IN THE CASE OF: BOARD DATE: 3 May 2016 DOCKET NUMBER: AR20150001430 BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ___x____ ___x____ ___x____ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ________ ________ ________ DENY APPLICATION 2 Enclosures 1. Board Determination/Recommendation 2. Evidence and Consideration IN THE CASE OF: BOARD DATE: 3 May 2016 DOCKET NUMBER: AR20150001430 BOARD DETERMINATION/RECOMMENDATION: 1. The Board determined the evidence presented is sufficient to warrant a recommendation for partial relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by: a. showing the applicant was unable to personally perform four activities of daily living (ADL) without required assistance during the period 17 November 2010 through 7 February 2011; and b. showing the applicant's appeal claim for Traumatic Injury Protection under Servicemembers' Group Life Insurance (TSGLI) was approved on 22 February 2013. 2. The Board further determined the evidence presented is insufficient to warrant a portion of the requested relief. As a result, the Board recommends denial of so much of the request that pertains to correcting the applicant's record to show he was unable to perform four ADLs without assistance during the period 8 February 2011 through 17 March 2011. _____________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. IN THE CASE OF: BOARD DATE: 3 May 2016 DOCKET NUMBER: AR20150001430 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, an appeal review of the denial of his Traumatic Servicemembers' Group Life Insurance (TSGLI) claim. 2. The applicant states he was unable to perform four activities of daily living (ADL) for at least 120 days. 3. The applicant's supporting documentation is identified in a cover letter provided by counsel. COUNSEL'S REQUEST, STATEMENT, AND EVIDENCE: 1. Counsel requests, in effect, that the applicant be granted TSGLI benefits for the injury he sustained. 2. Counsel states, in effect, the applicant is appealing the finding that he did not incur a qualifying scheduled loss. 3. Counsel provides the following as evidence: * a letter from the Office of SGLI, Prudential Insurance Corporation, dated 13 September 2011 * a personal statement from the applicant, dated 18 November 2012 * a personal statement from the applicant's wife, dated 18 November 2012 * a letter from the Special Compensations Branch, U.S. Army Human Resources Command (HRC), Fort Knox, Kentucky, dated 4 March 2013 * a letter from T.B., RN, of Colorado Springs, dated 30 June 2014 * SGLV 8600 (Application for TSGLI Benefits), dated 8 July 2014 * approximately 200 medical documents, of which many are duplicates 4. Counsel provided approximately 100 pages of additional medical documents and clinical notes from the applicant's civilian physical therapy clinic, Physicians Home Health, on a computer disc on 19 June 2015. 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. The applicant is currently serving on active duty in the rank of lieutenant colonel. 3. The applicant, while serving in the rank of major, injured his back on 17 November 2010 while conducting an airborne parachute landing. He was assessed by medics on hand and airlifted to a hospital in Colorado Springs, Colorado. He was diagnosed with an L-1 (lumbar) burst fracture in his spine. He was then air lifted to a hospital in Denver for further treatment and surgery. 4. During the processing of this case, the HRC Special Compensation/TSGLI medical consultant provided a summary of the applicant's case submissions, wherein he stated: * the applicant's initial application for TSGLI was received on or about 26 August 2011 and was denied on 7 September 2011 * his application for reconsideration was received on or about 11 October 2011 and was denied on 29 February 2012 * his appeal application was received on or about 28 November 2012 and was denied on 22 February 2013 5. The applicant's record contains an SGLV Form 8600, dated 6 July 2011. This form shows: a. Part A (Member's Claim Information and Authorization) was completed by the applicant. He stated in Part A, Item 3 (Traumatic Injury Information) that he had suffered a very serious injury on 17 November 2010; specifically, a traumatic spinal injury to the L1 vertebrae while conducting Airborne Proficiency Training at Fort Carson, Colorado. He was evacuated to Saint Michael's Trauma Center, Denver, Colorado, where his treatment included a spinal fusion on 19 November 2010, from the T12 vertebrae to the L2 vertebrae. His injury and subsequent surgery left him dependent on others to perform daily activities of life. He still requires assistance getting dressed. b. Part B (Medical Professional's Statement) was not completely filled out. Item 2 (Reason for Inpatient Hospitalization) indicates the predominant reason was "other traumatic injury." It indicates he was transported and admitted to the hospital on 17 November 2010 and he was discharged on 22 November 2010. c. This form only has pages 3-9 and does not include the pages that list the ADLs he could not perform nor the medical professional's comments and indorsement. 6. The applicant received a letter from the Office of Servicemembers' Group Life Insurance, administrator of the TSGLI Program, on 13 September 2011. The letter stated the following: a. The applicant's claim for the inability to perform ADLs due to traumatic injury (other than traumatic brain injury) and hospitalization could not be approved. b. The applicant's claim for the inability to perform ADLs due to traumatic injury…was not approved because his loss did not meet the standards for TSGLI. To qualify, a claimant must have been unable to independently perform at least two ADLs for at least 30 consecutive days. The claimant was considered unable to perform an activity independently only if he or she required at least one of the following, without which they would be incapable of performing the task: * physical assistance (hands on) * stand-by assistance (within arm's reach) * verbal assistance (must be instructed) c. The applicant's inability to perform two or more ADLs for at least 30 days must also have been certified by a medical professional. d. The applicant's claim for hospitalization was not approved because his loss did not meet the TSGLI standard. Under TSGLI, hospitalization is defined as an inpatient hospital stay which lasts for 15 or more consecutive days in a hospital or series of hospitals. 7. He submitted another SGLV Form 8600 for reconsideration on 13 September 2011. This form shows: a. Part A was completed by the applicant, who stated in Item 3 the following: On 171130 November 2010 [1130 hours on 17 November 2010], I suffered a Traumatic Event while conducting Airborne Operations at Sullivan Drop Zone, Fort Carson, CO. While conducting my Parachute Landing Fall I felt an intense pain in my lower back that caused immediate pain. I was unable to remove the parachute harness because the pain in my lower back prevented me from standing or rolling onto my side. My extremities tingled for about 30 minutes but I was not paralyzed. After approximately 5-10 minutes the Special Forces Medics arrived and began trauma treatment. The medics stabilized me with a neck collar and began an examination and treatment. That Traumatic Event resulted in a Traumatic Spinal Injury, a burst L1 vertebrae resulting in 70% compression of my spinal cord. I was evacuated by air to Saint Michael's Trauma Center, Denver, CO, where my treatment result[ed] in a spinal fusion from T-12 to L-2 and the implantation of supporting rods and screws into my spine for stability. The initial restrictions as prescribed by my surgeon included no lifting for six (6) weeks, assisted walking as prescribed by Physical Therapy and as tolerated, physical assistance to get into and out of hospital bed, physical assistance and presence (within arm's reach) at all times when not supine on the hospital bed. This injury and subsequent treatment left me dependent upon others to perform numerous Activities of Daily Living for more than 120 days (four months). b. Part B was completed by his primary care manager at Fort Carson, Colorado on 30 September 2011, who further states he observed the patient's loss. (1) Part B, Item 2 indicates the predominant reason was for "other traumatic injury." It indicates he was transported and admitted to the hospital on 17 November 2010 and he was discharged on 22 November 2010. (2) Part B, Item 3 indicates the predominant reason he was unable to independently perform ADLs was because he suffered a traumatic spinal injury, which resulted in a dependence upon others for bathing, dressing, and personal hygiene for 120 days (four months). (a) The applicant was unable to perform the ADL "bath independently" from 17 November 2010 to 17 March 2011 because he needed physical assistance (hands-on) and stand-by assistance (within arm's reach). The medical professional made the following entry in the block marked "describe the assistance needed": "Due to range of motion restrictions and risk of fall, SM was unable to bathe independently." This form states a patient is UNABLE to bathe independently if he or she requires assistance from another person to bathe (including sponge bath) more than one part of the body or get in or out of the tub or shower. (b) The applicant was unable to perform the ADL "dress independently" from 17 November 2010 to 17 March 2011 because he needed physical assistance (hands-on) and stand-by assistance (within arm's reach). The medical professional made the following entry in the block marked "describe the assistance needed": "SM was unable to independently put on / take off clothing, specifically pants, socks, and shoes/boots." This form states a patient is UNABLE to dress independently if he/she requires assistance from another person to get and put on clothing, socks, or shoes. (c) The applicant was unable to perform the ADL "eat independently" from 17 November 2010 to 20 November 2010 because he needed physical assistance (hands-on). The medical professional made the following entry in the block marked "describe assistance needed": "SM required liquid nourishment for the first four (4) days of hospitalization." This form states a patient is UNABLE to eat independently if he/she requires assistance from another person to get food from plate to mouth or, take liquid nourishment from a straw or cup or, he/she is fed intravenously or by a feeding tube. (d) The applicant was unable to perform the ADL "toilet independently" from 17 November 2010 to 17 March 2011 because he needed physical assistance (hands-on) and stand-by assistance (within arm's reach). The medical professional made the following entry in the block marked "describe assistance needed": "SM initially required a bedpan and later required assistance to get onto/off of toilet and to perform associated personal hygiene." This form states a patient is UNABLE to toilet independently if he/she must use a bedpan or urinal to toilet or, requires assistance from another person for any of the following: going to and from the toilet, getting on and off the toilet, cleaning self after toileting, getting clothing off and on. (e) The applicant was unable to perform the ADL "transfer independently" from 17 November 2010 to 17 March 2011 because he needed physical assistance (hands-on) and stand-by assistance (within arm's reach). The medical professional made the following entry in the block marked "describe the assistance needed": "SM was unable to get onto/off of the hospital grade bed and personal bed. SM also required assistance getting into and out of chairs." This form states a patient is UNABLE to transfer independently if he/she requires assistance from another person to move into or out of a bed or chair. 8. The TSGLI Branch Chief informed the applicant that the Army TSGLI Program Office reconsidered its decision in his previous claim and were unable to overturn the previous adjudication. The claim of ADL losses originating from a parachute landing in November 2010 did not met the TSGLI standards for loss of ADL. The medical documentation submitted did not indicate he suffered physical injury that would make him incapable of performing the ADL losses of bathing, dressing, eating, toileting, or transferring, which are covered by TSGLI standards. 9. The applicant submitted another SGLV Form 8600 on 2 November 2012, appealing the previously denied claims, including approximately 70 medical documents as supporting evidence. a. This form contained information from the medical surgeon for the 10th Special Forces Group (the applicant's unit at the time of his injury) and a form from the unit's physical therapist, both attesting and certifying the applicant's inability to perform the ADL tasks of bathing, dressing, toileting, and transferring for the time of 17 November 2010 to 17 March 2011, a period of 120 days. b. It does not indicate the applicant was submitting a claim for his hospitalization period. c. In addition, he submitted two Standard Forms 600 (Chronological Record of Medical Care) that were completed by his unit's physical therapist and surgeon, dated 30 August 2012 and 2 November 2012, respectively. These forms show the applicant was evaluated, during the timeframe of 15 to 120 days after the accident, as requiring maximum assistance (75%) from others in the ADL of bathe, dress, toilet and transfer. 10. On 4 March 2013, the Special Compensations Branch Chief (TSGLI), HRC, informed the applicant that his TSGLI appeal request was received. He informed that applicant that after reviewing the claim and his supporting documentation, they were unable to overturn the previous adjudication. In addition, he informed the applicant that he could appeal the decision to the Army Review Boards Agency (ARBA). The adjudication was upheld for the following reasons: * the documentation did not indicate he was hospitalized for 15 consecutive days or more * the submitted documentation did not indicate he was incapable of performing the ADLs of toileting, dressing, bathing, transferring, continence or eating for 30 days or more, per TSGLI guidelines 11. The applicant, through counsel, provided a letter from a T.B., RN, of Colorado Springs, Colorado, dated 30 June 2014, which restates the applicant's medical condition and concludes the applicant does qualify for TSGLI benefits for ADL losses. This individual's connection to the hospital, doctors, or applicant is unclear; however, he/she is presumed to be an independent medical reviewer. The letter states, in effect, the following: a. In summary, the applicant suffered a lumbar spine fracture after a hard parachute landing on 17 November 2010. Surgery was performed on 19 November 2010 by Dr. L.E.L. The applicant remained in the hospital until 22 November 2010. For the first 42 days, at-home nursing care was ordered. From 22 November 2010 through 17 March 2011, the applicant was unable to independently bathe, dress, toilet, and transfer without physical and stand-by assistance. b. It further states the applicant's three treating physicians all certified his ADL loss. His physical therapist at Fort Carson, Colorado attested to his inability to perform ADL tasks over a period of 120 days. The first 30 days, he was dependent in bathing, dressing, toileting, and transferring. At 60 days, he was dependent in transferring, getting in/out of the tub/shower and required maximum assistance with bathing and dressing. For the 90-120 day period, he still required maximum assistance with ADL of bathing, dressing, toileting, and transferring. c. His doctor ordered him to wear a back brace for 3 months following surgery. Also, for the initial 60 days his physical restrictions included no bending or lifting over 10 pounds, use of a shower chair by his caregiver, and the prescribed use of a medical bed. During the period of ADL loss, the applicant was unable to bend over, twist or stoop to bathe and dress. It states he couldn't reach down, bend over and pull his pants off and on or put his socks and shoes on. He was unable to go up and down stairs, get up and off the toilet or get in and out of the bath tub/shower without someone standing by to make sure he didn’t fall. Although, he was given some adaptive equipment (a hospital bed, bedpan, shower chair and walker), he was not able to independently use them without the assistance of a caregiver. 12. The applicant, through counsel, submitted the following as evidence that has not been already addressed above: a. A two-page medical document by his attending surgeon, dated 28 December 2010, related to his 6 week post-operative follow-up. It documents his surgeon's way-ahead plan as follows: * continue to advance walking as tolerable * continue post-op back restrictions for 6 more weeks; no lifting greater than 10 pounds, no twisting, no bending, or no pushing * begin brace wean over the next 4 weeks and initiate formal physical therapy in 5-6 weeks * wean off pain mediation within the next 6 weeks * work restrictions b. A sworn affidavit by his wife and caregiver, dated 18 November 2012, states the following: * her husband had a spinal operation on 19 November 2010 * the hospital discharged him on 22 November 2010, pursuant to doctors' orders and was sent home to recover * the operation rendered him immobile, unable to bend at the waist or pick up any objects, or exert any physical force or activity * a nurse was ordered to assist with her husband's care for the first few weeks and he was entirely dependent on their care and assistance * between 22 November 2010 and, at least, 17 March 2011, she physically assisted or provided stand-by assistance to all of his daily living activities * he was not able to bathe, groom, toilet, or shower on his own or with the help of any equipment * specifically, in order of importance, she assisted her husband with the following tasks: dressing; grooming; getting in and out of the shower; bathing multiple parts of his body; getting to, on and off the toilet; and transferring in and out of the bed and chairs * under the direction of a physical therapist, for the first 60 days after his discharge, she assisted with his physical therapy to help him walk c. A sworn affidavit by the applicant, dated 18 November 2012, wherein he states the following: * on 17 November 2010, he was injured in a parachute training exercise * Special Forces Medical Sergeants evaluated him, and after he complained of numbness in his arms and legs was airlifted to a hospital in Colorado Springs, CO * doctor's informed him he suffered a fracture in his spine, and he was then again airlifted to a hospital in Denver, CO * he was evaluated by an orthopedic surgeon specializing in the spine and was told he needed an operation immediately * on 19 November 2010, he had the operation and on 22 November 2010, he was discharged and sent home to recover * the surgeon directed him to avoid lifting anything greater than 10 pounds, no pushing or pulling, kneeling, squatting, or crawling, climbing ladders, and stooping, bending, or twisting * between 22 November 2010 and, at least, 17 March 2011, he was unable to perform ADLs on his own * he was even unable to perform activities with the assistance of medical equipment due to his back which rendered him immobile and was unable to engage in any activity that caused any stress on his back * he was unable to groom, bathe, toilet, or transfer to and from his bed or chairs on his own * his wife physically helped him or provided stand-by assistance with all his activities * for the first 7 days a nurse taught his wife how to clean and bandage his incision, bathe him, and empty his bedpan * for the first 42 days a nurse evaluated him 3 times a week and provided assistance * for the first 60 days, he was prescribed physical therapy 3 times a week to help him regain his ability to walk * between 22 November 2010 and 21 February 2011, he was prescribed a hospital bed, bedpan, an adult walker with folding wheels, and a raised toilet seat with arms * although he used the medical equipment to move in and out of bed, going to and from the toilet, and getting cloths off and on, he always used assistance from his wife and nurse d. Approximately over 250 medical documents, invoices and claim forms as evidence of his surgical procedure and claims for benefits. These documents, dated from 17 November 2010 to 3 June 2015, depict his surgical procedure, treatment and therapy regiment, hospital equipment expenses and invoices, as well as his claims and appeal processes for TSGLI. e. Approximately 100 pages of additional medical documents and clinical notes from the applicant's civilian physical therapy clinic, Physicians Home Health, were submitted on 19 June 2015 via a computer disc. These documents, as noted by counsel, were not looked at by HRC because they were submitted after the final appeal. These documents are physical therapy clinical notes and goals on the applicant's progress. The time period for these documents are dated between 23 November 2010 and 29 December 2010. The following two documents highlight the beginning and the ending of the applicant's civilian physical therapy sessions: (1) On 23 November 2010, his "Start of Care" document, depicts the applicant as being unable to or needing assistance on the following ADL: bathing, dressing, toileting, and transferring. (2) On 29 December 2010, his "Discharge from Agency" document, depicts the applicant as being able to independently perform the ADL of bathing, dressing, toileting, and transferring. REFERENCES: 1. 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 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. 2. 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 $1.00 deducted 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 between 7 October 2001 and 30 November 2005 while supporting OIF and OEF or under orders in a combat zone tax exclusion 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. 3. 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 metacarpophalangeal joints; f. quadriplegia, paraplegia, or hemiplegia; g. third degree or worse burns covering 30 percent of the 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 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 (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 will not be approved without a certification from a healthcare provider, additional documentation must be provided to substantiate the certification. 4. The TSGLI Procedural Guide, version 2.25, dated 2 April 2014, provides the definition and criteria of ADL. ADLs are routine self-care activities that a person normally performs every day without needing assistance. There are six basic ADL: eating, bathing, dressing, toileting, transferring (moving in and out of bed or chair) and continence (managing or controlling bladder and bowel functions). When determining if a member has a loss of ADL, he/she is considered to have a loss of ADL if the member requires assistance to perform at least two of the six activities of daily living. If the patient is able to perform the activity by using accommodating equipment (such as a cane, walker, commode, etc.) or adaptive behavior, the patient is considered able to independently perform the activity. a. The table below should be used to help to determine whether a member has lost the ability to perform a particular ADL. Patient is… if he/she requires physical, stand-by, or verbal assistance from another person… UNABLE to bathe independently to bathe more than one part of the body (via tub bath or sponge bath) or get in or out of the tub or shower UNABLE to maintain continence independently to manage catheter or colostomy bag. The patient is also unable to maintain continence independently if he/she is partially or totally unable to control bowel and bladder function. UNABLE to dress independently to get and put on appropriate clothing (i.e. dress for the correct season), socks or shoes (may have help tying shoes). UNABLE to eat independently to get food from plate to mouth, or take liquid nourishment from a straw or cup. The patient is also unable to eat independently if he/she is fed intravenously or by a feeding tube. UNABLE to toilet independently to go to and from the toilet, get on and off the toilet, clean self after toileting, or get clothing off and on before and after toileting. The patient is also unable to toilet independently if he/she must use a bedpan or urinal. UNABLE to transfer independently to move into or out of a bed or chair. b. When a member is unable to perform two of the six ADLs due to a traumatic injury other than traumatic brain injury, the TSGLI benefit will be paid based on the number of consecutive days the member is unable to perform ADL. The duration of the loss of ADL includes the date the member began to be unable to perform ADL and the date the member was again able to perform ADL. c. Payments for loss of ADLs due to traumatic injury other than brain injury will be made as follows: $25,000 at the 30th consecutive day; an additional $25,000 at the 60th consecutive day; an additional $25,000 at the 90th consecutive day; and an additional $25,000 at the 120th consecutive day. DISCUSSION: 1. The applicant's request for review and consideration of his TSGLI appeal, and for TSGLI benefits for 120 days for the injury he sustained, was carefully considered. 2. By law, TSGLI claims may be filed for loss of ADLs if the claimant requires assistance (emphasis added) to perform at least 2 of the 6 ADLs for 30 days or more. The applicant claims to have required assistance for 4 of the 6 ADLs (bathing, dressing, toileting, and transferring) for a period of 120 days. 3. After a review of all the available evidence, there is some conflict in the exact number of days that the applicant was dependent on others. His civilian physical therapist states he was dependent on others for 4 ADLs (bathing, dressing, toileting, and transferring) for the period from 23 November 2010 to 29 December 2010, a period of 37 days. Including the 6 days of his hospitalization, this period would total 43 days. 4. At the applicant's 6-week post-operative follow-up on 28 December 2010, his attending surgeon ordered 6 more weeks of continued back restrictions, which included no lifting greater than 10 pounds, no twisting, no bending, or no pushing. This 6-week period would have ended on or about 7 February 2011. It can be assumed the applicant would have complied with these orders and the ADLs of bathing, dressing, toileting, and transferring would have required a degree of both hands-on or stand-by assistance from his wife. This is evident by their affidavits. 5. According to his unit's medical professionals, the applicant was dependent on others for at least 120 days for the ADLs of bathing, dressing, toileting, and transferring. These documents were submitted on Standard Forms 600, dated 30 August 2012 and 2 November 2012, as a part of his appeal application that was submitted on or about 28 November 2012. 6. Other than the Standard Forms 600 provided by the unit's medical professionals, there is no other corroborating medical documentation that definitively shows the applicant's inability to perform the 4 ADLs for the total period of 120 days. The TSGLI decision, reviewed by staff physicians, denied the initial application, the subsequent reconsideration, and the appeals based on a review of his medical records and evidence submitted. Furthermore, their opinions are tempered by a knowledge of the treatment histories of numerous applicants with the same set of medical circumstances. 7. Notwithstanding the denials by the TSGLI office at HRC, there appears to be a period of 83 days in which the applicant was dependent on someone else, either by direct hands-on or stand-by assistance, for the ADLs of bathing, dressing, toileting, and transferring. This period, 17 November 2010 to 7 February 2011, is defined from the initial injury to the approximate end of the attending surgeon's post-operative examination restrictions of 6 weeks. 8. In accordance with TSGLI guidelines, when a member is unable to perform 2 of the 6 ADLs due to traumatic injury other than traumatic brain injury, payments for loss of ADL will be made as $25,000 at the 30th consecutive day and an additional $25,000 at the 60th, 90th and 120th consecutive day. 9. 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 did submit evidence that would satisfy that requirement. As a matter of equity and fairness, the applicant's corroborated medical documentation clearly shows a period of 83 days of loss, thereby falling in between payments for the 60th and 90th consecutive days. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20150001430 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20150001430 14 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2