MS 285: Volunteer Description of Service Statement and Certificate of Group Health Coverage

Date: 01/15/98, partial revision 07/15/99
Office: International Operations (IO)
Supersedes: 10/15/96, 1/15/87; MS 299, 5/18/73

Table of Contents
Attachments

Table of Contents

Attachments

1.0 Purpose

The Volunteer Description of Service (DOS) Statement serves as the official Peace Corps reference for returned Volunteers. It describes the Volunteer's training and overseas activities in non-evaluative terms and, when appropriate, includes EO 11103 certification (see paragraph 3.0 below). The DOS Statement is available to the returned Volunteer and, with the consent of the returned Volunteer, to prospective employers and school officials. Trainees do not receive a DOS Statement.

The Certificate of Group Health Plan Coverage is issued to all Volunteers and Trainees when they leave service.

2.0 DOS Statement Preparation

2.1 Collecting Information (07/15/99)

At least three months before completion of service (COS), or at the time of early termination in-country, the Country Director should provide information in writing to terminating Volunteers regarding the preparation of the DOS Statement.

The Country Director should suggest that terminating Volunteers include the following information in preparing their DOS Statements (see Attachment A for an optional template):

2.1.1 Information for Teachers

• Supervising authority (e.g., Minister of Education)
• On-the-job supervisor (e.g., principal, department chairman)
• Type and level of school, name of school, district, region and country, and U.S. equivalent
• Size of school (number of students and teachers)
• Date(s) of beginning and ending of school year (day and month)
• Total number of school days in the school year and number that Volunteer taught
• Subjects/grades taught and students/hours in each class
• Special difficulties encountered and overcome (e.g., prepared students for Cambridge School Certificate)
• Extracurricular activities
• Secondary project(s)
• Special awards or commendations

2.1.2 Information for Non-Teachers

• Supervising authority (e.g., Minister of Commerce)
• On-the-job supervisor (e.g., District Officer)
• Type of project (e.g., Urban Community Development)
• Level of work and title (e.g., supervisor, engineer, nutritionist)
• Any teaching responsibilities
• Size of community or number of persons involved in project
• Special difficulties encountered and overcome
• Secondary project(s)
• Special awards or commendations

Note: Returned Volunteers who are applying for employment, to graduate school, or for training programs often find it useful to have their experience quatified (how many persons affected, hours involved, bridges built, persons inoculated, gardens planted, fish ponds developed, and so forth).

2.2 Preparing DOS Statement

Each DOS Statement and three copies should be prepared on good-quality locally procured Peace Corps official letterhead (see Attachments B and C for DOS Statement examples). In addition to the above information, include the following:

• Full name of the Volunteer (including maiden name if female Volunteer married while overseas) and the social security number
• The Volunteer?s training dates, enrollment date, and termination date
• Statement of Eligibility for Federal Employment Tenure Benefits, inserted immediately before the Executive Order 11103 certification:

  Pursuant to Section 5(f) of the Peace Corps Act, 22 USC 2504(f), as amended, any former Volunteer employed by the United States Government following his/her Peace Corps Volunteer Service is entitled to have any period of satisfactory Peace Corps service credited for purposes of retirement, seniority, reduction in force, leave, and other privileges based on length of Government service. That service shall not be credited toward completion of the probationary or trial period of any service requirement for career appointment.

• Statement of Executive Order 11103 certification, if Volunteer is eligible, as the final paragraph (see paragraphs 3.1 and 3.2 for eligibility and wording)
• Optional - Privacy Act Waiver on a separate page (see Attachment D)

2.3 Review of DOS Statement

The Country Director must sign and date all copies of the DOS Statement.

2.4 Distribution of DOS Statement (07/15/99)

The Country Director will return the original DOS Statement to the Volunteer before the Volunteer leaves the Post. Two copies of each DOS Statement, grouped by program and alphabetically by name should be sent to Volunteer and Staff Payroll Services (OPBF/F/VSPS) along with a cover memo (see Attachment E). One copy of the DOS Statement is filed at Post for one year.

VSPS will file DOS Statements for 60 years. Distribution of the DOS Statement to prospective employers or others is subject to the requirements of the Privacy Act of 1974 (5 USC § 552a). The DOS Statement cannot, except as authorized pursuant to law, be distributed without the express written consent of the Volunteer to whom it relates. With written consent (Privacy Act Waiver, see Attachment D), VSPS can release the DOS Statement. Contact the Certifying Officer in the office of VSPS to request a copy of a DOS Statement.

In the case of Volunteers not terminating their service at Post, the Volunteer will prepare the DOS Statement and forward it to the Post for the Country Director's signature. The Country Director will then return the original DOS Statement to the Volunteer, send two copies to VSPS, and file one copy at Post

3.0 Executive Order 11103 Certification

Under the Provisions of Executive Order (EO) 11103 (5 CFR, § 315.605), certain returned Volunteers are awarded one year of non-competitive eligibility for selection for federal employment. This eligibility does not mean that returned Volunteers are entitled to federal employment.

Non-competitive eligibility permits, but does not require, an agency to hire a returned Volunteer who meets the minimum qualifications for the position without going through all of the formalities of the competitive process. The decision whether to hire a returned Volunteer under non-competitive eligibility is within the discretion of the hiring agency.

3.1 Completion of Full Term of Service (07/15/99)

Volunteers who have satisfactorily completed a full term of service are eligible for EO 11103 certification. Country Directors should include the following certification statement as the final paragraph on the DOS Statements of Volunteers granted this benefit:

This is to certify in accordance with Executive Order 11103 of April 10, 1963, that served successfully as a Peace Corps Volunteer. His/her service ended on . He/she is therefore eligible to be appointed as a career-conditional employee in the competitive civil service on a non-competitive basis. This benefit under the Executive Order extends for a period of one year after termination of Volunteer service, except that the employing agency may extend the period for up to three years for a former Volunteer who enters military service, pursues studies at a recognized institution of higher learning, or engages in other activities that, in the view of the appointing agency, warrant extension of the period.

3.2 Early Termination (07/15/99)

The Country Director will make the Agency decision regarding eligibility for EO 11103 certification in all cases of early terminating Volunteers. The Country Director may issue certification to Volunteers who have satisfactorily served for twelve consecutive months, including training, and whose termination is determined to be for reasons beyond the Volunteer's control. Country Directors should include the certification statement from paragraph 3.1 as the final paragraph on the DOS Statements of Volunteers granted this benefit.

3.3 Denial of Certification and Appeal (07/15/99)

The Country Director must provide terminating Volunteers who are denied EO 11103 certification with notification in writing. Notification must include the reasons for denial and the following paragraph on appeal procedures:

If you wish to appeal this decision, please write to the Peace Corps Director, c/o Special Services (VS/SS), Peace Corps, Washington, DC20526. The appeal must be postmarked within 30 days of notification of denial of certification. In the absence of special circumstances, appeals postmarked after this period will not be considered. Your appeal must detail specifically the reason for the appeal and include a copy of the Country Director's written notification.

The Country Director must provide the Volunteer with the original of this notification and maintain a copy in the Volunteer's in-country file.

If a terminating Volunteer disagrees with the Country Director's decision regarding eligibility for EO 11103 certification, he/she may appeal that decision through Special Services (VS/SS) to the Director of the Peace Corps. The appeal must follow the procedures above.

4.0 Personal Recommendations

Peace Corps staff members may serve as personal references for Volunteers and returned Volunteers as long as the following rules are observed:

Rule 1. A letter of recommendation can be provided by a Peace Corps employee using his/her official title in response to a request for an employment recommendation or character reference. The recommendation must be based on personal knowledge of the ability or character of the Volunteer, acquired by the reference writer in the course of his/her job. An example of this would be a request by a returned Volunteer for a letter of recommendation from his/her Country Director. Under these circumstances, it is permissible to use official stationery and sign the letter using an official title, provided that Rule 2 is observed.

Rule 2. When providing a reference for a Volunteer, the employee must clearly state in the reference that it is based on personal knowledge and that it is not an official evaluation by the Peace Corps. For example, "this reference is based on my personal knowledge of ________ and should not be construed as an official evaluation by the Peace Corps."Additionally, such a statement must be added whenever a preprinted appraisal or reference form is completed for a Volunteer.

5.0 Certificate of Group Health Coverage

Under legislation enacted in 1996, returned Volunteers and Trainees may be entitled to enter employer-provided group health plans without exclusion of pre- existing health conditions, if they have had sufficient health care coverage and become employed without a break in coverage of more than 63 days. The certificate tells employers that Peace Corps service qualifies toward meeting coverage requirements.

Under 45 CFR Part 146, Peace Corps must issue a "Certificate of Group Health Plan Coverage" (see Attachment F) to each Volunteer or Trainee (V/T) as he/she leaves service for any reason.

5.1 Completing the Certificate

Post must follow these steps each time a V/T leaves service:

• Fill out the certificate per the instructions in Attachment F and print it on Post letterhead.
• Sign.
• Make one copy and send it to VSPS. For Volunteers, attach the copy to the DOS Statement.
• Give the original to the V/T.

5.2 Certificate Questions

VSPS at PC/Washington will field questions and issue duplicate certificates if needed.