It is presented to employees of State, USAID, and civilian contractors assigned to diplomatic and consular facilities for events that lead to death or serious illness or injury.

The rules were later changed to allow for members of other personnel systems killed while working on behalf of a foreign affairs agency.

There had been controversy about the name of the award, which suggested that only diplomats serving under the Foreign Service personnel system were eligible.

Examples of employees meeting the selection criteria include, but are not limited to: Nominations for the Thomas Jefferson Star for Foreign Service must be initiated by the chief of mission or by an assistant secretary, cleared by the medical director, as appropriate, and then submitted to the Department Awards Committee for review and recommendation to the secretary.

An employee or surviving next of kin may petition the Department Awards Committee to consider individuals who are eligible and deserving of the Thomas Jefferson Star for Foreign Service notwithstanding the fact that the illness, injury or death occurred prior to the effective date.