IN THE CASE OF:	  

		BOARD DATE:	  29 March 2012

		DOCKET NUMBER:  AR20120003116 


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 approval of his Traumatic Servicemember’s Group Life Insurance (TSGLI) injury request.

2.  The applicant states that he received a partial payment of his TSGLI claim for his right eye in February 2008 but has been unable to receive the remainder of his claim for the damage to his eye from a RPG (rocket propelled grenade) blast in Iraq on 18 August 2007.  He further states that his right eye will never be right again and glasses and surgery cannot correct the damage because there is a corneal tear that causes blurred and double vision in the right eye.

3.  The applicant provides a copy of his TSGLI claim and copies of his medical treatment records.

CONSIDERATION OF EVIDENCE:

1.  The applicant enlisted in the Regular Army on 30 May 2006 for a period of 3 years and 19 weeks, training as a cannon crewman and a 17,000 enlistment bonus.  

2.  He completed his one-station unit training at Fort Sill, Oklahoma and was transferred to Fort Drum, New York for assignment to an artillery battery. He was deployed to Iraq when he was wounded by an RPG explosion on 18 August 2007 and was awarded the Purple Heart. 

3.  He reenlisted on 6 June 2008 with a waiver for a period of 4 years and training as a UH-60 (Blackhawk) helicopter repairman.  He successfully completed his training at Fort Eustis, Virginia and is currently serving at Fort Riley, Kansas.

3.  The applicant made his original TSGLI claim on 5 December 2007 and was paid $25,000 for an other than total injury for temporary activities of daily living loss on 14 January 2008. 

4.  An internal review of his case (claim) was conducted in March 2009 and no further losses were found.

5.  The applicant again applied for TSGLI benefits on 19 August 2009 and his claim was denied because he did not qualify under the TSGLI schedule of losses.  

6.  He applied for reconsideration of his claim on 7 January 2010 and his request was denied due to insufficient documentation to support his medical professional’s statement.

7.  He again appealed the decision on 15 November 2010 and his request was again denied.  The denial of his appeal indicated that the applicant sustained a right eye injury and is claiming loss of vision based on visual field restriction.  The Optometrist certifies that the Soldier has temporal field of vision restricted to 10 degrees in the right eye.  There appears to be normal visual acuity and overall field of vision well over 20 degrees (~50 degrees) in the right eye.  The opining physician indicates that the Soldier’s visual impairment does not appear to meet TSGLI program guidelines for compensable loss and recommended that his claim be denied.

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 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 TSGLI program.  The TSGLI program was established by Congress to provide relief to Soldiers and their families after suffering a traumatic injury.  The TSGLI provides between $25,000.00 and $100,000.00 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 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 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 (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 two of the six ADLs for 30 days or more (15 days or more in the case of traumatic brain injuries (TBI)).  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.

10.  The TSGLI Schedule of Losses also provides for a TSGLI payment of $25,000 for a traumatic injury resulting in inability to perform at least two Activities of Daily Living (ADL) for 30 consecutive days.  An additional payment of $25,000 may be made for 60 consecutive days of ADL loss, 90 consecutive  days of ADL loss, and 120 consecutive  days of ADL loss. 

DISCUSSION AND CONCLUSIONS:

1.  The applicant's contention that he is qualified for additional TSGLI benefits was carefully considered and unfortunately determined to be without merit.

2.  Records clearly show he sustained an injury to his right eye during an RPG explosion in Iraq on 18 August 2007.  However, it does not appear that his injury qualifies for additional TSGLI benefits without a loss of ADLs.

3.  Additionally, there is no evidence in the available records and the applicant has not provided sufficient evidence showing he was unable to perform two of the ADLs for the required period.

4.  Absent evidence to show that the applicant's disabilities met the criteria for award of TSGLI benefits, there is no basis to grant the relief requested.

5.  The applicant and all others should know that the sacrifices he made in service to the United States during the Global War on Terrorism are deeply appreciated.  The applicant and all Americans should be justifiably proud of his service in arms.

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)                                         AR20120003116





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ABCMR Record of Proceedings (cont)                                         AR20120003116



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