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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