Servicemember Traumatic Injury Insurance Claims

TSGLI is a form of insurance coverage created to compensate military service members who were traumatically injured while serving in the military – regardless of whether their injury occurred while on-duty or off-duty. TSGLI is considered a rider to SGLI (Servicemember Group Life Insurance) and many servicemembers are unaware that this coverage was included in their SGLI premiums. If you paid for SGLI during your time spent in the military, and you suffered a significant injury, you may be eligible for compensation up to $100,000.

 

Am I eligible for TSGLI?

You may be eligible for TSGLI compensation if you were insured by TSGLI and experienced a traumatic injury on or after October 7, 2001, and you meet all of the requirements listed below.

All of the following must be true:

  1. You have a scheduled loss that is a direct result of the traumatic injury, and
  2. You suffered a traumatic injury before midnight on the day you left the military, and
  3. You suffered a scheduled loss within 2 years (730 days) of the traumatic injury, and
  4. You were an active-duty military member, a Reservist, a National Guard member, on funeral-honors duty, or on 1-day muster duty.
 

Who’s covered by TSGLI?

Service members who were covered by TSGLI at the time of the injury and were serving in any one of the following capacities:

  1. Active duty
  2. Funeral Honors Duty
  3. National Guard
  4. One-Day Muster Duty
  5. Reserve
 

Does TSGLI cover injuries that occur off duty?

Yes. TSGLI may cover injuries that occurred while on duty or off duty.

 

What types of injuries are covered by TSGLI?

  1. Amputation of 4 Fingers on 1 Hand or Thumb Alone
  2. Amputation of All Toes, Including the Big Toe on 1 Foot
  3. Amputation of Big Toe Only, or other 4 Toes on 1 Foot
  4. Amputation of Hand
  5. Burns
  6. Coma from Traumatic Injury and/or Traumatic Brain Injury (TBI) where the TBI results in the inability to perform at least two Activities of Daily Living (ADLs)
  7. Facial Reconstruction (Jaw, Nose, Lips, Eyes, Facial Tissue)
  8. Foot Amputation
  9. Hearing Loss
  10. Hospitalization due to Traumatic Brain Injury
  11. Injuries to Men: Anatomical Loss of Penis, Permanent Loss of Use of Penis, Anatomical Loss of One Testicle, Anatomical Loss of Both Testicles. Additionally, permanent Loss of Use of Both Testicles, permanent loss of urinary system function
  12. Injuries to Women: Anatomical Loss of uterus, vulva, or vaginal canal, anatomical loss of one ovary. Additionally, anatomical loss of both ovaries, permanent loss of use of both ovaries, total and permanent loss of urinary system function
  13. Limb Salvage of Arm
  14. Limb Salvage of Leg
  15. Loss of Speech
  16. Loss of Vision
  17. Paraplegia
  18. Quadriplegia
  19. Uniplegia
 

Are any injuries excluded from TSGLI?

Yes. To qualify for TSGLI, your injury cannot:

  1. Be self-inflicted, on purpose or the result of an attempt at self-injury, or
  2. Involve the use of an illegal drug or controlled substance taken in any manner inconsistent with the advice of a medical doctor, or
  3. Be the result medical or surgical treatment of an illness or disease, or
  4. Occur while you’re committing or trying to commit a felony, or
  5. Be the result of a physical or mental illness or disease (not including illness or disease caused by a wound infection; a chemical, biological, or radiological weapon; or accidental ingestion of a contaminated substance).
 

Are there other types of claims that also apply?

Yes. Service members can file a claim related to the Loss of Activities of Daily Living (ADLs). A service member is considered eligible if the member is unable to independently perform at least 2 of 6 ADLs listed below. The inability must last at least 30 consecutive days. Generally speaking, inability means that the service member requires assistance to safely perform the activity as a result of the injury.

What are the six (6) ADLs?

  1. Bathing
  2. Continence
  3. Dressing
  4. Eating
  5. Toileting
  6. Transferring
 

What can I expect from filing a TSGLI claim?

Compensation can range from a baseline of $25,000 to a maximum of $100,000 (per traumatic event), depending on the specific details of your injury. This is meant to provide short-term monetary support to help you recover from your traumatic injury.

 

Does your firm handle TSGLI appeals on a contingency basis?

Yes. We charge no fee or costs until you recover.

 

How do I know if I have this benefit?

Since TSGLI is an automatic rider to full-time SGLI coverage, anyone who was signed up for SGLI should be covered. As long as your injury occurred while you were signed up with SGLI, there should be no issues in qualifying for this benefit.

 

Still wondering what qualifies as a TSGLI claim?

Below are nine examples of cases which would qualify for TSGLI compensation, followed by two examples of cases which would not qualify. To determine if you have a TSGLI claim contact us today at (800) 277-1193. It won’t cost you anything unless we are successful in obtaining compensation for you.

Covered by TSGLI:

Example 1: A service member’s vertebra is fractured in a mortar blast in Iraq. While undergoing surgery for the fractured vertebrae, a blood clot forms, causing the service member to be paralyzed from the waist down. The service member’s loss would be covered by TSGLI.

Example 2: A service member is injured in a motor vehicle accident. She suffers injuries to her leg. Unfortunately, her wounds develop a pus-forming infection (pyogenic infection) and gangrene spreads up her leg, resulting in amputation. The service member’s loss would be covered by TSGLI.

Example 3: While serving in Afghanistan, a service member is hit with materials from a chemical weapon. He develops an illness that causes the deterioration of his retinas, resulting in permanent vision loss. The service member’s loss would be covered by TSGLI.

Example 4: A service member is accidentally exposed to radiation while working at an Army weapons depot. The service member subsequently develops cancer and has to have his leg amputated. The service member's loss would be covered by TSGLI.

Example 5: A service member serving in Iraq is involved in a skirmish with enemy forces. He is forced to wait out the enemy for three days in a remote area. He only has a one-day supply of water. In order to survive, he drinks water from a small stream nearby. After escaping from his hiding place, the service member returns to base and becomes ill with vomiting, diarrhea, and a fever. After a few days of these symptoms, the service member falls into a coma for 20 days. It is determined that contaminated water from the stream caused the illness which then caused the coma. The service member’s loss would be covered by TSGLI.

Example 6: A service member is injured when his motorcycle slides on a wet road. He has deep skin abrasions, termed road rash, on his arms and legs. He undergoes wound care at a local Burn Center. He is unable to perform bathing and dressing for 30 days after his accident. The service member does not qualify for payment related to the burns, but does qualify for $25,000 for the inability to perform two ADLs for 30 days.

Example 7: A service member goes into a coma as the result of a military motor vehicle accident. The service member recovers from the coma 60 days later. The service member’s loss would be covered by TSGLI.

Example 8: A service member is injured in an automobile accident on March 1. She is taken to a local trauma center and is admitted. On March 6, her condition is stabilized and she is transferred to another hospital. She is released from the second hospital on March 17. She has accrued 15 consecutive hospitalization days (March 1-15) and would be paid a $25,000 TSGLI benefit.

Example 9: A service member is injured in a car accident on March 1. He is hospitalized from March 1 to March 12 but, due to his injuries, he is unable to perform the ADLs of bathing and dressing from March 1 to March 30. He regains his ADL on March 31. Due to complications, he is hospitalized a month later from May 1 to May 15. The service member will receive a $25,000 benefit for loss of ADLs for 30 days. He will not be paid for the subsequent 15-day hospitalization. Payment is made for either the 15-day hospitalization OR the first ADL milestone, whichever occurs first, not both.

Not Covered by TSGLI:

Example 1: A service member goes to the hospital for a routine colonoscopy. Due to a medical error, the patient is injured and must remain in the hospital for 15 days. The service member’s loss would not be covered by TSGLI.

Example 2: A service member has diabetes which begins to cause problems to her foot, ultimately resulting in the amputation of her leg. The service member’s loss would not be covered by TSGLI because it was the result of treatment for an existing condition.

 

Contact Us

To contact us for a free confidential consult, you can call us at (850) 435-7000 or (800) 277-1193. You also can request a confidential consultation by clicking Free & Confidential Consult, which form will be immediately reviewed by one of our attorneys.