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AF | BCMR | CY2007 | BC-2007-00222
Original file (BC-2007-00222.DOC) Auto-classification: Denied

RECORD OF PROCEEDINGS
             AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:                       DOCKET NUMBER:  BC-2007-00222
                                             INDEX CODE:  128.14
      XXXXXXXXXXXXXXXXX                 COUNSEL:  NONE

                                             HEARING DESIRED:  NO


MANDATORY CASE COMPLETION DATE:  17 July 2008


________________________________________________________________

APPLICANT REQUESTS THAT:

His Traumatic  Insurance  Protection  under  the  Traumatic  Servicemembers’
Group Life Insurance (TSGLI) claim be approved based on Item 6  (Hemiplegia)
of Appendix C – Schedule of Losses, of the TSGLI Procedures Guide.

________________________________________________________________

APPLICANT CONTENDS THAT:

Denial of his claim for TSGLI should be reconsidered.  On 17 June  2005,  he
had a stroke while serving in  Germany  in  support  of  Operation  Enduring
Freedom.  As a result of the stroke, he suffered  Hemiplegia  (paralyzed  on
one side of his body) for more  than  120  days,  plus  additional  on-going
problems.  For more than 120 days, he could not dress, bathe, or go  to  the
bathroom by himself, and he had very limited ability to feed  himself  using
the non-affected side of his body.  The result is partially paralyzed right-
side balance, speech, and emotional (brain) damage.  His condition  was  the
result of his traumatic event and  he  does  not  understand  the  reply  he
received.

He has not gotten a copy of his military medical records and does  not  feel
comfortable having them send him a copy.  They are kept at  Maxwell  AFB  if
they are needed to prove his stroke.

In support of his appeal, he has provided  copies  of  an  undated  personal
statement to a Senior NCO at ARPC, a letter from ARPC/CC,  dated  5  October
2006, Appendix C  –  Scheduled  Losses  from  the  TSGLI  Procedures  Guide,
another undated letter to the Senior NCO at  ARPC  with  numerous  documents
pertaining to his TSGLI claim, a letter from the Office of SGLI denying  his
TSGLI claim and explaining why his claim was denied, dated 22  August  2006,
a  letter  from  the  Department  of  Veterans  Affairs   with   attachments
pertaining to Certification of TSGLI, a  letter  from  ARPC/SG  recommending
the denial be upheld, dated 26 September 2006, and a  Personal  Data  Report
on Individual Person (RIP), dated 11 August 2006.

Applicant’s complete submission, with attachments, is at Exhibit A.

________________________________________________________________

STATEMENT OF FACTS:

Applicant’s records reflect that his date of birth is 6 November  1964  (age
42) and he was a unit assigned  reservist  assigned  to  the  908  Logistics
Readiness Squadron at Maxwell AFB,  AL.   He  was  performing  duty  as  the
Assistant NCOIC, Demand Processing, was serving in the grade of  TSgt,  and,
as of 20 October 2005, had completed 19 years, 11 months,  and  29  days  of
satisfactory service for a reserve retirement.  In  February  2006,  he  was
found medically disqualified for continued military duty due  to  a  Basilar
Artery Stroke.  He was assigned to the Retired Reserve  and  placed  on  the
USAF Reserve Retired List effective 2 May 2006, and  is  currently  awaiting
retired pay at age 60.

TSGLI is a traumatic injury protection  rider  under  Servicemembers’  Group
Life Insurance (SGLI).  It provides payment to any member of  the  uniformed
services covered by SGLI, who sustains a traumatic injury  that  results  in
certain severe losses.  To be eligible for payment, a  Service  member  must
be insured by SGLI, must have incurred a scheduled loss that  was  a  direct
result of a traumatic injury, must have suffered the traumatic injury  prior
to midnight of the day that they separate from the uniformed services,  must
have suffered a scheduled loss within 365 days of the traumatic injury,  and
must survive for a period of not less than seven full days from the date  of
the traumatic injury.  For the purposes  of  TSGLI  coverage,  a  qualifying
traumatic injury is an injury or loss  caused  by  application  of  external
force or violence (a traumatic event) or a  condition  whose  cause  can  be
directly linked to a traumatic event.

Effective 1 December 2005, every  service  member  who  has  SGLI  also  has
TSGLI.  TSGLI coverage is automatic for those insured under SGLI and  cannot
be declined.  The only way  to  decline  TSGLI  is  to  decline  basic  SGLI
coverage.  This benefit is  also  provided  retroactively  for  members  who
incur a qualifying loss as a result of a traumatic injury  incurred  between
7 October 2001 and 1 December 2005, if the  loss  was  a  direct  result  of
injuries incurred in Operations Enduring/Iraqi Freedom.  Covered losses  and
payments are listed in the TSGLI Schedule of Payments for Traumatic  Losses,
and the amount that will be paid ranges from a  total  amount  of  not  less
than $25,000, to a total amount not greater  than  $100,000.   According  to
the TSGLI Schedule of
Payments for Traumatic Losses, if the qualifying  loss  is  Hemiplegia,  the
amount that will be paid is $100,000.

________________________________________________________________

AIR FORCE EVALUATION:

ARPC/DPP recommends denial.  Applicant submitted  a  claim  to  them  on  10
August 2006  for  Stroke/Hemiplegia  which  he  suffered  while  serving  in
Germany in support of Operation  Enduring  Freedom.   Although  he  provided
medical documentation to support his initial claim,  HQ ARPC/SGO  determined
that it  did  not  appear  to  meet  the  criteria  outlined  in  the  TSGLI
Procedural Guide in that the event does not meet  the  requirement  that  it
occur as a result of a traumatic event.  His claim was denied  on  14 August
2006.

Applicant filed an appeal with HQ ARPC on 25 September 2006.  He provided  a
letter reiterating his condition,  but  provided  no  additional  supporting
documentation or evidence of loss due to a traumatic event.   On  5  October
2006, ARPC/CC, the final approval authority, denied his appeal based on  his
injury  not  meeting  the  eligibility  criteria  outlined  in   the   TSGLI
Procedural Guide or  the  eligibility  criteria  outlined  in  the  guidance
provided by the Office of Servicemembers’ Group Life Insurance (OSGLI).

No  evidence  has  been  submitted  which  indicates  any  injustices   have
occurred.  Applicant has not provided evidence  to  substantiate  his  claim
that his injuries were a direct cause of a traumatic event.

If the Board determines that  the  applicant’s  medical  records  should  be
changed to reflect that his Stroke/Hemiplegia  was  caused  by  a  traumatic
event,   ARPC/DPP   will   submit   his   case    to    OSGLI    with    the
certification/recommendation  from  the  AFBCMR  that  applicant  should  be
awarded the appropriate funds as designated by OSGLI.

The ARPC/DPP evaluation, with attachments, is at Exhibit C.

________________________________________________________________

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

A complete copy of the evaluation was  forwarded  to  the  applicant  on  16
February 2007, for review and comment, within 30 days.  However, as of  this
date, no response has been received by this office.

________________________________________________________________




THE BOARD CONCLUDES THAT:

1.  The applicant has exhausted all remedies provided  by  existing  law  or
regulations.

2.  The application was timely filed.

3.  Insufficient relevant evidence has been  presented  to  demonstrate  the
existence of  error  or  injustice.   We  took  notice  of  the  applicant's
complete submission in judging the merits of the  case;  however,  we  agree
with the opinion and recommendation of  the  Air  Force  office  of  primary
responsibility and adopt its rationale as the basis for our conclusion  that
the applicant has not been the victim of an error or  injustice.   There  is
no evidence to substantiate his claim that his injuries  meet  the  criteria
specified by the 23 November 2005 Office of the Under Secretary  of  Defense
Memorandum which defines the term trauma as injuries or wounds to  a  living
body caused by application of  external  force  or  violence,  or  that  his
injuries can be directly linked to a traumatic  event.   Therefore,  in  the
absence of evidence  to  the  contrary,  we  find  no  compelling  basis  to
recommend granting the relief sought in this application.

________________________________________________________________

THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented  did  not  demonstrate
the existence of material error  or  injustice;  that  the  application  was
denied without a personal appearance; and that the application will only  be
reconsidered upon the submission of newly discovered relevant  evidence  not
considered with this application.

________________________________________________________________

The following members of the Board considered  Docket  Number  BC-2007-00222
in Executive Session on 3 May 2007, under the provisions of AFI 36-2603:

                       Mr. James W. Russell, III, Panel Chair
                       Ms. Maureen B. Higgins, Member
                       Ms. Josephine L. Davis, Member

The following documentary evidence was considered:

    Exhibit A.  DD Form 149, dated 17 Jan 07, w/atchs.
    Exhibit B.  Applicant's Master Personnel Records.
    Exhibit C.  Letter, ARPC/DPP, dated 14 Feb 07.
    Exhibit D.  Letter, SAF/MRBR, dated 16 Feb 07.
    Exhibit E.  Letter, OSD, dated 23 Nov 05, w/atchs.




                                   JAMES W. RUSSELL, III
                                   Panel Chair

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