RECORD OF PROCEEDINGS IN THE CASE OF: BOARD DATE: 7 February 2008 DOCKET NUMBER: AR20070017201 I certify that hereinafter is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in the case of the above-named individual. Ms. Catherine C. Mitrano Director Ms. Antoinette Farley Analyst The following members, a quorum, were present: Mr. William D. Powers Chairperson Ms. Rose M. Lys Member Mr. Qawiy A. Sabree Member The Board considered the following evidence: Exhibit A - Application for correction of military records. Exhibit B - Military Personnel Records (including advisory opinion, if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests, in effect, that his Traumatic Servicemembers’ Group Life Insurance (TSGLI) claim to the U. S. Army Physical Disability Agency (PDA) be reconsidered. 2. The applicant states, in effect, that he is appealing the findings of his disability finding at the PDA. 3. The applicant continues that he is being seen by a multitude of physicians trying to overcome his medical issues. The applicant continues that since his last appeal he has been hospitalized twice and both times were due to his back injury which made him unable to walk due to incapacitating pain. The applicant continues he is currently going through a second medical board and provided a copy of that documentation. 4. The applicant continues that after his last hospitalization DR. P_________ ordered a sitting MRI which revealed annulus tears in his disc at L4/5 and L5/S1 and require surgery. The applicant continues that his surgery was not approved pending the outcome of a medical board. 5. The applicant continues that a narrative summary provided by DR H______ shows that his injuries were connected to his incident in Iraq, and is not a separate issue. 6. The applicant alleges that he also has an Axillary compression of his back. The applicant continues that his mobility has greatly decreased with problems walking which adds a permanent impairment. 7. The applicant continues that he was diagnosed with Reflex Sympathetic Dystrophy by DR. Pr_____ who also included a notation of Reynaud's Phenomenon. The applicant states that the above conditions are related to his initial spinal cord injury. 8. The applicant continues that his condition deteriorates weekly and indicates that the Army no longer seems to have a use for him. The applicant adds that he is in extreme pain everyday, uses a prescribed morphine medication which he limits so he will not become addicted, and is non-functioning. The applicant continues that he does not get dressed because it's too difficult, has gone up to 3-days without a shower because he can not stand or climb into the tub because of pain. The applicant concludes that he is fighting to overcome his disabilities. 9. The applicant provides copies of a Examination Form from the Barksdale Air Force Base, dated 1 October 2007; a Routine Medical Assessment Form, dated 17 October 2007; a DA Form 3947 (Medical Evaluation Board Proceedings), dated 6 September 2007; Page four of his TSGLI claim form Part A- (Member's Identifying Information and Authorization - to be completed by the member, guardian or attorney-in-fact), undated; a Prescription Form for pain medication, dated 2 October 2007; a treatment assessment form from the Spine Institute, dated 17 October 2007; and a Comprehensive Neuro-Surgery outpatient consultation form in support of these claim application. CONSIDERATION OF EVIDENCE: 1. The applicant is currently a member of the Louisiana Army National Guard. 2. The applicant's service records are incomplete; however, his records show that the U.S. Army Physical Disability Agency (PDA), Traumatic Servicemember's Group Life Insurance (TSGLI) Branch provided a chronology summary of the applicant's appeals. The TSGLI summary chronology listing shows that: a. in January 2005, the applicant claimed he hurt his neck during physical fitness training; b. on 26 June 2005, the Defense Casualty Information Processing System showed the applicant hurt his left leg doing physical fitness training; c. on 27 June 2005, the applicant was transferred to the Landstuhl Regional Medical Center, Germany; d. on 29 June 2005, the applicant was released to outpatient treatment at Carl R. Darnell Army Medical Center, Fort Hood, Texas; e. on 2 June 2006, his MRI findings showed he had a mild cord impingement and a mild compression deformity from an injury "Years ago;" and f. on 15 June 2006, the applicant was returned to duty and was released without limitations. 3. The TSGLI appeals summary shows the applicant's first TSGLI claim was sent on 30 August 2006, in which he claimed an injury to his neck (cervical paralysis) with no loss of ADLs. The applicant's claim was denied and a disapproval letter was sent to him on 14 September 2006. 4. The TSGLI appeals summary shows the applicant's second TSGLI claim was sent on 25 September 2006, in which he claimed an injury to his neck (cervical paralysis) with no loss of ADLs. The applicant's claim was denied and a disapproval letter was sent to him on 5 October 2006. 5. The TSGLI appeals summary shows the applicant's third TSGLI claim was sent on 6 March 2007, in which he claimed an injury to his neck (cervical paralysis) with no loss of ADLs. The applicant's claim was denied and a disapproval letter was sent to him on 11 May 2007. 6. The applicant provided a copy of his Examination Form from the Barksdale Air Force Base, dated 11 October 2007, which shows he received a CT Scan which revealed evidence of annulus tear at the level of L4-L5 and L5S1. The symbols L1 through L5 represent the five lumbar vertebrae. The lumbar vertebrae are situated behind the spinal column. 7. The applicant provided a copy of his Medical Evaluation Board (MEB), dated 6 September 2007, which was convened at the Darnell Army Medical Center, Fort Sam Houston, Texas. The MEB shows he was diagnosed with Spinal Stenosis, Thoracic, with myelopathic features, which shows he failed conservative management and may require surgery in the future; Cervical Radiculopathy bilaterally at C8; Degenerative disk disease, multilevel, Spondylosis, multilevel, Raynaud's with dysthesia, Reflex sympathetic dystrophy with dysthesia, Polyarthralgias secondary to patellofemoral syndrome, Osteoarthritis of the knees and adjustment disorder with depressed mood. The applicant's medical board found that these conditions render him unfit in accordance with Army Regulation 40-501, Chapter 3-30(j). Therefore, his case was referred to the Physical Evaluation Board (PEB) for determination of fitness. 8. On 27 September 2007, the PEB found the applicant unfit, with a disability rating of 30 percent and recommended he be placed on the Temporary Disability Retired List (TDRL). 9. On 9 October 2007, the applicant did not concur with the findings of the PEB, and requested a formal hearing. 10. On 31 October 2007, the applicant waived his request for a formal hearing and concurred with the PEB findings; however, his records show he is still serving in the Louisiana Army National Guard. 11. The applicant provided a copy of page four of his TSGLI claim form Part A- (Member's Identifying Information and Authorization - to be completed by the member, guardian or attorney-in-fact), undated, which had not been completed by his guardian or an Attorney. 12. The applicant provided a Prescription Form which authorized medication for his back, dated 2 October 2007. 13. The applicant provided a medical pain treatment assessment plan from the Spine Institute medical, dated 17 October 2007, which outlined the use of a breakthrough medication, a Comprehensive Neuro-Surgery outpatient consultation sheet advising him of the imaging results and discussion of treatment options. 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. U.S. Army Combat-Related Special Compensation (CRSC) 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 and $100,000 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 OIF and OEF or under orders in a Combat Zone Tax Exclusion (CZTE) 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. 15. There are some 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 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 2 of the 6 ADLs for 30 days or more (15 days or more in the case of traumatic brain injuries). 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 won't be approved without a certification from a healthcare provider, additional documentation must be provided to substantiate the certification. DISCUSSION AND CONCLUSIONS: 1. The applicant contends that he should be granted TSGLI because he was disabled with impaired mobility due to a neck (cervical paralysis) injury during physical fitness training. 2. The evidence provided by the applicant was carefully considered. The Board noted the applicant’s disagreement with responses to his TSGLI claims; however, evidence of record clearly shows he received treatment for pain, but does not show his inability to carry out 2 of the 6 ADLs because of his injury. Therefore, the applicant has not satisfied the necessary criteria for award of TSGLI claims. 3. Additionally, the applicant has not provided a statement by his attending physician in Part B of his TSGLI claim form which shows that he could not perform ADLs for at least 60 days. 4. The applicant's medical records show that he received pain management therapy, and on 27 September 2007, was found unfit, with a disability rating of 30 percent with a recommendation he be placed on the TDRL. The applicant's records show that he is still serving in the Louisiana Army National Guard. However, the evidence in his service medical records does not approach the level of required documentation to justify a TSGLI payment for loss of ADLs. 5. Additionally, the applicant has not provided sufficient documentation supporting his contention that his TSGLI claims were improperly disallowed. Neither the available records nor the medical documentation the applicant provided establish a basis to support his request. 6. Based on the foregoing, there is no basis to grant the relief requested in this case. 7. In order to justify correction of a military record the applicant must, or it must otherwise satisfactorily appear, that the record is in error or unjust. The applicant has failed to submit evidence that would satisfy that requirement. In view of the foregoing, there is no basis for granting relief to the applicant in this case. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING _QAS_ __ _RML___ __WDP__ 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. _William D. Powers_____ CHAIRPERSON INDEX CASE ID AR SUFFIX RECON YYYYMMDD DATE BOARDED YYYYMMDD TYPE OF DISCHARGE (HD, GD, UOTHC, UD, BCD, DD, UNCHAR) DATE OF DISCHARGE YYYYMMDD DISCHARGE AUTHORITY AR . . . . . DISCHARGE REASON BOARD DECISION (NC, GRANT , DENY, GRANT PLUS) REVIEW AUTHORITY ISSUES 1. 2. 3. 4. 5. 6.