IN THE CASE OF:	  

		BOARD DATE:	    4 August 2015

		DOCKET NUMBER:  AR20140019747 


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:

The applicant requests correction of his military records to show he is entitled to payment for a Traumatic Servicemembers' Group Life Insurance (TSGLI) claim.  The applicant defers to counsel for all arguments and evidence.

COUNSEL'S REQUEST, STATEMENT AND EVIDENCE:

1.  Counsel requests correction of the applicant's military records to show he is entitled to payment for a TSGLI claim.

2.  Counsel states:

* the applicant went from near perfect vision to blindness in his left eye within a short time
* all evidence indicates the rapid and sudden loss of vision was due to a high-powered laser blast, however it was incorrectly diagnosed as farsightedness/astigmatism
* according to multiple sources, the only reason the loss of vision was so rapid and permanent was due to a high-powered laser blast
* farsightedness/astigmatism cannot be the cause
* the applicant's story should be taken into account and the TSGLI determination reversed

3.  Counsel provides a digital versatile disc containing the following documents:

* proof and acknowledgment of representation
* SGLV Form 8600 (Application for TSGLI Benefits), dated 1 July 2012
* letter from counsel to U.S. Army Human Resources Command (HRC), dated 10 April 2014, including six exhibits, appealing the TSGLI determination
* letter from HRC denying TSGLI appeal, dated 10 June 2014
* follow-up letter from counsel to HRC, dated 17 June 2014, requesting TSGLI appeal reconsideration
* HRC letter to counsel, dated 25 June 2014
* letter from counsel to applicant's Member of Congress, dated 22 August 2014
* multiple Standard Forms 600 (Chronological Record of Medical Care)

CONSIDERATION OF EVIDENCE:

1.  The applicant enlisted in the Alabama Army National Guard on 23 January 2007.  He was discharged from the Alabama Army National Guard on 29 January 2009 for the purpose of immediate enlistment in the Regular Army.  He enlisted in the Regular Army on 30 January 2009.

2.  He deployed to Afghanistan in support of Operation Enduring Freedom from 13 June 2010 through 5 November 2010.

3.  On 11 April 2012, a Medical Evaluation Board (MEB) Narrative Summary (NARSUM) was prepared based on examination of the applicant and review of his medical records.  The MEB NARSUM shows:

* the applicant was referred to the Integrated Disability Evaluation System because of limitations from his diagnosis of left eye vision loss, recurrent headaches, depression and anxiety, and cervical and thoracic strain
* vision screening on 6 February 2009 at Fort Benning showed right eye distant vision was 20/20, right eye near vision was 20/20, left eye distant vision was 20/30, and left eye near vision was 20/20
* in October 2010 he was medically evacuated from Afghanistan
* he was seen by the Landstuhl Regional Medical Center (LRMC) Ophthalmology Clinic from 22 October to 2 November 2010 and by the Psychiatry Clinic from 1 to 2 November 2010
* he met his medical retention determination point for left eye blindness and for headaches because he was unable to return to duty after extended treatment since his return from Afghanistan
* he did not meet medical retention standards for left eye blindness due to a change in his vision from February 2009 to December 2011
* he did not have any trauma to his left eye and no traumatic brain injury
* there is no other underlying medical condition that was discovered causing the vision loss
* the applicant claimed he was struck in his left eye with a high-powered green laser used by a local Afghani and he noted pain above his left eye and difficulty with vision subsequent to the laser strike within 2 weeks
* examinations showed a normal anatomy of the eye – magnetic resonance imaging (MRI) reconstruction with and without contrast showed a normal eye, brain, and orbit
* psychiatry did not find any indication of a conversion disorder
* 18 months post onset of his left eye vision loss there was no clear explanation of the etiology and no specific underlying pathology or neurological condition
* it is speculative that he sustained some injury from a laser in Afghanistan, but this is the only significant history that is suggestive of this
* he was found to not meet medical retention standards for left eye blindness and headaches and found to meet medical retention standards for the other conditions

4.  On 1 July 2012, the applicant submitted an application for TSGLI benefits claiming that a high-powered laser trauma to his left eye inflicted by Afghani insurgents while he was deployed caused his left eye blindness.

5.  The physician's review and analysis of the TSGLI application is summarized below:

* the physician thoroughly reviewed the case in the Armed Forces Health Longitudinal Technology Application (AHLTA) which contained more medical notes and documents than the applicant submitted in support of his claim
* only one eye examination not prior to the claimed traumatic event was recorded in AHLTA, written on 20 August 2007, documenting his hypermetropia (one eye with significantly worse vision than the other) and astigmatism, which predisposes one to amblyopia
* his visual acuity in his left eye on that day was 20/40 uncorrected
* the first documented medical attention after the alleged traumatic event was on 21 October 2010 and the reason for the visit was listed as amblyopia
* amblyopia is a condition where one eye (the "lazy" eye) fails to develop because it is significantly poorer than the other – if not diagnosed and treated early, the amblyopic eye becomes permanently impaired
* on that day the ophthalmologist diagnosed the applicant with non-physiologic vision loss in his left eye, a possible superimposition of amblyopia in the left eye, and uncorrected hyperopic astigmatism of the right eye
* after a very thorough work-up at LRMC over a 2-week period, no evidence of ocular abnormality was found
* the applicant's claimed laser incident was never reported in any LRMC documentation
* a dilated fundus (interior surface of the eye) examination found no scarring, which a laser strike would certainly have caused
* his orbits, optic nerves, and brain were all normal according to an MRI
* he was then referred to psychiatry where conversion disorder was not diagnosed
* the diagnosis of amblyopia and hypermetropia were consistently made and the applicant was told on several occasions that his left eye blindness was likely due to amblyopia
* the conclusion was that his visual loss was non-physiologic, having no basis in tissue or organ dysfunction or damage
* the applicant was then medically evacuated from LRMC to Martin Army Community Hospital with a diagnosis of amblyopia; there is no mention of laser damage
* the first claim of green laser damage documented in AHLTA was on 16 November 2011, a full year after the alleged laser hit
* the applicant stated that after the laser strike, his vision went downhill over several weeks; this is uncharacteristic of green laser strikes which cause damage very quickly (within seconds to minutes) with little improvement over time
* a final medical note in AHLTA on 10 July 2012 finds the applicant had "subjective vision loss with normal dilated examination – possibly some underlying amblyopia"

6.  The reviewing physician recommended disapproval of the claim of loss of vision stating that the alleged traumatic event, a green laser strike, either never occurred or, if it did, caused no ocular damage and that there was ample evidence that his visual loss resulted from longstanding (from childhood) amblyopia.  His application for TSGLI was subsequently denied.  The TSGLI denial letter is not in the applicant's available records for review.

7.  After undergoing an MEB, the applicant underwent a physical evaluation board, which upheld the MEB findings.  On 13 February 2013, he was retired from the Army due to permanent disability and assigned a disability rating of 50 percent.

8.  On or about 13 August 2013, the applicant appealed the TSGLI determination.  His appeal was examined by another physician, who agreed with the prior medical opinion and conclusion that the applicant's blindness was not the result of a traumatic event.  He reviewed the additional medical documentation presented with the appeal and determined that none of it lent any credence to a laser eye injury as the etiology of the applicant's blindness.  The Appeals Review Panel unanimously recommended denial of the appeal based on lack of evidence of a traumatic event.

9.  As part of the appeals process, the Department of Veterans Affairs (VA) Insurance Center opined on the TSGLI appeal in September 2014, concurring with the Army TSGLI determination that the applicant was ineligible for TSGLI payment for loss of vision because the evidence of record does not provide independent verification of a traumatic event causing the blindness and does not provide a medical link between the alleged traumatic event and his blindness.  Additional VA compensation examination records related to his claim for blindness show he was examined on 12 December 2011 and told a VA contract physician:

* the condition existed since 2009
* his eye condition is not due to a trauma
* he does not remember trauma and has memory loss
* he experienced a slow decline in vision in his left eye with no other symptoms
* maybe a laser light caused the vision loss, though he doesn't know of any laser lights

10.  Counsel provided a letter to HRC, dated 10 April 2014, in which he filed an appeal of the TSGLI claim denial as the applicant's retained counsel.  In the letter he argued that it is clear the applicant was struck by a high-powered green laser beam and that this should be classified as a traumatic event.  The nurse practitioner who signed his SGLV Form 8600 on 3 July 2012 wrote on page 12, "green laser injury to left eye in August 2010 while in Afghanistan; left eye 20/uncorrectable," which certifies the event transpired.  He further argued that as the laser beam was green, it had a much more drastic effect on the eye than other colored lasers and has been used in the war zone as a weapon, as evidenced in the four articles he enclosed.

11.  A 10 June 2014 letter from HRC to the applicant, informed him that the TSGLI Office received his further appeal request and after reviewing the claim with supporting documentation was unable to overturn their previous adjudication.  His appeal was denied because the medical documentation provided and documents in AHLTA did not indicate the vision loss in his left eye was directly related to exposure to a green laser.  Additionally, documents indicate his vision loss was related to a history of amblyopia and uncorrected hypertropic astigmatism.

12.  On 17 June 2014, counsel again wrote to HRC requesting reconsideration of the TSGLI denial.  Therein, he makes the arguments that the applicant's history of amblyopia and uncorrected hypertropic astigmatism showed a minimal effect on his vision at the time of his deployment and he would not have been deployed or passed his pre-deployment screening had it been known he had a pre-existing condition with the potential risk of rapid degeneration of his vision.  To deny his claim on this basis defies good reason.  Additionally, this ignores the Army's finding that the applicant's condition was caused by armed conflict or an instrumentality of war, incurred in the line of duty, and a disability related to a combat injury.  Finally, in light of the physical and psychological trauma incurred by the applicant, it is not surprising that he failed to disclose the laser until 1 year after the incident when his vision was determined to be a permanent problem unrelated to migraine headaches.

13.  On 25 June 2014, HRC informed counsel by letter that the applicant had exhausted his appeal rights with HRC as his claim was previously denied at the initial, reconsideration, and appeal levels and he was directed to submit any further appeals to the Army Review Boards Agency.

14.  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.  The U.S. Army Combat-Related Special Compensation Office 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 $25,000.00 and $100,000.00 to severely-injured Soldiers who meet the requisite qualifications set forth by the Department of Defense.  A service member must meet all of the following requirements to be eligible for payment of TSGLI.  The service member must have:

* been insured by SGLI at the time of the traumatic event
* incurred a scheduled loss and that loss must be a direct result of a traumatic injury
* suffered the traumatic injury prior to midnight of the day of separation from the Uniformed Services
* suffered a scheduled loss within 2 years (730 days) of the traumatic injury
* survived for a period of not less than 7 full days from the date of the traumatic injury (in a death-related case)

15.  A qualifying traumatic injury is an injury or loss caused by a traumatic event or a condition whose cause can be directly linked to a traumatic event.  The HRC official TSGLI website lists two types of TSGLI losses, categorized as Part I and Part II.  Each loss has a corresponding payment amount.

16.  Part I losses includes sight, hearing, speech, quadriplegia, hemiplegia, uniplegia, burns, amputation of hand, amputation of four fingers on one hand or one thumb alone, amputation of foot, amputation of all toes including the big toe on one foot, amputation of big toe only, or other four toes on one foot, limb salvage of arm or leg, and facial reconstruction.

17.  Part II losses include traumatic injuries resulting in the inability to perform at least two activities of daily living (ADL) for 30 or more consecutive days and hospitalization due to a traumatic injury and other traumatic injury resulting in the inability to carry out two of the six ADL, which are dressing, bathing, toileting, eating, continence, and transferring.  TSGLI claims may be filed for loss of ADL if the claimant is completely dependent on someone else to perform two of the six ADL for 30 days or more.  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.

18.  Appendix B (Glossary of Terms) of the TSGLI Procedures Guide, dated September 2008, provides the following definitions:

	a.  Traumatic Event:  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 a living body. Examples include:

* military motor vehicle accident
* military aircraft accident
* civilian motorcycle accident
* rocket propelled grenade attack
* improvised explosive device attack
* civilian motor vehicle accident
* civilian aircraft accident
* small arms attack
* training accident

	b.  Traumatic Injury:  The physical damage to a living body that results from a traumatic event.

	c.  External Force:  A force acting between the body and the environment, including a contact force, gravitational force, or environmental force, or one produced through accidental or violent means.

DISCUSSION AND CONCLUSIONS:

1.  The applicant's request for correction of his military records to show he is entitled to payment for a TSGLI claim stemming from left eye blindness was carefully considered, but found to be without merit.

2.  His initial TSGLI claim and subsequent requests for appeal and reconsideration were fully considered and denied because the evidence of record does not show the applicant meets the criteria for a TSGLI payment for his loss of vision.  The evidence of record does not provide independent corroboration of a traumatic event that caused the blindness and there is no medical link between the alleged traumatic event, should it have occurred, and his blindness.

3.  There is no third-party evidence verifying the applicant was injured by a green laser pointed in his eye while deployed in Afghanistan.  All documents referring to this event use the applicant's claims of the event as the source documentation of its occurrence.  There is no independent documentation in any of his military records that this event occurred and the applicant himself did not claim to have been struck by a green laser until 1 year after the attack.

4.  Additionally, there is no medical evidence that had the laser incident been independently corroborated it could be linked to the applicant's vision loss.  There was no scarring of the eye which a laser strike certainly would have caused.  His medical documents state that after thorough optical examinations, there does not appear to be any underlying pathology or neurological condition causing the blindness, suggesting the progressive vision loss was subjective, considering all studies and tests performed were found to be normal.  The diagnoses of amblyopia and hypermetropia were consistently made in his medical records and his left eye blindness was determined to be likely due to amblyopia, not a traumatic event.


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 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)                                         AR20140019747



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ABCMR Record of Proceedings (cont)                                         AR20140019747



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