Do You Need a TSGLI Benefits Attorney
If you have suffered a severe traumatic injury during U.S. military service, you may qualify for a special benefit of up to $100,000 tax-free through The Servicemembers’ Group Life Insurance Traumatic Injury Protection Program, known as TSGLI. However, service members’ claims for benefits are often turned down initially or members receive a settlement offer that is less than it should be. The injury and disability lawyers of the Disparti Law Group Accident & Injury Lawyers, P.A. can help if you are entitled to TSGLI benefits that you have been unfairly denied. We also can assist Florida veterans in the initial TSGLI claims process to help ensure the claim is not rejected and benefit payments are not delayed.“If you are a traumatically wounded warrior or a veteran’s family member who is concerned about a TSGLI claim, contact us today for a free initial consultation at (888) 711-7920 or fill out our online contact form.
Coverage Under the TSGLI Progra
The TSGLI Traumatic Injury Protection Program is an insurance program designed to provide severely injured service members a monetary benefit to help the member and their family through a long recovery period. It is bundled with Servicemembers’ Group Life Insurance (SGLI) and an additional $1 was added to the SGLI premium to cover TSGLI. A “Qualifying Traumatic Injury” under TSGLI is an injury or loss caused by an external force, violence, or a condition whose cause can be directly linked to a traumatic event. Veterans who were injured on or after December 1, 2005 must have been insured by SGLI at the time of the traumatic event to be eligible for TSGLI benefits. Vets who were injured between October 7, 2001 and November 30, 2005 were made retroactively eligible for TSGLI benefits. As long as the service member experienced the traumatic event while in service, they can apply for the benefit, even if they have since been discharged. You will not be eligible for benefits if your injuries are due to:
- Self-inflicted wounds
- Attempted suicide
- An injury caused by the willful use of an illegal or controlled substance not under prescription
- Committing or attempting to commit a felony
- Medical or surgical treatment of an illness or disease
- A mental or physical illness or disease, unless the illness or disease is caused by:
- A pyogenic (pus forming, often from a wound) infection, biological, chemical, or radiological weapon
- Accidental ingestion of a contaminated substance.
TSGLI pays a one-time benefit ranging from $25,000 to a maximum of $100,000, depending on the service member’s qualifying loss. In most cases, covered losses may be combined and treated as one loss for purposes of a single payment. Covered losses include:
- Sight (vision)
- Hearing
- Speech
- Paralysis (quadriplegia, hemiplegia, paraplegia, uniplegia)
- Burns (2nd degree or worse to 20 percent of body or face)
- Amputations
- Salvaged limbs (in lieu of amputation)
- Facial reconstruction
- Traumatic Brain Injury (TBI)
- Coma from traumatic injury and/or TBI resulting in inability to perform at least two “Activities of Daily Living” (ADL)
- Genitourinary losses (anatomical loss or loss of use of testicle(s), penis, vulva, ovary(s), uterus, vaginal canal, urinary system).
Obtaining Your TSGLI Benefit
To apply for a TSGLI benefit payment, the injured service member, guardian, power of attorney, or military trustee must complete the required SGLV 8600 Application for TSGLI Benefits form. A healthcare provider must complete Part B of the form. Part B should provide details of the injuries that qualify the service member for the TSGLI benefit. The service member must also provide medical documentation of their injury(s) and an explanation of how they ocurred. These documents may include:
- Occupational/physical therapy report (ADL documentation)
- Neurological reports (TBI/ADL documentation)
- OR report (amputation)
- Hearing test results (for hearing loss)
- Eye test results (for sight loss)
- Speech test results (for speech loss)
- Patient discharge summaries
- Medical summary and/or history
- Patient movement request
- Radiographic reports (X-Ray, MRI, ultrasound, etc.)
- Accident report
- Line of duty (LOD)
- Medical/physical evaluation board (MEB/PEB)
- Other diagnostic test results (e.g., lab reports, etc.)
- Other pertinent documents demonstrating injury type and duration of ADL loss.
You can only file one TSGLI claim per traumatic event, regardless of the number of traumatic injuries incurred in a given event. If you receive multiple traumatic injuries from the same event, you should file only one TSGLI claim, but it should include information about all traumatic injuries suffered as a result of that one event. Each branch of the service processes its members’ TSGLI claims. The Department of the Army says the average processing and adjudication time for a claim is approximately 120 days after the claim application is received. Incomplete forms, missing medical documentation, and incorrect or missing contact information can result in a longer processing time.
Once the Army, for example, makes a decision, the claim is forwarded to the Office of Servicemembers’ Group Life Insurance (OSGLI) for review. It will take an additional 14 business days after OSGLI receives the claim to complete the process, the Army says. If your claim was approved, you will receive a monetary deposit in the financial institution you chose on the TSGLI claim form. If your claim is denied, you will be advised by mail from either OSGLI or TSGLI, and the letter will contain guidance regarding filing an initial appeal, known as reconsideration.
Legal Assistance with Your TSGLI Claim
Many traumatically injured veterans have found that obtaining TSGLI benefits is no simple task. The burden of proof is on the veteran, but it can be difficult for a severely injured veteran to obtain the required documentation. In many cases, records from field hospitals are incomplete or missing, and finding witnesses to the traumatic event is difficult, or impossible if a witnessing service member has since died. A Disparti Law Group Accident & Injury Lawyers’s TSGLI claims lawyer can help you with your claim, whether it is an initial application or an appeal. We can ensure your records are complete and provide a full explanation of your injuries and the harm they have caused you. If we believe that you need additional medical exams to document your injuries, we can help you obtain help through many qualified medical professionals. Working with the Disparti Law Group Accident & Injury Lawyers ensures thatr you are not on your own as you face the military/medical/insurance bureaucracy to ask for the benefits you have earned. We know the way, and we will stand beside you and fight for you.
How Can I Afford to Hire a TSGLI Benefits Lawyer?
During an initial consultation, which is free, we will review the specifics of your accident and discuss your legal options. If we determine that we can handle your case, we will represent you on a contingent fee basis. You will not be charged for legal fees or costs unless we obtain compensation for you through a settlement or court award. At that time, the fee for our legal representation will come from a percentage of the final award.
