News: TSGLI: Know your benefits
Story by Lance Cpl. Damany Coleman
NORTH CAROLINA - Since Sept. 2001, the Traumatic Injury Protection Under Service members' Group Life Insurance provides for payment to service members who are severely injured, on or off duty, as the result of a traumatic event and suffer a loss. They all qualify for the Service Members’ Group Life Insurance Traumatic Injury Protection program.
“We need to get the word out so the Camp Lejeune area knows about this program,” said William Klemm, a medical support assistant at the Battalion Aid Station, Wounded Warrior Battalion-East. “When the program started, it was for combat wounded only. If you were non-combat wounded, you couldn’t receive any compensation. Now you can submit a claim.”
The TSGLI payments are designed to help traumatically injured service members and their families with financial burdens associated with recovering from a severe injury. TSGLI payments range from $25,000 to $100,000 based on the qualifying loss suffered, if they meet all the criteria, said Klemm.
“It has to be from a traumatic event,” said Klemm. “Trauma is an external force hitting your body. It’s not for kidney failure, diabetes or cancer, or any disease type processes.”
Every member who has SGLI also has TSGLI as of Dec. 1, 2005. TSGLI coverage is automatic for those insured under basic SGLI and cannot be declined. The only way to decline TSGLI is to decline basic SGLI coverage.
There are also two types of TSGLI claims: traumatic brain injuries and other traumatic injuries.
“If you experience or have losses, hearing, sight, fingers, burns, coma, you can submit a claim and possibly receive compensation,” said Klemm. “If you have been hospitalized for 15 days or more, including medical evacuation time, you can submit a claim. Knowing your benefits should be just like knowing your general orders. If you get hurt, you’re eligible for this.”
Service members and their families typically know the plan of action after loss of life. Klemm believes they need to know what to do when they get hurt.
“That money is to help out during that period of time,” said Klemm. “It’s not to go out and buy a brand new vehicle. There are also financial services available in the contract to help service members because it’s a substantial amount of money.”
Klemm added that the compensation service members receive should be put away for a ‘rainy day’ when they’ll need it later on.
To be eligible for payment of TSGLI, you must meet all of the following requirements:
- must be insured by SGLI when you experience a traumatic event
- must incur a scheduled loss and that loss must be a direct result of a traumatic injury
- must have suffered the traumatic injury prior to midnight of the day that you separate from the uniformed services
- must suffer a scheduled loss within 2 years (730 days) of the traumatic injury
- You must survive for a period of not less than seven full days from the date of the traumatic injury
As long as the service member experienced the traumatic event while in service and covered by SGLI, they can apply for the benefit even if they have been discharged.
Another part of filing for TSGLI would require the service member to need assisted daily living. There are six different types of ADLs, which are bathing, dressing, toileting, eating, transferring and incontinence. Service members must meet two out of the six ADLs to submit a claim, along with all medical documents to support it.
If the service member dies as a result of the traumatic injury, TSGLI is still payable if the member survived for a period of not less than seven full days from the date of the traumatic event and died before the maximum benefit for which the Service member qualifies is paid.
Payment of TSGLI has no impact on the amount of SGLI payable. For example, if a service member is insured for $400,000 of SGLI coverage and receives a TSGLI payment of $50,000 for a traumatic injury, that member is still insured for the full $400,000 of SGLI coverage, which will be paid upon the Service member's death.
Effective November 26, 2008, VA has increased the number of traumatic injuries covered under TSGLI as well as liberalizing the criteria of other injuries.
The TSGLI program is modeled after the dismemberment portion of commercial Accidental Death and Dismemberment policies, expanded to take into account the unique circumstances of military service. AD&D policies typically do not cover illnesses, diseases or minor injuries.
“Right now, a lot of them are still fairly young and the injuries may not bother them very much,” said Klemm. “When they get older, what happened in Afghanistan or Iraq is going to be bothering them a lot. They should use it to ease the aches and pains or something positive and not materialistic. By all means, take care of yourself, but save that to help you out later down the road.”
For more information contact the Office of Service members' Group Life Insurance by phone at 1-800-419-1473 or by email at firstname.lastname@example.org.