IN THE CASE OF:	  

		BOARD DATE:	        21 January 2009

		DOCKET NUMBER:  AR20080013178 


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 his Traumatic Servicemembers’ Group Life Insurance (TSGLI) claim to the U.S. Army Physical Disability Agency be considered.

2.  The applicant provides no statement with this application.

3.  The applicant provides numerous medical documents and excerpts from his military records in support of this application.

CONSIDERATION OF EVIDENCE:

1.  Records show that, on 23 May 2004, while serving in Iraq, the applicant encountered multiple Improvised Explosive Device (IED) explosions.

2.  The applicant's medical records show that he was diagnosed with a mild traumatic brain injury, Post-Traumatic Stress Disorder (PTSD), and depression.

3.  The applicant is currently serving on active duty as a member of the Army National Guard.

4.  The applicant provided a two-page document, dated 30 June 2008, from the U.S. Army Human Resources Command TSGLI section.  The document informs that applicant that his TSGLI appeal request was received and that they were 

unable to provide him with a favorable decision.  The TSGLI section further informed the applicant that his claim was not approved because the medical documents submitted did not support that he was unable to independently perform two or more of the activities of daily living for more than 30 days.

5.  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 has been designated as the lead agent for implementing the Army's 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 and Operation Enduring Freedom, or under orders in a combat zone tax exclusion 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.

6.  There are 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 activities of daily living (ADL), 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 two of the six 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 will not be approved without a certification from a healthcare provider, additional documentation must be provided to substantiate the certification.

DISCUSSION AND CONCLUSIONS:

1.  The applicant's request for consideration of his TSGLI claim was carefully considered and unfortunately was found to lack sufficient merit to grant the relief requested.

2.  The applicant clearly sustained a traumatic brain injury and suffered from PTSD and depression; however, these conditions are not qualifying conditions for TSGLI benefits.  Specifically, there is no evidence that the traumatic brain injury resulted in the applicant's inability to perform 2 or more ADLs for 15 days or more and therefore does not meet the qualifications for TSGLI benefits.  As for the PSTD and depression conditions, these conditions are not covered by TSGLI and are not a basis to receive TSGLI benefits.

3.  Absent evidence to the contrary, there is no basis to amend the previous TSGLI findings.


4.  Although there is insufficient evidence to grant the relief requested, this by no means diminishes the applicant's dedicated service to and sacrifices for a grateful Nation.

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)                                         AR20080013178



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ABCMR Record of Proceedings (cont)                                         AR20080013178



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