RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2011-00095 COUNSEL: NONE HEARING DESIRED: NO _________________________________________________________________ APPLICANT REQUESTS THAT: His claim for compensation under the Traumatic Servicemen’s Group Life Insurance (TSGLI) program be honored. _________________________________________________________________ APPLICANT CONTENDS THAT: He experienced a qualifying “traumatic event that resulted in a traumatic injury that caused scheduled losses” as defined under the program. His claim is a multi-loss claim involving a LeFort type II fracture (avulsion, discontinuity defects to the left side of his face and head, including multiple deep lacerations (open wounds, discontinuity defects). His claim also qualifies for a loss of Activities of Daily Living (ADL) compensation, as his injuries involved a traumatic brain injury (TBI). In support of his request, the applicant provides a personal statement, a memorandum, the TSGLI Procedural Guide, extracts from his medical records, a fracture definition from the Free Dictionary website, a Power Point presentation, an article from The Journal of Prosthetic Dentistry and various other documents associated with his request. The applicant's complete submission, with attachments, is at Exhibit A. _________________________________________________________________ STATEMENT OF FACTS: The applicant is presently serving in the Regular Air Force in the grade of master sergeant. On 21 Jul 08, the applicant was involved in a roll-over logging truck accident in the mountains of Utah. The applicant submitted three claims for TSGLI compensation; however, the claims were denied as they did not meet the eligibility criteria. On 10 Nov 10, HQ AFPC/DPSD advised the applicant his next level of appeal was to the Air Force Board for Correction of Military Records (AFBCMR). Other relevant facts pertaining to this application are contained in the advisory opinion prepared by the BCMR Medical Consultant, which is at Exhibit D. _________________________________________________________________ AIR FORCE EVALUATION: HQ AFPC/DPWC recommends denial. DPWC states the applicant’s losses do not meet the TSGLI eligibility criteria for payment. The complete DPWC evaluation, with attachments, is at Exhibit B. _________________________________________________________________ APPLICANT'S REVIEW OF AIR FORCE EVALUATION: A copy of the Air Force evaluation was forwarded to the applicant on 11 Mar 11 for review and comment within 30 days (Exhibit C). As of this date, this office has not received a response. _________________________________________________________________ ADDITIONAL AIR FORCE EVALUATION: The BCMR Medical Consultant recommends denial. He states the applicant has not met the burden of proof that warrants the desired change to the record. The applicant’s injuries were potentially life-threatening; however, he received prompt emergency care. None of his injuries presented a gross disfigurement or required surgery to correct discontinuity loss of the tissue of 50 percent or more under a certain interpretation of an “avulsion” or “discontinuity defect.” Regarding the applicant’s alternative contention for receiving the benefit under loss of ADL, the BCMR Medical Consultant states two of the following qualifying requirements must be met, as a minimum at the “30th consecutive day” or the 15th consecutive day where there is a coma from trauma and/or TBI resulting in inability to perform at least two activities of daily living: unable to bathe independently, unable to maintain continence, unable to dress independently, unable to eat independently, unable to toilet independently, and unable to transfer independently. The applicant would have required hospitalization for 15 consecutive days. Based on the documentation, the application falls short by one day of the benefit. His hospitalization was from 21 Jul 08 through 3 Aug 08. However, the Board has the authority to alter a predicate fact should this serve the best interest of justice. The BCMR Medical Consultant concedes the applicant may have been unable to independently dress himself, or at best found this to be a difficult task, particularly when putting on socks or buttoning clothing with his dominant extremity. However, the applicant’s unilateral peripheral (ulnar and median nerve) neuropathy or likely neuropraxia should not have precluded bathing more than one part of the body, nor should have it interfered with maintaining continence, toileting or the independent transfer in and out of bed or chair. Further, there is no evidence provided to show the applicant sustained a lasting cognitive or other functional deficit due to the TBI that impaired his reasoning, thought processing, computing, or other mental functions for the qualifying duration of time. The complete BCMR Medical Consultant’s evaluation, with attachment, is at Exhibit D. _________________________________________________________________ APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATION: A copy of the BCMR Medical Consultant’s evaluation was forwarded to the applicant on 8 Apr 11 for review and comment within 30 days (Exhibit E). As of this date, this office has not received a response. _________________________________________________________________ THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was timely filed. 3. Insufficient relevant evidence has been presented to demonstrate the existence of error or injustice. The applicant’s complete submission was thoroughly reviewed and his contentions were duly noted; however, no evidence has been presented that convinces us the applicant met the eligibility criteria for traumatic injury protection under the TSGLI program. Therefore, we agree with the opinions and recommendations of the Air Force office of primary responsibility and AFBCMR Medical Consultant and adopt their rationale as the basis for our conclusion the applicant has not been the victim of an error or injustice. In the absence of persuasive evidence to the contrary, we find no basis to recommend granting the relief sought in this application. ________________________________________________________________ THE BOARD DETERMINES THAT: The applicant be notified that the evidence presented did not demonstrate the existence of material error or injustice; that the application was denied without a personal appearance; and that the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application. ________________________________________________________________ The following members of the Board considered AFBCMR Docket Number BC-2011-00095 in Executive Session on 2 Aug 11, under the provisions of AFI 36-2603: Panel Chair Member Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 23 Nov 10, w/atchs. Exhibit B. HQ AF/DPWC, Letter, dated 28 Feb 11, w/atchs. Exhibit C. SAF/MRBR, Letter, dated 11 Mar 11. Exhibit D. BCMR Medical Consultant, Letter, dated 6 Apr 11. Exhibit E. SAF/MRBR, Letter, dated 8 Apr 11, w/atch. Panel Chair