IN THE CASE OF:	  

	BOARD DATE:	  5 June 2008

	DOCKET NUMBER:  AR20080001805 


THE BOARD CONSIDERED THE FOLLOWING EVIDENCE:

1. Application for correction of military records (with supporting documents provided, if any).

2. Military Personnel Records and advisory opinions (if any).


THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:

1.  The applicant requests, in effect, reconsideration of entitlement to Traumatic Service Member's Group Life Insurance (TSGLI) coverage for a traumatic head injury that occurred on 13 November 2005.  

2.  The applicant states, in effect, that he qualifies under the criteria for TSGI and is providing additional documentary evidence to support his claim.  

3.  The applicant provides the following documents in support of his application:   Self-Authored Letter, TSGLI Army Review Board Agency (ARBA) Summary, undated; Separation Document (DD Form 214); Correction to DD Form 214 (DD Form 215); Report of Separation and Record of Service (NGB Form 22); and Headquarters, United States Army Garrison, Orders Number 159-066, dated 9 June 2006.

CONSIDERATION OF EVIDENCE:

1.  Incorporated herein by reference are military records which were summarized in the previous consideration of the applicant's case by the Army Board for Correction of Military Records (ABCMR) in Docket Number AR20070007422, on 7 August 2007.


2.  During the original review of this case, the Board found that during the period 11 October 2005 through 16 December 2005, the applicant was in basic combat training (BCT) at Fort Sill, Oklahoma (OK), and not deployed in support of Operation Enduring/Iraqi Freedom (OEF/OIF) when he fell from a stake truck traveling 40 miles per hour causing him to receive a traumatic head injury.  

3.  The applicant provides a TSGLI ARBA Summary as new evidence.  This document shows that on 4 April 2006, 15 June 2006, and 18 July 2006, the applicant submitted TSGLI claims in which he claimed severe traumatic brain injury (TBI).  However, based on the fact that the applicant's injury was incurred while assigned to Fort Sill for basic combat training (BCT) and not while in a combat zone, his claims were disallowed and disapproval letters were sent on 
16 May, 7 July, and 14 September 2006.

4.  The applicant's record shows he enlisted into the Illinois Army National Guard on 22 September 2005.  

5.  On 11 October 2005, the applicant was ordered on active duty for training (ADT) for completion of basic combat with assignment at Fort Sill, Oklahoma.  

6.  The applicant's record contains a Statement of Medical Examination and Duty Status (DA Form 2173), dated 5 January 2005.  This document shows that on 
23 November 2005, while riding in a stake truck traveling at the speed of 40 miles per hour the back gate opened causing the applicant to fall off the back of the vehicle and land on his head in which he incurred multiple skull fractures.

7.  The TSGLI appeals summary completed by the Physical Disability Agency (PDA) shows that on 4 April 2006, the applicant submitted his first TSGLI claim based on a severe traumatic brain injury (TBI).  On 5 May 2006, the PDA sent the applicant a letter stating his claim was denied.  

8.  On 19 May 2006, a Medical Evaluation Board (MEB) found the applicant medically unfit based on his diagnosis of Dementia and Personality Change due to head trauma and referred his case to a PEB for evaluation.  

9.  On 23 May 2006, the applicant’s case was evaluated by a PEB convened at Fort Sam Houston, Texas.  The PEB found that the applicant was physically unfit and recommended a disability rating of 30% for his Dementia and Personality Change, due to severe closed head injury and that he be placed on the Temporary Disability Retired List (TDRL) with a reexamination during November 2007.  

10.  On 15 June 2006, the applicant submitted a TSGLI reconsideration claim for his severe TBI.  The PDA denied the applicant's claim and sent him a disallowed and disapproval letter on 7 July 2006.  Subsequently, the applicant submitted an appeal on 18 July 2006, which the PDA also disallowed and disapproved with a letter on 14 September 2006. 

11.   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 11 May 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 OIF and 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. 

12.  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.  

13.  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 applicant's contention of entitlement to the TSGLI and the documents he provided were carefully considered.  However, there is insufficient evidence to support this claim.

2.  While it is unfortunate that the applicant may have suffered financial hardship based on the injury he sustained after falling off a truck and incurring TBI, by law, in order to qualify for the retroactive TSGLI program coverage, a Soldier must have incurred the traumatic injury during the period 7 October 2001 through 
30 November 2005, while serving in support of OIF and OEF or under orders in a Combat Zone Tax Exclusion area.  

3.  The evidence of record confirms the applicant's TBI was incurred while he was attending BCT at Fort Sill, and not while deployed in support of OIF/OEF or under orders in a Combat Zone Tax Exclusion.  Therefore, he does not qualify for retroactive TSGLI coverage, and it would not be appropriate to grant the requested relief.

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 or to amend the original Board decision n this case.  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

___x ____  ___x____  ___x____  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 to amend the decision of the ABCMR set forth in Docket Number AR20070007422, dated 7 August 2007.



      _________x______________
      	CHAIRPERSON
      
I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case.

ABCMR Record of Proceedings (cont)                                         AR20080001805



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ABCMR Record of Proceedings (cont)                                         AR20080001805



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