Traumatic Servicemembers’ Group Life Insurance (TSGLI) Claims and Appeals

When injured while serving in the U.S. Armed Forces, National Guard, on active duty or reserve, you could qualify for a tax-free benefit totaling up to $100,000.

TSGLI, formerly known as Traumatic Servicemembers’ Group Life Insurance program allows automatic catastrophic injury coverage to those already covered under Servicemembers’ Group Life Insurance program, or SGLI. This program provides support to injured service members along with their families, helping alleviate financial burdens with a benefit payment ranging from $25,000 to $100,000. A qualifying injury does not have to be service-connected or be combat-related. Furthermore, applying for and receiving Traumatic Servicemembers’ Group Life Insurance benefits will not affect a service member’s ongoing Veteran’s Affairs (VA) disability claims.

Speak With a TSGLI Attorney

After a traumatic injury, it can be challenging to find or collect necessary documentation to receive benefits. Brett O’Brien Law, LLC can help you determine if you qualify for a TSGLI claim. The firm can also provide assistance with the claim process, allowing you the best opportunity at obtaining the largest benefit available. Complete the contact form or call the law firm at (202) 600-4996 today and schedule a no-obligation case evaluation.

Obtain Benefits Through Traumatic Servicemembers’ Group Life Insurance (TSGLI)

Service members can recover under the TSGLI program if they have been injured while doing an activity outside of their service. For instance, Army Reserve members can seek benefits even when their injury occurred while riding a motorcycle or on a day not related to reserve activity.

The United States Department of Veteran’s Affairs provides that all service members file their claims with the government in order to obtain benefits, which can be done by filing form SGLV 8600. A study conducted by the U.S. The Government Accountability Office found that in 2009, the Department of Veteran’s Affairs approved less than 63 percent of claims filed for a traumatic head injury. The agency further found that there was a lack of consistency in the program across all branches, and it also lacked assurances that the decisions made about payment benefits were at all accurate. While the Department of Defense along with the Department of Veteran’s Affairs took steps to enhance the functionality of the program, the Department of Veteran’s Affairs continues to routinely deny claims, even though injuries appear to qualify for benefits.

TSGLI Eligibility and Available Categories of Loss

Service members are eligible for Traumatic Servicemembers’ Group Life Insurance benefits when they meet eligibility criteria, which have been predetermined by the program. In general, eligibility for benefit payments may be possible when the following requirements are met: The injury took place after October 2001; The injury took place prior to a separation from the U.S. Armed Forces; The injury sustained directly caused one of the losses covered; The loss was sustained within two (2) years from the traumatic injury; The service member was insured by SGLI at the time of his or her injury.

The Department of Veteran’s Affairs has outlined various categories of losses that could be covered, which include, but are not limited to the following: Paralysis; Burns; Loss of sight; Loss of hearing; Loss of speech; Facial reconstruction; Damage to limbs; Damage to genitourinary functions; Amputation; Comas; Traumatic head trauma; Hospitalization as a result of a traumatic injury and/or Limitations on day-to-day activities.

When a traumatic injury has resulted in limitations of two (2) or more Activities of Daily Living (ADL) for a minimum of 30 days, it may be possible to qualify for a Traumatic Servicemembers’ Group Life Insurance claim on these activity limitations alone. ADL can include continence, dressing, bathing, toileting, eating, or transferring. When requiring verbal or physical assistance to perform any of the aforementioned tasks as a consequence of an injury or require support on the basis of fluctuating ability, it may be possible to qualify for TSGLI benefits.

Retroactive Payments

Retroactive payments of TSGLI benefits have been expanded by the Veteran’s Benefits Improvement Act of 2010. When a traumatic injury occurred between October 7th, 2001, and November 30th, 2005, it may be possible to qualify for a retroactive payment, even when SGLI coverage was not paid at the time. Initially, retroactive payments were available only to service members who suffered an injury overseas as part of Iraqi Freedom or Operations Enduring. Eventually, Congress expanded benefits to be applicable for service members serving during this time period, regardless of where their injury occurred.

Determine If You Have a TSGLI Claim – Discuss Your Case With an Experienced Attorney

When injured while serving in the National Guard, U.S. Armed Forces, on active duty or reserve, there may be an opportunity to obtain benefits through Traumatic Servicemembers’ Group Life Insurance. For any injured service member, the injury can result in serious financial hardship. While filing a Form SGLV 8600 does not require the support of an attorney, it is important to understand the U.S. Department of Veterans Affairs does not always grant benefits, even when the injury appears to qualify for benefits. As a result, obtaining the legal support of a skilled attorney may be beneficial to your claim. A well-versed attorney will ensure you obtain the highest amount of benefits available.

Brett O’Brien Law, LLC is committed to ensuring service men and women obtain the benefits they are entitled to. Attorney O’Brien understands the challenges often faced by injured service members, and he also understands that most service members are denied even when their injury qualifies them for benefits. Attorney Brett O’Brien will vigorously advocate on your behalf to ensure you obtain the benefits you deserve. If you would like legal support and guidance with your TSGLI claim or would like to file an appeal after a claim denial, Brett O’Brien Law, LLC can help. The firm will focus on the bureaucratic process so that you can focus on what is important – your recovery. For more information, consider contacting Brett O’Brien Law. Fill the online contact form or call (202) 600-4996 today for a complimentary consultation.