IN THE CASE OF: BOARD DATE: 13 July 2021 DOCKET NUMBER: AR20180005154 APPLICANT REQUESTS: payment of Traumatic Servicemember Group Life Insurance(TSGLI) Injury Protection for injuries that resulted in loss of Activities of Daily Living (ADL) in the amount of $25,000. He also requests a personal appearance before the Board APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * Acknowledgment of Representation * 3 Attorney Letters * Application for TSGLI Benefits * Applicant Statement TSGLI Claim * Applicant’s Parent T__ Statement * 2 Registered Nurse B__ Letters * 4 U. S. Army Human Resources Command, Human Resources Command TSGLI Letters * Copy of CFR 9.20-Traumatic Injury Protection Law * Medical Records * 5 United States District Court Decisions FACTS: 1. The applicant states, through his attorney: a. The applicant’s TSGLI claim for losses of ADL for 30 days has been denied. The most recent decisions dated 5 March 2018 provides reliance on some medical records. However, a close examination of the letter does not show a complete assessment of the evidence that shows required assistance due to ADL losses for 30 days. The nature of the injuries, treatment, recovery time, bilateral casts, immobility “after” the casts were removed, records, and statements show that some improvement did not alleviate the requirement of ADL assistance until 30 days. The assumption made by the TSGLI office for ADL adaptivity are also not consistent with the actual TSGLI standards for ADL losses, see below. b. The applicant claimed four ADLs requiring physical assistance: dressing, toileting, eating, and bathing, but only two ADLs are required. In the recent decision letter, assistance with dressing was conceded. However, statements, opinions, reasonable recovery time to perform ADLs, and the overall records outweigh a few presumptions from the TSGLI office based on selectively mentioned notes in the records. c. In sum, the evidence allows more than one ADL to be found to require assistance for at least 30 days, and it was an error not to provide TSGLI benefit, it should also be noted that the TSGLI application and procedure guide have minimal requirements for the ADL tasks that require assistance. “He/She requires assistance from another person to bathe (including sponge bath) more than one part of the body or get in out of the tub or shower.” “He/She requires assistance from another person with any of the following: going to and from the toilet, getting on and off the toilet, cleaning self after toileting, getting cloths off and on.” “He/She requires assistance from another person to get food from plate to mouth or take liquid nourishment from a straw or cup.” “There only needs to be a small part of each ADL that requires assistance.” The medical records do not assess ADLs under these standards. As such, this assessment is not in accordance of the law, and is in error, and unjust, and should be corrected. d. TSGLI program benefits are administered by the Secretary of the Veterans Administration and 38 USC§ 5107(b) is fully applicable to TSGLI benefit determinations. As such, the standard applicable in this case is of “substantial evidence", meaning: "[w]hen there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant." 38 U.S.C. § 5107(b). see also Koffarnus v. United States, 2016 WL 1261155, *6 n. 6 (W.D. Ky. Mar. 30. 2016). Please review under this standard. The applicable case law and statutory law is enclosed as Exhibit B". 2. The applicant provides: a. Acknowledgment of representation, dated 20 February 2015, that states the applicant has retained counsel, and will represent him in the entirety of his claim for any and all loss, damage or injury he suffered until his case is settled, when final judgment or verdict is handed own, or until further notification. b. Attorney letter, dated 16 March 2015, shows he had been retained by the applicant to file a claim for TSGLI benefits. The TSGLI claim for a traumatic injury leading to a loss of ability to independently perform at least two ADLs for over 30 days. On 26 March 2006, he was assaulted and stabbed multiple times at a NY club. He was admitted to Roosevelt Hospital, NY for emergency treatment. He suffered stab wounds to both hands, chest, abdomen, left lung leg and left buttock. Surgery to repair the tendon lacerations of both hands was performed on 27 March 2006. On 30 March 2006, he was discharged with casts on both arms/hands to the care of his mother, T__, who is a nurse’s aide. His right cast was removed after 4 weeks. The left cast was removed 6 weeks later and replaced with a soft cast. (1) He was unable to independently bathe/groom, dress, eat and toilet without physical assistance for a period of over 30 days. His mother assisted him on a daily basis with these ADLs, as he was physically unable to do them on his own due to the casts on both arms/hands. (2) His medical records have been reviewed by an independent registered nurse, B__, RN, BSN. She has further confirmed the extent of the traumatic injuries as well as the impact that these injuries had on him. (3) He is entitled to recovery of $25,000.00 under the TSGLI coverage. Therefore, in light of the foregoing, his attorney, requests $25,000.00 be issued to his law offices under the TSGLI Schedule of Losses #20 for suffering a traumatic injury resulting in inability to perform at least two ADLs for over 30 consecutive days of ADL loss, but less than 60 days, which under Schedule of Losses #20, qualifies for $25,000.00. 3. Review of the applicant’s service records shows: a. He enlisted in the New York Army National Guard (ARNG) on 26 July 2001. He entered active duty on 25 June 2002 to 13 February 2003, and completed training for award of military occupational specialty 25U (Signal Support Systems Specialist). b. He entered active duty on 1 October 2003. He served in Kuwait/Iraq from 24 February 2004 to 1 January 2005. He was honorably released from active duty on 6 February 2005. c. Incident Report, dated 26 March 2006, states the applicant was assaulted with a knife outside of a club and received multiple stab wounds to both hands, left knee, left buttock, left chest, and left abdomen. Traumatic injury resulting in inability to perform at least 2 ADL for 30 days. The document lists the applicant’s hospitalization and other medical details. d. He again entered active duty on 17 January 2008. He served in Afghanistan from 28 March 2008 to 2 January 2009. He was honorably released from active duty on 17 February 2009 with an honorable character of service. e. Post-operative care, dated 13 March 2012, shows his treatment, diagnosis for flexor tendon repair and medications prescribed. f. Orders 212-1050, dated 31 July 2014, shows he was honorably discharged from the ARNG effective 25 July 2014 for expiration term of service. His NGB Form 22 (Record of Service) shows the applicant was honorably discharged from the ARNG on 25 July 2014. It also shows that he completed 13 years of service. 4. Review of the TSGLI Case, dated 2015, shows the following: a. The applicant submitted a claim for Other Traumatic Injury (OTI) related TSGLI program specific ADL loss of greater than 30 days, claimed from 26 March 2006 to 25 April 2006): Inability to Bathe, Inability to Dress, Inability to Eat, and Inability to Toilet. OTl-related AOL loss is awarded by $25,000 increments at the milestones of 30, 60, 90, and 120 days of consecutive loss. The maximum payment for this loss is $100,000. For determining if a member has a loss of TSGLI program specific ADLs, the TSGLI Guidebook states "the member is considered to have a loss of AOL if the member requires assistance to perform at least two of the six activities of daily living. If the member 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." b. Self-Authored letter, dated 13 March 2015, states that on 26 March 2006, he was assaulted and stabbed and was admitted to the hospital for surgery on his left and right hand to repair tendons; after surgery he had a body cast on both hands and his mother had to assist him for 4 weeks and an additional 2 months until he was no longer under care. c. Parent letter (Mother), dated 13 March 2015, states that she had to provide personal care for him after he was discharged from the hospital under her care; she is also a medical assistant and nurses aid by profession; the applicant had a cast for 4 weeks and required help with bathing, feeding and had to do everything for him. d. Nurse Reviewer letter, dated 13 March 2015, states that a review of the records provided for the applicant confirmed that he was assaulted and stabbed multiple times at club. He was treated and sustained injuries to include lacerations on right hand, tendon lacerations on left index finger, left buttock, and left knee and left hip. Bilateral hand surgery to repair to repair the tendon was performed on 27 March 2006; from 26 March 2006 to 25 April 2006 he was unable to independently perform ADL’s and required assistance with bathing/grooming, dressing, eating and toileting. His mother provided daily assistance with ADLs. Without the use of either hand for over 4 weeks, he was unable to feed himself, bathe, groom, dress or use the toilet on his own. The right cast was removed after 4 weeks. The left cast was removed after 6 weeks and replaced with a soft cast. Due to the inability to us both of his hands, it is reasonable to state that he would have been unable to perform ADLs specified without physical assistance while casted for a period of at least 30 days. e. Army Human Resource Command (HRC) letter, dated 7 August 2015, states that the TSGLI office had received his incomplete TSGLI application and that additional information was required in order to process his claim. A checklist was provided. f. HRC Letter, dated 10 November 2015, explained that his claim was not approved because hospitalization was not approved as his loss did not meet TSGLI medical standard; Medical documentation provided with his claim did not indicate that he was hospitalized for 15 consecutive days or greater. g. Attorney Letter to AHRC, dated 10 December 2015, states that the applicant requested that TSGLI provide a de novo review of this claim and to evaluate all of the evidence submitted herein to support his claim for ADL losses; the TSGLI office must work only within the guidelines of 38 C.F.R 9.20-the absence of potential bad faith insurance actions, which is a check and balance system on wrongful denials, creates a greater responsibility of the TSGLI to be self-policing, and there must be careful consideration to avoid wrongful denials, to fully consider the totality of all evidence and provide the benefit. h. Nurse Reviewer letter, dated 10 December 2015, states that a review of the records provided for the applicant confirmed that he was assaulted and stabbed multiple times at club. He was treated and sustained injuries to include lacerations on right hand, tendon lacerations on left index finger, left buttock, and left knee and left hip. Bilateral hand surgery to repair the tendon was performed on 27 March 2006; from 26 March 2006 to 25 April 2006 he was unable to independently perform ADLs; Speaking from her experience as a nurse and independent medical record reviewer for many years, military and civilian medical staff rarely documented the inability to perform ADLs. This is a common and widely recognized problem with these types of TSGLI claims for ADL losses. Thus, the branch of service for TSGLI must take into account all evidence to support ADL losses as there is not contrary evidence to support he was able to perform his ADLs independently. It is common sense that from the date of his initial injuries and postoperatively for the first 4 weeks after his bilateral hand surgeries, he would not have been able to use his hands to perform the ADLs specified. It was her professional opinion that he would not have been able to perform his ADLs without assistance due to the severity of his bilateral hand injuries, immobilization, decreased strength and limited range of motion form the date of his initial injury and following his surgery up to a period of at least 4 weeks. i. Information regarding nerve repair therapy (google search 10 December 2015) shows therapy instructions timeline following post-operative surgery. j. HRC Letter, dated 18 July 2016, states the applicant’s claim was not approved because the medical documentation provided did not cover the time period claimed per the TSGLI guidelines, as subsequent appeals to this case should contain “new and material evidence”, which is to say that the evidence should be both new and not previously considered. k. HRC Letter, dated 5 March 2018, states the claim was not approved because when determining ADL loss, the TSGLI procedural Guide states “the member is considered to have a loss of ADL if the member requires assistance to perform at least two of the six activities of ADL; if the patient is able to perform the activity by using accommodating equipment, the patient is considered able to independently preform the activity. The Army TSGLI program office was unable to overturn the previous adjudication concerning claimed loss of ADL from the traumatic event on March 26, 2006 in New York. When determining ADL loss, the TSGLI Procedural Guide states "the member 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." (1) The medical record does not support TSGLI payment at the 30 day milestone. The March 26, 2006 Hand Surgery Consultation Note documents the Soldier had full flexion and extension of the left thumb and all of the right fingers and thumb. The March 30, 2006 (Day 5 after the traumatic event) 24 Hour Nursing Assessment/Documentation Record documents he met the outcome criteria of performing ADLs to optimal independence and was out of bed independently. It states he was independent with feeding and toileting. The March 30, 2006 Discharge Nursing Assessment documents he was ambulatory with a steady gait, but needed assistance with grooming. It shows his left hand/wrist was still in a splint, but his right hand was merely wrapped with a dressing and ACE wrap. The April 3, 2006 (Day 9 after the traumatic event) Surgery Clinic Note documents his abdomen, chest, knee, and buttocks were superficial with no signs of infection. Since the wounds were superficial with no signs of infection, it is reasonable to assume they would be healed and no longer require dressings prior to the 30 day milestone. The April 22, 2006 (Day 28 after the traumatic event) Doctor's Note documents his left hand/wrist was still in a cast with the index and middle fingers attached to rubber bands. It records right small finger active ranges of motion were within functional limits. This note shows his right hand had returned to a functional status by this time. (2) With a functional right hand along with a functional left thumb (as noted in March 26, 2006 Hand Surgery Consultation Note) and his remaining functional joints throughout his body, he should be able to bathe (with a long-handled sponge in his right hand), eat, and toilet in at least a modified independent manner per TSGLI guidelines. He may still require assistance with dressing at that time, however this is only one ADL, which does not meet the 2 or more ADL standard needed for payment. Therefore, the Other Traumatic Injury-related ADL loss claim does not qualify for TSGLI payment at the 30 day milestone. (3) The applicant's and his mother's statements were considered for this adjudication. The statement that his mother provided ADL assistance is accepted. However, the fact that she provided ADL assistance is not the standard for TSGLI payment. The standard is that the ADL assistance must have been rendered because without such assistance the Soldier could not have performed ADLs in even a modified independent manner. Both statements declare he had casts on both hands for over 4 weeks, however the medical record does not support this declaration. As noted above, his left hand was in a cast for over 4 weeks, however the right hand was not in a cast at the earliest by Day 5 after the traumatic event and the latest Day 28 after the traumatic event. The medical record shows the right hand and fingers were also functional at the latest by Day 28 after the traumatic event. Therefore, the right hand could be used to perform basic ADLs in at least a modified independent manner prior to the 30 day milestone. 5. By regulation (AR 15-185), the ABCMR may, in its discretion, hold a hearing or request additional evidence or opinions. Applicants do not have a right to a hearing before the ABCMR. The Director or the ABCMR may grant a formal hearing whenever justice requires. 6. The TSGLI 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. Part II losses include traumatic injuries resulting in the inability to perform at least two 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 required assistance from another person 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. 7. MEDICAL REVIEW: a. The claimant through counsel, requests compensation through the TSGLI program for required assistance for 30 days or more but less than 60 days, for 4 ADLs (activities of daily living). The claimed loss was due to the other than traumatic brain injury event on 26Mar2006 when he sustained lacerations to digits on both hands when he was assaulted and knifed at a club in Manhattan. The Army Review Boards Agency Medical Advisor was asked to review this request. The review included, but was not limited to the claimant's medical and military records; the claimant’s mother’s statement; the independent nurse reviewer’s statement (13Mar2015, 10Dec2015 and 13Aug2016); the claimant’s counselor’s brief; and the TSGLI Procedural Guide. The records were carefully reviewed. b. The claimant was admitted to Roosevelt Hospital on 26Mar2006 and was discharged on 30March2006. As a result of the nightclub stabbing, he underwent repair of lacerations to tendons of the right 5th digit ulnar digital nerve; and repair of flexor tendons of the left 2nd and 3rd digit on 27Mar2006. He also sustained superficial wounds to left knee, left buttock, left chest, and left abdomen. c. The claimant contends they were unable to perform the following ADLs for greater than 30 days after the event (from 26Mar2006 to 25Apr2006): (1) Unable to bathe independently because he was unable to groom and bathe due to inability to use his hands. He required physical assistance. (2) Unable to dress independently. He needed assistance to put on/off clothing due to inability to use his hands. He required physical assistance. (3) Unable to eat independently. He required assistance getting food to his mouth due to inability to use his hands. He required physical assistance. (4) Unable to toilet independently. He required assistance to get pants up/down and to clean himself due to inability to use his hands. He required physical assistance. d. The claimant’s mother provided written testimony that the applicant was discharged to her care (who is herself a medical assistant and nurse’s aide) and that she provided assistance with bathing/showering and feeding because her son had casts on both hands for over 4 weeks. The 13Mar2015 Independent Nurse Reviewer indicated that the medical documents were reviewed summarizing treatment received. The testimony that the reported care was provided is accepted. However, the fact that care was provided is not the TSGLI standard. The standard is that the assistance must be necessary and without with the task would not be able to be completed. e. The medical treatment records showed the following: (1) 26Mar2006 (Day 1 after the event) Emergency Room Note showed the claimant was seen for multiple stab wounds. On exam right hand had full ROM. (2) 26Mar2006 (Day 2) Trauma Surgery Note indicated the claimant was admitted to ICU. The 8A East ICU note documented the claimant was unable to move the left II and III digits but the sensation was normal. The right hand had movement of all fingers and sensation was within normal limits. (3) 27Mar2006 (Day 2) Blue Surgery Resident (pre-surgery note) indicated that the left hand was wrapped and splinted and motor function could not be tested. The right hand showed 3/5 flexion strength and extension strength of the 5th digit; and the rest of the hand had good motor and sensory function. (4) 28Mar2006 (Day 3) 24 Hour Nursing Assessment/Documentation Record showed that he was independent with feeding, but needed help with grooming. His physical mobility was also impaired. (5) 28Mar2006 (Day 3) Orthopedic Post-Op notes showed that the claimant had left hand tendon repair; and right 5th digit ulnar nerve repair. (6) 28Mar2006 Patient Order Session showed the orders included instructions to begin the Kleinart Protocol for the left hand: An early motion program for rehabilitation of flexor tendon injuries. (7) 29Mar2006 (Day 4) Nursing Note: Foley catheter was discontinued (8) 29Mar2006 (Day 4) Occupational Therapy Initial Assessment: The claimant had active range of motion (ROM) for the shoulder and elbow that were within functional limits. Sensation was minimally decreased to digits in the left hand. The right hand digits I, II and III had active ROM within functional limits. The right hand was in an ulnar gutter splint. Motor muscle testing was 2+ to 3 out of 5. Digits IV and V were limited by the cast. Left hand digits I-V were limited by the cast (Kleinart splint) and precautions. (9) 29Mar2006 (Day 4) 24 Hour Nursing Assessment/Documentation Record (5pm) documented that the claimant’s functional status/safety status was that he needed assistance with self-care. He had impaired physical mobility. (10) 30Mar2006 (Day 5) 24 Hour Nursing Assessment/Documentation Record (4am) documented that the claimant’s functional status/safety status was independent with feeding, toileting, and grooming. His gait was steady and could get out of bed as desired. (11) 30Mar2006 (Day 5) Discharge Nursing Assessment indicated that concerning his ability to perform ADLs, he needed assistance with grooming. It was not selected that he needed complete care. It was also not selected that he needed assistance with eating or ambulating. He was discharged with the left hand splinted and an ace wrap. Compared to the unaffected fingers, he had decreased sensation in the left II and III digits but was able to move them with effort. He was noted to be able to wiggle the right 5th digit. He was reminded about the importance of ROM activity. He denied pain. (12) 30Mar2006 (Day 5) Blue Surgery Resident (post-surgery note) (13) 30Mar2006 Discharge instructions included that he was discharged to self- care. It also indicated that he was to avoid lifting. (14) 22Apr2006 (Day 28) Naturo-Medical Health Care PC Doctor’s Note recorded that there was right 5th digit active ROM was within functional limits. The right hand was not noted to be splinted. In contrast, the left hand was still splinted. This note showed that the applicant had full use of his right hand; however, complete use of the left hand was still impaired. f. Review of the medical documentation provided does not indicate that the claimant’s loss met the minimum TSGLI standard. By the 28th day, records showed that the applicant had full use of the right arm and hand as well as fully operational lower extremities. As such, he would be able to eat with one hand. He would be able to bathe independently with or without assistive equipment. In addition, he would be able to adjust clothing to toilet independently. Indeed, he was able to independently perform these tasks at the time of discharge. However, it is acknowledged that he may have still required some assistance with dressing. Based on review of available evidence, the claimant’s loss did not meet the minimum requirements for a loss of 2 ADLs under TSGLI standard for 30 days, for traumatic injury other than traumatic brain injury. BOARD DISCUSSION: After reviewing the application and all supporting documents, the Board determined it could reach a fair and equitable decision in the case without a personal appearance by the applicant. The Board also determined relief was not warranted. Based upon the available documentation and the findings and recommendation of the medical advisor, the Board concluded there was insufficient evidence of an error or injustice which would warrant payment of Traumatic Servicemember Group Life Insurance(TSGLI) Injury Protection for injuries to the applicant. BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 : : : GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING :XXX :XX :XXX 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. 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. 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. 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) 2. 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. 3. 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, facial reconstruction, and coma from traumatic injury and/or traumatic brain injury resulting in the inability to perform 2 Activities of Daily Living. 4. Part II losses include traumatic injuries resulting in the inability to perform at least two 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 required assistance from another person 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. 5. 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. d. Limb Salvage: A series of operations designed to save an arm or leg rather than amputate. 6. Veteran Affairs (VA): Traumatic Injury Protection (TSGLI) provides short-term financial support to help eligible service members recover from a severe injury while serving in the military, find out how to file a claim for TSGLI or appeal a past decision. To qualify applicant must: * Have a scheduled loss that is a direct result of the traumatic injury * Suffered the traumatic injury before midnight on the day before leaving the military * Suffered a scheduled loss within 2 years (730) days of the traumatic injury * Have survived for a period of not less than 7 full days from the date of the traumatic injury * Were an Active Duty military member, a Reservist, a National Guard member, on funeral-honors duty, or on 1-day muster duty 7. Veteran Affairs (VA): Traumatic Injury Protection (TSGLI) excluded injury claims includes: * Self-inflicted on purpose or the result of an attempt at self-injury * Involve the use of an illegal drug or a controlled substance that was given or taken without the advice of a medical doctor * Be the result of medical or surgical treatment of an illness or disease * Occur while your committing or trying to commit a felony * 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 accidentally swallowing a contaminated substance) 8. Veteran Affairs (VA): Traumatic Injury Protection (TSGLI) if a service member or former service member was injured between 7 October 2001 and 30 November 2005, and meets all of the TSGLI qualifications, a service member or former service member may use this benefit no matter where the injury happened (whether on or off duty) or even if SGLI coverage was not in effect when the service member or former service member was injured. Service members who are covered by SGLI are covered by TSGLI. 9. AR 15-185, (ABCMR) prescribes the policies and procedures for correction of military records by the Secretary of the Army, acting through the ABCMR. The ABCMR begins its consideration of each case with the presumption of administrative regularity, which is that what the Army did was correct. a. The ABCMR is not an investigative body and decides cases based on the evidence that is presented in the military records provided and the independent evidence submitted with the application. The application has the burden of proving an error or injustice by a preponderance of the evidence. b. The ABCMR may, in its discretion, hold a hearing or request additional evidence or opinions. Additionally, it states in paragraph 2-11 that applicants do not have a right to a hearing before the ABCMR. The Director or the ABCMR may grant a formal hearing whenever justice requires. //NOTHING FOLLOWS// ABCMR Record of Proceedings (cont) AR20180005154 11 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1