IN THE CASE OF:	  

	BOARD DATE:	  24 June 2008

	DOCKET NUMBER:  AR20080007215 


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, that her Traumatic Servicemembers’ Group Life Insurance (TSGLI) claim be reconsidered. 

2.  The applicant states the documentation is inconsistent and is missing information.  She states that her family was available and provided her with assistance which is why her medical records do not show that she was unable to take care of herself.   

3.  The applicant provides approximately 100 pages of her service medical records.

CONSIDERATION OF EVIDENCE:

1.  On 7 December 2003, the applicant entered active duty as a United States Army Reserve (USAR) Soldier.  Her military occupational specialty (MOS) was 88M (Motor Transport Operator).

2.  On 14 April 2004, the applicant sustained a complex fracture to her right fibula and broken teeth in a motor vehicle accident.

3.  On 25 October 2006, the applicant filed her first TSGLI claim.  Her physician did not certify any activities of daily living (ADL), namely, dressing, toileting, eating, continence, and transferring.  The medical documentation submitted did 
not substantiate inability to independently perform her ADLs for 30 or more days due to her traumatic injuries.  Her claim was disallowed and a disapproval letter was sent to her on 1 November 2006.

4.  On 4 December 2006, the applicant requested reconsideration of her TSGLI claim.  Her physician did not certify any ADLs.  The medical documentation submitted did not substantiate inability to independently perform her ADLs for 
30 or more days due to her traumatic injuries.  Her claim was again disallowed and a disapproval letter was sent to her on 3 January 2007.

5.  On 23 February 2007, the applicant was separated from active duty and medically retired under the provisions of Army Regulation 635-40, paragraph 
4-24B (2) due to physical disability.  She had completed a total of 5 years, 
9 months, and 25 days of creditable active duty.  

6.  On 8 May 2007, the applicant submitted an appeal of her TSGLI claim to the United States Army Physical Disability Agency.  Her physician certified the following ADLs: bathing – 12 days; dressing – 12 days; transferring – 16 days.  The medical documentation submitted did not substantiate an inability to independently perform her ADLs for 30 or more days due to her traumatic injuries.  Her appeal was denied and a letter was sent to her on 26 July 2007. 

7.  A review of the medical documentation provided by the applicant did not show that she was unable to perform her ADLs for 30 or more days.   

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 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. 

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 medical 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 was carefully considered.  However, it did not show that she was unable to perform her ADLs for 30 or more days.  She has not provided any evidence to support her contention that her family had to assist her for 30 days or more in the performance of her ADLs.

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

 3.  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

___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 for correction of the records of the individual concerned.



	__________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)                                         AR20070016793



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ABCMR Record of Proceedings (cont)                                         AR20080007215



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