IN THE CASE OF:	   

		BOARD DATE:	  11 February 2014

		DOCKET NUMBER:  AR20130008556 


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, his Traumatic Servicemembers’ Group Life Insurance (TSGLI) claim be approved.

2.  The applicant states his TSGLI claim meets all the necessary criteria for approval of his claim.

3.  The applicant provides:

* DA Form 2173 (Statement of Medical Examination and Duty Status), dated 19 March 2010
* Letter, dated 8 February 2012
* Letter, 8 May 2012
* Statement, dated 18 April 2013

CONSIDERATION OF EVIDENCE:

1.  Title 10, U.S. Code, section 1552(b), provides that applications for correction of military records must be filed within 3 years after discovery of the alleged error or injustice.  This provision of law also allows the Army Board for Correction of Military Records (ABCMR) to excuse an applicant's failure to timely file within the 3-year statute of limitations if the ABCMR determines it would be in the interest of justice to do so.  While it appears the applicant did not file within the time frame 


provided in the statute of limitations, the ABCMR has elected to conduct a substantive review of this case and, only to the extent relief, if any, is granted, has determined it is in the interest of justice to excuse the applicant's failure to timely file.  In all other respects, there are insufficient bases to waive the statute of limitations for timely filing.

2.  After having had previous commissioned service, the applicant was appointed as a Reserve commissioned officer on 5 November 1997.  

3.  His record contains a chronological statement of retirement points and a retirement points detail worksheet, which shows from 27 May 2009 to 26 May 2010 he earned 24 active duty points.  During 2010, he only served on active duty and earned active duty retirement points on the following dates:

* 5 February 2010
* 27 February 2010 to 10 March 2010

4.  He provided a DA Form 2173, dated 19 March 2010, which shows he was admitted to the hospital on 19 March 2010 based on an injury (Acute stroke during physical training (PT) - he dissected his left internal carotid artery during PT and this led to his stroke).  

	a.  Item 11 (Medical Opinion) stated his injury was incurred in the line of duty. The medical official based his opinion on the applicant's history wherein he (applicant) indicated he was doing PT to prepare for his Army Physical Fitness Test (APFT) and during PT he suffered the carotid artery injury leading to his stroke.

	b.  Item 15 (Details of Accident or History of Disease) states the applicant "was doing PT preparing for his APFT and had a sudden onset of weakness [and] slurred speech… [He] was seen in Kingwood [M]edical Center and diagnosed with acute stroke on [19 March 2010] in Humble TX.”

	c.  The attending physician, Lieutenant Colonel (LTC) GM, signed and dated this form on 30 August 2012.

	d.  Section II (To Be Completed By Unit Commander or Unit Advisor), was not completed.  If his unit had completed this section, item 22 would have indicated whether or not he was on Active Duty (AD), Inactive Duty for Training (IDT), or Active Duty for Training (ADT).

5.  His records do not contain and he has not provided a copy of his medical records, a Line of Duty determination or a copy of his TSGLI application/claim.
6.  His record contains a letter issued by Prudential's Office of Servicemembers' Group Life Insurance, on 19 May 2011, which states:

	a.  The applicant's branch of service completed evaluating his claim for TSGLI benefits.  Unfortunately, his claim for loss of sight, loss of speech, hemiplegia, and hospitalization could not be approved.

	b.  His claim was not approved because his loss was not a direct result of a traumatic event.  Under TSGLI, a traumatic event is defined as "the application of external force, violence, chemical, biological, or radiological weapons, or accidental ingestion of a contaminated substance causing damage to a living being."  Because evidence indicated that his loss did not directly result from a traumatic event as defined above, his branch of service could not approve his claim.

	c.  The basic eligibility requirements include all of the following requirements must be met in order to be eligible for TSGLI:

		(1)  The member must be an active duty service member or reservist on the date a traumatic event occurs.  (For the purpose of TSGLI, membership in the uniformed services continues until midnight on the date of separation from service).

		(2)  The member must suffer a loss that is a direct result of a traumatic event and no other cause.

		(3)  The member must survive for a period of at least seven full days from the date of the traumatic event.  

		(4)  The member must suffer a loss covered under the law within 2 years of the traumatic event.

7.  He provided a letter from the U.S. Army Human Resources Command (HRC) TSGLI branch, dated 8 May 2012, which states:

	a.  The Army TSGLI program office received his appeal request.  After reviewing the claim and supporting documentation, the TSGLI program office was unable to overturn the previous adjudication.  

	b.  The documentation provided did not indicate that his losses were due to a qualifying traumatic event.  The documentation indicates that his losses were due to a stroke.  Within the documentation there was speculation by a physician that the occlusion may have originated as a carotid artery dissection following a traumatic event, and refers to an incident of facial trauma in 2002.  There was no TSGLI qualifying traumatic event within two years of the claimed loss to which the loss can be attributed.

8.  During the processing of this case, the HRC TSGLI branch medical consultant provided a summary of the applicant's case submissions wherein he stated the applicant's initial application for TSGLI, application for reconsideration, and his appealed application were all denied.

9.  He provided a letter from Dr. SF, dated 8 February 2012, which stated:

	a.  Dr. SF was the applicant's current treating neurologist.  The applicant is a 47-year-old male with right spastic hemiparesis and some speech impairment, who suffered a stroke on 19 March 2010.

	b.  Dr. SF stated, to the best of his knowledge, since he was not the treating physician at that time, on the day of stroke the applicant went for his usual exercise run and while running on the embankment, he fell.  The applicant managed to make it back home but he was unable to speak clearly and was staggering; therefore, he was brought to the hospital where he was found to have had a stroke in the left MCA territory.  

	c.  Later it was found that he had an acute occlusion of the terminal segment of the left internal carotid artery.  Further evaluation at that time showed that he had no atherosclerotic disease and no evidence of the risk factors for embolic disease and since the stroke happened quickly after the fall, the conclusion of the treating physician at that time, Dr. RW, was that the etiology of the occlusion is most likely secondary to the dissection of the internal carotid artery with thrombus dislodging and occluding the distal left internal carotid artery.  Since dissection was considered a direct reason for stroke, further evaluation was performed and did not show any predisposition to dissection either fibromuscular disease or any other causes. 

	d.  Not all of the applicant's medical evaluation was available to Dr. SF.  However, the records he was able to examine seem to show the applicant had a very thorough evaluation and no other plausible explanation was found at that time.  Therefore, as far as Dr. SF can tell by reviewing the records, though he 
was not the physician of record at the time, Dr. SF opined that the internal carotid artery dissection was the most likely cause of his stroke.  Dr. SF further opined it was the fall and the injury from the fall that was the most likely cause of the dissection.

10.  The applicant's brother provided a statement, dated 18 April 2013, wherein he stated:

	a.  According to the denial letter from TSGLI, dated 8 May 2012, the claim was not approved because there is no TSGLI qualifying traumatic event within two years of the claimed loss.  A copy of this letter has been enclosed.  This letter makes reference to an incident of facial trauma in 2002.  He could only assume that TSGLI believes that the applicant is claiming the 2002 facial trauma is the traumatic event that led to the claimed loss in 2010.

	b.  There was an incident of facial trauma in 2002 and treatment was received at Kingwood Medical Center.  However, the incident in 2002 has nothing to do with this claim and was not part of the submitted documentation.  The applicant's position is that he was running for PT on 19 March 2010 when he fell.  The applicant's brother spoke with a member of the TSGLI team handling this claim in the initial stages and this individual agreed that a fall resulting in an impact or a g-force to the body would constitute a TSGLI qualifying traumatic event.  

	c.  The medical professionals familiar with this case have considered the various causes of stroke (health, disease, etc.) and believe the most likely cause in this case was some type of trauma due to the fact that the applicant was in excellent health and physical condition and subsequent tests have failed to find any other root cause. 

	d.  Dr. SF is one of many medical professionals who have been involved in the applicant's care during this process.  In his professional opinion, the most likely cause for the stroke was a dissection brought on by the fall on 19 March 2010.  

11.  Public Law 109-13, signed by the President on 11 May 2005, established the TSGLI Program.  The TSGLI program was established by Congress to provide financial relief to Soldiers and their families after suffering a traumatic injury.  TSGLI payments are designed to help traumatically injured servicemembers and their families with financial burdens associated with recovering from a severe injury.  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.  To be eligible for payment of TSGLI, servicemembers must meet all of the following requirements: 

* the servicemember must be insured by SGLI when he or she experiences a traumatic event
* the servicemember must incur a scheduled loss, and that loss must be a direct result of a traumatic injury 
* the servicemember must have suffered the traumatic injury prior to midnight of the day he or she separates from the uniformed services
* the servicemember must suffer a scheduled loss within 2 years (730 days) of the traumatic injury
* the servicemember must survive for a period of not less than seven full days from the date of the traumatic injury 

12.  The Department of Defense (DOD) and Department of Veterans Affairs (VA) have joint responsibility for the Program.  The TSGLI Program is administered by HRC; however, the VA developed the TSGLI Procedures Guide.  This guide defines a traumatic event as the application of external force, violence, chemical, biological, or radiological weapons, accidental ingestion of a contaminated substance, or exposure to the elements that causes damage to the body.

* an external force is a force or power that causes an individual to meet involuntarily with an object, matter, or entity that causes the individual harm
* the event must involve a physical impact upon an individual - physical impacts do not require penetrating injuries to occur
* some examples would include: an airplane crash, a fall in the bathtub, or a brick that falls and causes a sudden blow to the head
* it would not include an injury that is induced by the stress or strain of the normal work effort that is employed by an individual, such as straining one’s back from lifting a ladder

DISCUSSION AND CONCLUSIONS:

1.  The applicant has provided a DA Form 2173 and a letter from a physician who does not have access to all of his medical records and did not treat him at the time of the stroke.  

	a.  The DA Form 2173 was not dated by an attending physician until 
30 August 2012, more than 2 years after the incident occurred.  

	b.  The letter provided by Dr. SF is insufficient evidence in and of itself to justify granting relief, because the recommendation is based on opinion, and the Doctor clearly stated he did not have full access to the applicants medical records.  His records do not contain and he has not provided a copy of his medical records, a Line of Duty determination or a copy of his TSGLI application/claim.  

2.  As such, it is impossible to determine if the stroke caused him to fall or the fall caused the stroke.
3.  Unfortunately, there is an insufficient evidentiary basis with which to justify granting the requested relief.

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)                                         AR20130008556





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ABCMR Record of Proceedings (cont)                                         AR20130008556



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