 year career. It's nice to see the lifers thrown a bit of a bone, though - in the same way it's nice to be eligible to transfer GI Bill benefits even if you already owe 4+ years.

Maybe they're losing more people than they expected at the end of their first RB contract? Hoping another 2 years puts them too close to retirement to leave?

It might also be an attempt to fight back against people negotiating favorable orders as a condition of reupping. If you have someone on the line for 6 years you know that there will be at least one PCS where you can force them to deal with whatever you need them to deal with.

Just speculation.

 

[cgk]

@pgg I think the logic is that a little more money might tip people over to staying and they didn't want to just bump up the 4 year. It doesn't overcome the changes to retirement though. Thanks for fixing the link.

The list of critical specialties for the accession bonus is also interesting. IM off the list but FP stays on. I think that specifically targets IM subspecialists who could have received the IM bonus otherwise it doesn't make any sense. The tone in the briefing card seems pretty argumentative. It defined Navy Medicine's mission pretty narrowly and argued that this wasn't a change (I feel like its a pretty big change since I remember SGs talking about Navy Medicine's many missions including humanitarian medicine, training doctors for future wars and caring for retirees).

I'm not sure why they took a gratuitous shot at Peds, Rads and Rad Onc but not IM subs, etc. Seems strange.

Does this mean if you are Peds, Rads, or Rad Onc and your 4 year contract ends in the middle of 2019, that they will not let you sign a new contract for another 4 years? Does this lock you out of the RB's?

 

[Perrotfish]

Does this mean if you are Peds, Rads, or Rad Onc and your 4 year contract ends in the middle of 2019, that they will not let you sign a new contract for another 4 years? Does this lock you out of the RB's?

If I'm reading this correctly it means that:
1) If you're a civilian pediatrician and you join after residency you get paid the same as someone coming out of HPSP. IP + BCP only, but none of the bonus that is supposed to take the place of the retention bonus/HPSP contract. I guess you could still go through HPLRP, which pays less way less. If you're in FM, on the other hand, you get the 275K bonus and then get paid IP + BCP on top of that.
2) If you signed a 2 year contract as a Pediatrician you're stuck with term of your agreement until the end of your contract. If you signed a 2 year agreement as an FM you can decide a year in to drop that contract and resign as a 4 year contract at the higher rate
3) Pediatricians are still eligible to sign for a retention bonus if they're at the end of their service obligation. The rate hasn't changed.

Corrections are welcome if I'm getting this wrong.

 

[Gastrapathy]

I personally love that their recommendation for not getting two bonuses in one calendar year and the subsequent tax issues (which is wholly their fault) is to sign up to serve for longer.

How does that pass for a good solution to anyone? Blows my mind.


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Yeah, its pretty ridiculous and given the new tax brackets, I think most people will pay the same tax rate. Single people definitely aren't affected given the 200k-500k bracket. MFJ might be affected if they are pushed over $315k AGI by a working spouse. Worse case is an extra 10% tax so ~$5000 which is clearly not worth 3 months of extra obligation.

 

[Neogenesis]

Also looks like they are realigning the bonuses to 1 Oct. Eligibility is 3 months after completing med school, internship, residency etc for the respective bonuses.


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[deleted772858]

boy has the world changed.

 

[didja]

Will be interesting to see if Air Force follows this same pay plan.

 

[QBach]

Will be interesting to see if Air Force follows this same pay plan.

Yeah, I wonder if, as DHA drives everything closer to the proverbial purple suit, there will be some kind of standardization among the services.

 

[milmed14]

Yeah, I wonder if, as DHA drives everything closer to the proverbial purple suit, there will be some kind of standardization among the services.

Except it was standardized across branches before CSP. Then CSP “unified” the pays and DHA changed everything.

 

[DrMetal]

FY20 Specialty Pay Guidance: any idea when this gem will be out? Last year the NAVADMIN came out in DEC, I think.

 

[chronick]

Question on the RB:

Am I reading that correctly that you must have completed an ADSO before being eligible?

My situation:
4 year HPSP
1 year TY
2 years GMO
3 year Residency (incurred 3 year payback)

Would my first year eligible be after I finished 3 years of payback post-residency, or would it be 2 years post-residency because of my 2 GMO years?

 

[Cooperd0g]

Yes, you must complete ADSO.

After 3 year payback for residency since it is longer than your remaining 2 year HPSP payback.

 

[DrMetal]

When is this bloody thing coming out?! It's almost march.

 

[militaryPHYS]

I bet soon. They will probably piggyback on the DHA 703 report and just get all of the official major changes out of the way at one time.

 

[backrow]

When is this bloody thing coming out?! It's almost march.

Rumor from the specialty leader is “soon”.

I’m actually a little concerned. I’m hoping I’m wrong, but it seems like it must have either been controversial or a big change if it’s taking this long.


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[militaryPHYS]

Rumor from the specialty leader is “soon”.

I’m actually a little concerned. I’m hoping I’m wrong, but it seems like it must have either been controversial or a big change if it’s taking this long.


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Yep. If I had to guess the budget needed some budging. 703 helps. "Adjusting" bonus structure will also help their cause. We will get to see the 6 year outlook on what to expect with each specialty based on the numbers in special pays guidance. Should be interesting.

Maybe we are getting a big raise because of that GAO report a couple months back! 😵

 

[pgg]

I bet someone noticed that military physician pay hasn't changed since the 1990s, not even to account for inflation, and thought "Wow that's awful and we should fix it" and the delay is because they were earnestly discussing whether or not they should go for an immediate 85% increase (to account for a full quarter century of missed inflation adjustments) or gradually phase it in with 26% increases every year for the next 4 years.

 

[Mace1370]

I bet someone noticed that military physician pay hasn't changed since the 1990s, not even to account for inflation, and thought "Wow that's awful and we should fix it" and the delay is because they were earnestly discussing whether or not they should go for an immediate 85% increase (to account for a full quarter century of missed inflation adjustments) or gradually phase it in with 26% increases every year for the next 4 years.

Yes, definitely this. Only reasonable explanation really 🤣

 

[Gastrapathy]

Remember when we used to worry about the delay running into the next tax year....seems quaint now.

how you pay people shows how you value them.

 

[DrMetal]

Random question: Do you have to be actually working in your specialty to collect the specialty pay? For instance: the General surgeon who is billeted to the Assitant-HMFIC job at Medical Readiness Blunder division 3.0....he wont see an OR for 3 years. Still gets GS specialty pay?

 

[backrow]

Random question: Do you have to be actually working in your specialty to collect the specialty pay? For instance: the General surgeon who is billeted to the Assitant-HMFIC job at Medical Readiness Blunder division 3.0....he wont see an OR for 3 years. Still gets GS specialty pay?

For Navy the terminology is “credentialed, privileged, and practicing”, although there are apparently waivers available. I have seen most “fulfill” this by working a day or two a month or something like that.

I am somewhat torn about this: without the bonus no physician would likely take those jobs (which would be a detriment to the medical system) but at the same time if they are only working their specialty “on paper” then should they get it. In my humble opinion there should be some sort of terminology that allows some time in admin without monetary loss.


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[Chonal Atresia]

Remember when we used to worry about the delay running into the next tax year....seems quaint now.

how you pay people shows how you value them.

This is spot on.

I realize that military physician pay will never equal 50th %tile civilian physician pay; however, can you really even call it a “pay gap” when the average mid-career orhopod makes $225-250k/yr in the military and >$750/yr as a civilian? Ancillaries such as PT, surgery center income, savings from “bundled payments”, etc add further revenue on top of regular salary which is not seen by military physicians. There are MANY surgical and medical specialties where the pay difference mirrors orthopedics (i.e. greater than 3x military salary).

The military has complete and utter disrespect for the medical profession. Gastrapathy said it well.

 

[DrMetal]

The military has complete and utter disrespect for the medical profession. Gastrapathy said it well.

I hear ya, and I definitely feel the pain. I'm eagerly awaiting my bonus so I can buy my new house, more whiskey, and guitars.....but the military doesn't serve the medical corps. It's a common sentiment among the staff and support communities (legal, chaplain, medical, whatever have you) to feel that the mil doesn't 'respect' them.

I can guarantee you the line military doesn't mean the disrespect, but they also don't care, they have much bigger fish to fry. And they would just as well see us all civilianized (though that'd still be expensive) so they don't have to deal with us.

Frankly, I'd agree with that: I think the medical corps should become a predominantly reserve force. Then we wouldn't have to worry about specialty pays!

 

[Perrotfish]

I hear ya, and I definitely feel the pain. I'm eagerly awaiting my bonus so I can buy my new house, more whiskey, and guitars.....but the military doesn't serve the medical corps. It's a common sentiment among the staff and support communities (legal, chaplain, medical, whatever have you) to feel that the mil doesn't 'respect' them.

I can guarantee you the line military doesn't mean the disrespect, but they also don't care, they have much bigger fish to fry. And they would just as well see us all civilianized (though that'd still be expensive) so they don't have to deal with us.

Frankly, I'd agree with that: I think the medical corps should become a predominantly reserve force. Then we wouldn't have to worry about specialty pays!

Don't take the attitude that the line military for some reason either can't or shouldn't respect the medical corps. Military medicine was a perfectly functional system for decades when both our budgets and our manpower were much more strained then they are right now.

 

[militaryPHYS]

FY20 Special Pays Plan Released

The FY20 pay plan NAVADMIN was released today. Here are the documents and below them is the message I sent to the Medical Corps today about the plan and changes: FY20 MEDICAL DEPT SPECIAL PAYS ADMI…

mccareer.org

• Eliminates 4-year Retention Bonus for certain specialties to include: obstetrician/gynecology, ophthalmology, otolaryngology, urology, pathology, family medicine, general internal medicine, pediatrics, nuclear medicine, radiology, and radiation oncology.

Pretty clear list of specialties determined not vital to operational mission.

From Joel Schofer (Deputy Chief of MC): "...we must be willing to make tough choices as we engage in the great power competition and execute the NDS. As a result, Navy Medicine developed plans to align Fiscal Year (FY) 2020 special pays guidance with warfighter requirements and decided to reduce or eliminate some special and incentive pays for select medical specialties."

Question is: are these changes made to downsize force to new sustainment levels (eventually reinstate RB's once force structure is at determined "appropriate numbers") or are these specialties going to continue to be targeted with further decreases in compensation, fewer and fewer GME spots until eventual elimination from MilMed all together?

 

[Gastrapathy]

holy ****

 

[backrow]

• Eliminates 4-year Retention Bonus for certain specialties to include: obstetrician/gynecology, ophthalmology, otolaryngology, urology, pathology, family medicine, general internal medicine, pediatrics, nuclear medicine, radiology, and radiation oncology.

Pretty clear list of specialties determined not vital to operational mission.

Agree that this is essentially what this means, or that they feel they need much fewer of these than they currently have.

Question is: are these changes made to downsize force to new sustainment levels (eventually reinstate RB's once force structure is at determined "appropriate numbers") or are these specialties going to continue to be targeted with further decreases in compensation, fewer and fewer GME spots until eventual elimination from MilMed all together?

I would venture that the future force structure will not see these RBs brought back. Further in the memo it says that GME opportunities will be available in all specialties (I guess they don’t include PM&R in their calculations) so with that in mind they are going to continue to train which means people have to leave to keep whatever equilibrium they are looking for. You certainly wouldn’t want people hanging around for 7+ years after residency (min 3yrs residency commitment + 4yr RB) if you didn’t want to find yourself in an overmanned situation.

What this signals to me is a potential plan on graduating ‘em, chewing ‘em up, and then spitting them out. They really don’t want people staying to retirement apparently. With decreasing numbers of active duty to cover the deployment needs the tempo is going to increase while the GS hanging out at home gets paid twice as much and sees their kids every night. So with no real bonus available and watching your colleague down the hall sit there while you deploy there is going to be much less incentive to stay so folks are going to leave.

I’m probably a bit over-reaching here, but this is what the tea leaves look like from this side.


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[militaryPHYS]

I agree with you. Whether leadership likes it or not those specialties will be treated like crap in all aspects as MilMed moves forward. GME/FTOS spots, funding, compensation, duty locations, etc. No reason not to leave if they have opportunity. I think that is exactly what BUMED wants in order to meet budget and restructuring requirements. Sad but true.

 

[Gastrapathy]

we predicted this was the next step when they changed the terminology for the special pays.

To be clear, this removed max retention bonuses from the majority of physicians in the military (all of IM and FP).

This will be an effective pay cut for anyone at the 12+ year mark who was going to stay. And if you just signed a 4 year to take you to 16, you also just signed up for 4 years getting paid that much less (and zip in the last year or worse)

it’s dreadful.

 

[Gastrapathy]

The irony is they kept the bonuses for IM subs. I can’t fathom why Cards and GI were spared. As if there wasn’t enough pressure to subspecialize already.

and why did they take out urology. The urologist was in every down range trauma trying to preserve dude’s junk after IED blasts.

 

[SirGecko]

This definitely isn’t surprising. When they were making their circuits about the state of the medical corps and right sizing they were pretty explicit that cutting pay was going to be one of the tools they would use to try to decrease manning in the specialties that they don’t think they need. (They specifically said that the medical corps is the only field in the Navy that hasn’t paid less than the max allowed for bonuses and that would change) With so many people getting out after their commitment is up anyway it didn’t seem like all that effective of a lever to me but at least they cut RB not IP so its nominally in line with what they say they want to do. (Get people who have the option of leaving to leave).

 

[deleted480308]

The irony is they kept the bonuses for IM subs. I can’t fathom why Cards and GI were spared. As if there wasn’t enough pressure to subspecialize already.

and why did they take out urology. The urologist was in every down range trauma trying to preserve dude’s junk after IED blasts.

If I lost my junk because they wouldn’t pay the urologist, I would get myself arrested

 

[Perrotfish]

And in a year or two the surgeons will find out that they're covering all the SMO and regimental surgeon billets that the FPs have left vacant. Maybe some of the IM subs as well.

 

[Gastrapathy]

Yeah, taking FP from a specialty with a 6 year down to no 4 year is dramatic. Pretty big f you to primary care.

 

[Gastrapathy]

And I love the part where even SLs aren’t supposed to interact with the special pays office because they are too busy. Good customer service

 

[deleted480308]

And I love the part where even SLs aren’t supposed to interact with the special pays office because they are too busy. Good customer service

Yep...

Fu@& your money and fu@& you if you want to talk to us about how we are fu@&ing your money.

V/R
Money Fu@&ing committee

 

[Gastrapathy]

I also find it hard to believe that no one has a comment on his site. I’d bet a paycheck he’s censored comments.

what do you say Joel, stop lurking and come tell us why the corps chief has reduced pay for Navy physicians,

 

[HighPriest]

The irony is they kept the bonuses for IM subs. I can’t fathom why Cards and GI were spared. As if there wasn’t enough pressure to subspecialize already.

and why did they take out urology. The urologist was in every down range trauma trying to preserve dude’s junk after IED blasts.

They're going to make cod pieces mandatory. The larger the better.

 

[HighPriest]

So why even keep training some of these professions with military GME? I assume either the answer is: "that's on the block next", or "we'll just survive on people with 4 year post-training ADSOs." So, in a nutshell, the only ENTs you'll work with in the future are guys who regret having joined.

FWIW, the military doesn't need ENT. I mean, they actually do a lot of work in garrison, but you don't need them deployed. It's not that they can't do anything, but anything you might need them for is cross covered by someone else.

 

[Gastrapathy]

Joel says why to keep training. It’s so the recruiters can say they offer it.

 

[crazybrancato]

Joel says why to keep training. It’s so the recruiters can say they offer it.

Hey [deleted]: let's go easy on the first names yo.

 

[Gastrapathy]

Close but not quite. Well, not that close.

I’m not in the Navy. He’s a public figure with a blog. But trying to dox me shows what kind of person you are.

 

[HighPriest]

I mean...his name is right at the top of the blog. If he was shooting for anonymity, I think he misfired.

 

[backrow]

Close but not quite. Well, not that close.

I’m not in the Navy. He’s a public figure with a blog. But trying to dox me shows what kind of person you are.

Agree, that’s messed up.


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