RECORD OF PROCEEDINGS


      IN THE CASE OF:


      BOARD DATE:        3 July 2007
      DOCKET NUMBER:  AR20070000211


      I certify that hereinafter is recorded the true and complete record
of the proceedings of the Army Board for Correction of Military Records in
the case of the above-named individual.

|     |Mr. Catherine C. Mitrano          |     |Director             |
|     |Ms. Loretta D. Gulley             |     |Analyst              |


      The following members, a quorum, were present:

|     |Mr. Eric N. Andersen              |     |Chairperson          |
|     |Mr. Scott W. Faught               |     |Member               |
|     |Ms. Ernestine I Fields            |     |Member               |

      The Board considered the following evidence:

      Exhibit A - Application for correction of military records.

      Exhibit B - Military Personnel Records (including advisory opinion,
if any).

THE COUNSEL REQUEST, STATEMENT, AND EVIDENCE:

1.  The applicant’s counsel requests that his medical records be considered
in his Traumatic Servicemembers’ Group Life Insurance (TSGLI) request.

2.  The applicant’s counsel states, in effect, that he did not have his
medical records when he began his TSGLI process.

3.  The applicant’s counsel provides a copy of his service medical records,
paperwork related to his TSGLI application and denials requesting that the
Board favorably and quickly review the applicant’s case.

CONSIDERATION OF EVIDENCE:

1.  The applicant is currently a member of the Kansas Army National Guard.

2.  In November 2004, the applicant hyperextended his left hip while
securing cargo on a flatbed trailer.  The applicant did not seek treatment.
 The applicant’s hip become progressively worse and he sought treatment on
14 July 2005.

3.  On 25 April 2006, the applicant submitted a TSGLI claim for loss of
activities of daily living (ADLs) for dressing, bathing, and transferring
in and out of the bed for 60 days.  In June 2006, the TSGLI Branch, United
States Army Physical Disability Agency (USAPDA) informed the applicant that
his TSGLI case was disallowed, because the medical documentation submitted
did not substantiate his complete dependence on another for performance of
ADLs.

4.  On 6 July 2006, the applicant submitted a request for reconsideration
of his TSGLI claim for loss of ADLs for 60 days for dressing, bathing, and
transferring, but on 5 August 2006, the USAPDA again disallowed his claim
because the medical documentation submitted did not substantiate his
complete dependence on another for performance of ADLs.

5.  On 18 August 2006, the applicant filed an appeal of his TSGLI claim,
again claiming loss of ADLs for 60 days for dressing, bathing, and
transferring.  On
17 October 2006, the USAPDA disallowed his appeal because the medical
documentation submitted did not substantiate his complete dependence on
another for performance of ADLs.

6.  Part B (To be Completed by Attending Medical Professional) of the
applicant’s Certification of Traumatic Injury Protection form, dated 4
April 2006 and 11 April 2006, shows that the applicant’s attending
physicians essentially stated that he could not perform dressing, bathing,
or transferring independently for over 60 days.  He also stated, in effect,
that the applicant is in continuing treatment, will require additional
surgeries, and will require additional recovery time with continued loss of
ADL’s as indicated.  He also stated that the applicant was essentially
incapacitated for more than 60 days.

7.  Although the applicant’s service medical records show that he underwent
numerous operations to treat the injuries he sustained in November 2004,
the applicant’s first surgery was 9 March 2006 and the applicant was
ambulating and transferring independently thereafter.  Examples for the
record include:

      a.  A 17 March 2006 entry from his records following his surgery
shows the applicant could “bear weight, can climb stairs carefully.”
Entries on the applicant’s record prior to his surgery advised that he
could walk as tolerated.

      b.  An entry from 31 March 2006, states that the applicant is allowed
to walk as tolerated.  In the same entry, the applicant indicates his
desire to redeploy mid June.

      c.  An entry on 8 May 2006, states that the applicant is allowed to
walk at his own pace.

      d.  On 7 March 2006, the doctor advised the applicant that he would
have to use crutches after his 17 March 2006 surgery.  None of the entries
include a conclusion or a statement that the applicant was completely
unable to perform the ADLs indicated on his TSGLI claim.

8.  Public Law 109-13 (The Emergency Supplemental Appropriations Act, for
Defense, the Global War on Terror, and Tsunami Relief, 2005), signed by the
President on May 11,2005, established the TSGLI program.  U.S. Army Combat-
Related Special Compensation (CRSC) has been designated as the lead agent
for implementing the Army TSGLI program.  The TSGLI program was established
by Congress to provide relief to Soldiers and their families after
suffering a traumatic injury.  TSGLI provides between $25,000 and $100,000
to severely injured Soldiers who meet the requisite qualifications set
forth by the Department of Defense.  As of 1 December 2005, TSGLI is
included as part of a Soldier's SGLI coverage.  Any Soldier who elected
SGLI coverage automatically receives TSGLI coverage with an additional $1
taken out each month to cover the cost of the TSGLI policy.  Soldiers
paying for SGLI coverage cannot decline TSGLI--it is a package.  In
addition, there is a retroactive program, in which Soldiers who incurred a
qualifying traumatic injury from 7 October 2001 through 30 November 2005,
while supporting Operation Iraqi Freedom (OIF) and Operation Enduring
Freedom (OEF) or under orders in a Combat Zone Tax Exclusion (CZTE) area
are covered regardless of whether they elected SGLI coverage or not.
Soldiers who elect SGLI coverage and incur a qualifying traumatic injury
after 1 December 2005 (with the exception of some specific circumstances
under which a traumatic injury will not be covered), regardless of their
component (Active, Reserve, or National Guard) or the location in which
they incurred the injury will be covered by TSGLI.

9.  There are some specific circumstances under which a traumatic injury
will not be covered by TSGLI.  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.  Traumatic injuries covered may include, but are not limited to the
following types of losses:

      a.  total and permanent loss of sight in one or both eyes;

      b.  loss of hand or foot by severance at or above the wrist or ankle;


      c.  total and permanent loss of hearing in one or both ears;

      d.  loss of speech;

      e.  loss of thumb and index finger of the same hand by severance at
or above the metacarpophalandeal joints;

      f.  quadriplegia, paraplegia or hemiplegia;

      g.  3rd degree or worse burns covering 30 percent of body or 30
percent of the face;

      h.  coma or traumatic brain injury; or

      i.  other traumatic injuries resulting in the inability to carry out
two of the six ADLs, which are dressing, bathing, toileting, eating,
continence, and transferring.
TSGLI claims may be filed for loss of ADLs if the claimant is completely
dependent on someone else to perform 2 of the 6 ADLs for 30 days or more
(15 days or more in the case of traumatic brain injuries).  ADL loss must
be certified by a healthcare provider in Part B of the claim form, and ADL
loss must be substantiated by appropriate documentation such as
Occupational/Physical Therapy Reports, Patient Discharge Summaries, or
other pertinent documents demonstrating the injury type and duration of ADL
loss.  While TSGLI claims won't be approved without a certification from a
healthcare provider, additional documentation must be provided to
substantiate the certification.

10.  Army Regulation 15-185 (Army Board for Correction of Military Records)
prescribes the policies and procedures for correction of military records
by the Secretary of the Army, acting through the ABCMR.  This regulation
provides that the ABCMR begins its consideration of each case with the
presumption of administrative regularity.  The applicant has the burden of
proving an error or injustice by a preponderance of the evidence.

DISCUSSION AND CONCLUSIONS:

1.  The evidence provided by the applicant and his counsel of record, was
carefully considered.  The Board noted the applicant’s disagreement with
responses to his TSGLI claims; however, evidence of record clearly shows
that although he suffered a injury while serving in Iraq, he was ambulating
and transferring independently.  Evidence of record also shows that he was
walking to and from the bathroom independently, climbing stairs and did not
require medical treatment until 13 July 2005, and did not have surgery
until 6 March 2006.  Therefore, it is reasonable to presume that if he was
ambulatory only a couple of weeks after his surgery, he would not have been
completely dependent on another for dressing and bathing at that time
either.  There is also no evidence in his service medical records to
support his complete dependence for ADLs for 60 days or the minimum 30 days
for traumatic injuries other than traumatic brain injuries.

2.  The statement by the applicant’s attending physician in Part B of his
TSGLI claim form that he could not perform dressing, bathing, or
transferring independently for over 60 days is inconsistent and not
supported by information in his service medical records.  While the Board
does not dispute the fact that the applicant required extensive medical
care and support following his injury in November 2004, the evidence in his
service medical records does not approach the level of required
documentation required to justify a TSGLI payment for loss of ADLs.

3. The applicant has not provided sufficient documentation to support his
contention that his TSGLI claims were improperly disallowed.  Neither the
available records nor the medical documentation the applicant provided
establish a basis to support his request.

4.  In order to justify correction of a military record the applicant must,
or it must otherwise satisfactorily appear, that the record is in error or
unjust.  The applicant has failed to submit evidence that would satisfy
that requirement.  In view of the foregoing, there is no basis for granting
relief to the applicant in this case.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF

________  ________  ________  GRANT PARTIAL RELIEF

________  ________  ________  GRANT FORMAL HEARING

___ENA__  ___SWF_  ___EIF__  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

The evidence presented does not demonstrate the existence of a probable
error or injustice.  Therefore, the Board determined that the overall
merits of this case are insufficient as a basis for correction of the
records of the individual concerned.





                                  _    __Eric N. Andersen____
                                            CHAIRPERSON



INDEX

|CASE ID                 |AR20070000211                           |
|SUFFIX                  |                                        |
|RECON                   |YYYYMMDD                                |
|DATE BOARDED            |2007/07/03                              |
|TYPE OF DISCHARGE       |(HD, GD, UOTHC, UD, BCD, DD, UNCHAR)    |
|DATE OF DISCHARGE       |YYYYMMDD                                |
|DISCHARGE AUTHORITY     |AR . . . . .                            |
|DISCHARGE REASON        |                                        |
|BOARD DECISION          |DENY                                    |
|REVIEW AUTHORITY        |Ms. Mitrano                             |
|ISSUES         1.       |                                        |
|2.                      |                                        |
|3.                      |                                        |
|4.                      |                                        |
|5.                      |                                        |
|6.                      |                                        |


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