RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS
IN THE MATTER OF: DOCKET NUMBER: BC-2010-04721
COUNSEL: NONE
HEARING DESIRED: NO
_________________________________________________________________
APPLICANT REQUESTS THAT:
His disallowed Servicemembers Group Life Insurance Traumatic
Injury Protection (TSGLI) claims be reconsidered.
_________________________________________________________________
APPLICANT CONTENDS THAT:
He was wounded in Baghdad, Iraq, when a dual-array Improvised
Explosive Device (IED) struck his vehicle. He received a severe
concussion, Traumatic Brain Injury (TBI), Post Traumatic Stress
Disorder (PTSD), back and neck injuries (as well as fractured
teeth, loss of hearing, and injury to nose/sinuses). His care
for the first 18 plus months was disjointed and confused as there
was no single point of contact for his care resulting in a
dysfunctional and confused level of care. He was not enrolled in
the Air Force Wounded Warrior Program (AFW2P) until March 2009,
nearly two years after incurring his injuries; which resulted in
his lack of awareness of the facilities, programs, options, and
assets available.
His records underwent a Medical Evaluation Board (MEB) on
15 March 2009, which indicated that he should not be returned to
duty. On 14 May 2009, his records were evaluated by an Informal
Physical Evaluation Board (IPEB), which recommended he be placed
on the Temporary Disability Retired List (TDRL) with a 90 percent
disability rating.
He filed his first TSGLI claim for TBI in April 2009 and the
second claim for inability to perform Activities of Daily Living
(ADLs) in August 2009. His claims were subsequently denied.
However, he feels his two claims meet the TSGLI eligibility
requirements.
In support of his request, the applicant provides a personal
statement, and copies of Temporary Duty (TDY) orders, electronic
communications, TSGLI denial letter, excerpt of TSGLI claim,
Purple Heart Medal citation, Department of Veterans Affairs (DVA)
letter, medical records, and a Defense Finance and Accounting
Service (DFAS) letter.
The applicants complete submission, with attachments, is at
Exhibit A.
_________________________________________________________________
STATEMENT OF FACTS:
The applicant is a former member of the Regular Air Force who was
relieved from active duty effective 13 October 2009 and placed on
the TDRL effective 14 October 2009 in the grade of colonel (O-6),
with a 90 percent compensable disability rating.
The remaining relevant facts, extracted from the applicants
master military personnel records, are contained in the Air Force
evaluation at Exhibit B.
_________________________________________________________________
AIR FORCE EVALUATION:
ARPC/DPWC recommends denial (advisory opinion dated 8 February
2011). DPWC states that based on the eligibility criteria
outlined in the TSGLI Procedures Guide, Version 2.4, dated
23 November 2010, and Emergency Supplemental Appropriations Act
for Defense, the Global War on Terror, and Tsunami Relief,
2205,(Public Law 109-13), the applicants claimed losses, in both
TSGLI claims, do not meet the TSGLI eligibility criteria for
payment.
DPWC indicates that upon receipt of the applicants appeal, a
thorough review of both of his claims was conducted. His claim
for loss of hearing did not meet the criteria for hearing loss as
the Audiologists report states the applicants air and bone
conduction testing revealed hearing within normal limits
bilaterally for frequencies through 2000 megahertz. His claim
under hospitalization did not meet eligibility criteria because
he was seen as an outpatient.
The applicants second claim was for inability to perform ADLs
(bathe, dress, transfer) due to Other Traumatic Injury (OTI) for
at least 30 consecutive days. However, the loss must have
occurred within 730 days from the traumatic event. The date of
the applicants traumatic event was 28 April 2007. The cited ADL
dates were from 1 July 2009 through 5 August 2009.
Unfortunately, the cited loss does not meet the prescribed period
as defined by the regulation.
DPWC (additional advisory opinion dated 24 June 2011) states that
while evaluating the applicant appeal, he simultaneously
submitted an appeal package to AFPC/DPWCS and enclosed a third
claim for the same traumatic event. On 11 March 2011, upon
receipt of the needed medical documentation, their office
requested the Air Force medical representatives (USAF-SAM/OEHT),
make an assessment of the claim. They concluded the applicant
does meet the TSGLI eligibility criteria for the inability to
perform ADLs for at least 30 days due to OTI. Additionally, they
further stated that there is no evidence to suggest loss of 2 or
more ADLs beyond 30 consecutive days. Based on this evaluation,
the applicant was approved for payment of $25,000 for the
inability to perform two or more ADLs as a result of the surgery
on 1 November 2007 due to the direct result of the traumatic
event on 28 April 2007.
The complete DPWC evaluations, with attachments, are at Exhibit
C.
_________________________________________________________________
APPLICANT'S REVIEW OF AIR FORCE EVALUATION:
In response to the 8 February 2011 DPWC evaluation, the applicant
indicates he understands the gravity of the Boards task and
realizes there is no true black and white answer to his problem;
however, he asks that the Board apply a modicum of common sense
to this issue. He is currently having a therapeutic pool
installed at his house for aquatic therapy to allow his continued
rehabilitation at home, as the Veteran Affairs treatment center
is one and a half hours away and his out-of-pocket costs for
local therapy is costing him approximately $150 plus per month,
not including cost of transportation. The TSGLI funds would go
toward offsetting some of the pools cost.
The applicants complete rebuttal, with attachments, is at
Exhibit E.
_________________________________________________________________
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 in regard to the
applicants claim for TSLGI compensation for hearing loss. After
reviewing the evidence of record, we note the applicants appeal
of his claim for inability to perform ADLs for at least
30 consecutive days was approved. Therefore, we will only
address his request for TSLGI compensation for hearing loss. In
that regard, we note that according to the Audiologists report,
the applicants bone conduction test revealed hearing within
normal limits bilaterally for frequencies through 2000 megahertz;
therefore, his claim for hearing loss did not meet the criteria
for TSGLI compensation. The applicant has provided no evidence
showing that the Audiologists report is in error or invalid.
Therefore, in the absence of evidence to the contrary, we find no
basis to recommend granting relief.
_________________________________________________________________
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 AFBCMR Docket
Number BC-2010-04721 in Executive Session on 8 September 2011,
under the provisions of AFI 36-2603:
, Vice Chair
, Member
, Member
The following documentary evidence was considered in connection
with AFBCMR Docket Number BC-2010-04721:
Exhibit A. DD Form 149, dated 14 Oct 10, w/atchs.
Exhibit B. Applicant's Master Personnel Records.
Exhibit C. Letter, AFPC/DPWC, dated 24 Jun 11.
Exhibit D. Letter, SAF/MRBR, dated 1 Apr 11.
Exhibit E. Letter, Applicant, dated 12 May 11, w/atchs.
Vice Chair
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