IMPORTANT NEW INFORMATION: PRESIDENT OBAMA HAS JUST SIGNED INTO ACT THE 2010 VETERANS BENEFIT ACT!
This means that Retroactive traumatic injury protection coverage under TSGLI will be expanded to include veterans who incurred qualifying traumatic injuries on or after Oct. 7, 2001, regardless of where the injuries occurred.
INJURED SOLDIER--GET UP TO $100,000.00 CASH PAYMENT!
If you qualify under your TSGLI (Traumatic Servicemembers Group Life Insurance) coverage.
TSGLI is a complicated combination of Government regulations and private insurance--We are successful at handling TSGLI cases.
NOTE: MANY CLAIMS ARE BEING IMPROPERLY DENIED AT THE CLAIMS LEVEL AND COURT ACTION MAY BE REQUIRED.
Soldiers injured from December 1, 2005 to present are covered if you made payments for SGLI insurance (most everyone is covered due to automatic deduction of $1 per month from pay.
The loss must have occurred within 2 years of traumatic injury.
If you were injured after December 1, 2005, injury can be under nearly any circumstance and in any location. You do NOT have to be in a combat zone or even on duty. For example, civilian auto accidents are covered! Active, Reserve or National Guard members are covered.
"Present Service Members, Reservists, National Guard-If you have received a serious traumatic injury from any source on or off duty (even auto accidents) you may be entitled to up to $100,000.00 under the TSGLI (Traumatic Servicemembers Group Life Insurance) program!" ALL BRANCHES OF THE ARMED SERVICES ARE COVERED.
NOTE: In addition to scheduled injuries such as loss of limb, sight, hearing etc. a solder can get a scheduled payment for OTI, other traumatic injury.
A solder with any traumatic injury (OTI) can get a TSGLI payment if you cannot do ADL. Claims may be filed for loss of ability to do Activities of Daily Living (ADL) if the claimant is unable to independently perform any two (2) of the following (6) activities on a day-by-day basis for 30 days or more (15 days or more in the case of Traumatic Brain Injuries. Also, if you were hospitalized for 15 days, you automatically get the first $25,000). For each 30 days you qualify, you would receive another $25,000 payment up to $100,000.
What are the activities of daily living (ADLs)?
1. Eating----needs assistance in eating. Example: unable to get food from dish to mouth, or cannot grip or lift fork, or cannot lift or hold plate, glass, or cup or canâ€™t shake the salt etc.
2. Dressing--------needs assistance getting dressed. Example: Cannot pull shirt over head, or cannot button shirt, or cannot put foot into pants, or cannot put on or fasten belt, or unable to put on socks or shoes, or cannot tie shoes or boots without assistance
3. Bathing-----needs assistance in bathing or cannot get in and out of shower or bathtub, or cannot wash self without help from another person
4. Transferring---needs assistance from another person, or possibly even a cane or other assistive device,
to get in and out of bed or chair or car
5. Toileting-------needs assistance to go to and from toilet, or any help while in toilet
6. Continence----caregiver gives some assistance or has daily accidents
NOTE: IF YOU NEED EVEN A LITTLE HELP TO DO ANY ONE OF THE ITEMS NEXT TO A NUMBER --YOU ARE DISABLED UNDER THAT ADL-YOU DO NOT HAVE TO BE UNABLE TO DO THE WHOLE LIST! If a soldier cannot do number 4 (transferring), they obviously cannot do number 5(toileting).
Also, these are just examples, there may be actions you need assistance with that are not listed- that will still qualify you as disabled, everyone is different!
NOTE: This is my interpretation of how the rules should be applied!
THE INABILITY TO DO ADLS IS THEMAIN WAYTO PROVE UP MOST TSGLI CLAIMS AND GET THE PAYMENT YOU ARE ENTITLED TO!
Note to Claimants and Health Care Professionals:
The Part B (the section filled out by health care providers) form in use before 10-08 incorrectly states completely dependent upon another person to perform a listed activity-this is WRONG- see language above- the correct legal standard is now used by the VA in newer materials.
Unable to Independently Perform
The new Application Form and new Part B Medical form uses this standard-make sure you are using the latest application form with date at the bottom of page.
Do a search on your computer using TSGLI Application and you will see the latest form to start your claim.
A soldier needing assistance of another person, to get to the bathroom, or, (under 2008 changes to the rules) needs someone standing by (standby assistance) in case they need help or even needs verbal assistance-- would meet that ADL since he/she cannot independently perform that activity. Health Care Provider filling out the Part B---Make SURE you put the beginning and ending date (or check continuing) of the particular ADL.
Solders may also need medical reports and other evidence of treatment which proves there was an injury and the nature and extent of that injury.
Note: The above is my view of the correct way to interpret the TSGLI policy, law, and intent of Congress.
PTSD claims are not presently covered; however, many TBI (Traumatic Brain Injury) symptoms-WHICH ARE COVERED-may be mischaracterized by the VA as PTSD.
IF YOU HAVE BEEN DENIED, NO MATTER THE LOCATION, CALL US TOLL FREE AT 1-877-966-4968 OR SEND US A MESSAGE USING THE CONTACT US BOX BELOW. PLEASE INCLUDE YOUR PHONE NUMBER IN THE EMAIL SO THAT WE MAY CONTACT YOU.