Servicemembers’ Group Life Insurance Traumatic Injury Protection (TSGLI)

Servicemembers’ Group Life Insurance Traumatic Injury Protection (TSGLI) is a feature of the term life insurance program known as Servicemembers Group Life Insurance or SGLI. TSGLI is protection offered in the form of “short-term financial support” according to the VA official site, for those who experience a traumatic injury.

SGLI and TSGLI are offered to:

• Active-duty military
• National Guard
• Reservists
• Members of the Commissioned Corps of the National Oceanic and Atmospheric Administration (NOAA)
• Members of the Public Health Service
• Cadets
• Midshipmen
• Reserve Officer Training Corps (ROTC) members

SGLI requires payment of a monthly premium automatically taken out of the servicemember’s basic pay. You cannot be covered under TSGLI without having SGLI coverage first.

TSGLI Premiums

When you are signed up for SGLI at the start of your military career, you are automatically enrolled in TSGLI. When your SGLI coverage begins, the insurance premium automatically deducted from your base pay will include a flat one dollar flat rate premium for TSGLI.

TSGLI Benefits

Those who receive traumatic injuries that qualify for TSGLI support (see below) are offered “$25,000 to $100,000 in short-term financial support to help in your recovery from a traumatic injury” according to the VA official site.

The dollar amounts you see here are always subject to change; check the VA official site to learn the current year’s TSGLI payout amounts and other data.

These benefits may be paid for injuries received on or off-duty.

Who Qualifies For TSGLI

As mentioned above, eligibility for TSGLI is dependent on having SGLI. If you experienced a traumatic injury you may be covered if all the following are true:

• You have a VA-rated issue considered a direct result of the traumatic event or injury, and
• You had the traumatic injury “before midnight on the day that you left the military”, and
• You suffered a “scheduled loss” within two years of the traumatic injury, and
• You have “survived for a period of not less than 7 full days” from the traumatic injury event. This seven-day period begins on the date and time of the traumatic injury and ends 168 full hours later, and
• Were an active-duty military member, a Reservist, a National Guard member, on funeral-honors duty, or on one-day muster duty

TSGLI Definitions

The qualifying criteria listed above requires a bit of further explanation–what is considered a traumatic event, for example? What is a traumatic injury? Knowing how these are defined under the program can make determining your eligibility simpler.

• Traumatic Event: Defined for the purposes of approving or denying TSGLI claims, a traumatic event is “the application of external force, violence, chemical, biological, or radiological weapons, accidental ingestion of a contaminated substance, or exposure to the elements that cause damage to your body”.
• Traumatic Injury: Defined as “the physical damage to your body that results from a traumatic event”.
• Qualifying Loss/Scheduled Loss: A “qualifying loss” is defined as “a traumatic injury that is listed on the TSGLI Schedule of Losses, which lists all covered losses and payment amounts.” A “scheduled loss” is one that shows up in the TSGLI Schedule of Losses. The TSGLI office for your branch of military service is responsible for determining whether your injury is a qualifying loss under the TSGLI guidelines.

TSGLI Exclusions

There are conditions excluded from TSGLI coverage. In most cases the exclusion isn’t necessarily related to the injury itself but rather how it was received. None of the following can be true of your injury if you want to qualify for TSGLI.

• The injury must not be self-inflicted or the result of an attempt at self-harm
• The injury cannot involve the use of an illegal drug or a controlled substance that was given or taken without the participation of a licensed care provider
• The injury must not be the result of medical or surgical treatment of an illness or disease
• The injury must not have happened during the commission of a crime
• The injury must not be the result of a physical or mental illness or disease

It is important to note that the final requirement that the injury not be the result of mental illness does NOT include illness or disease caused by a wound infection; a chemical, biological, or radiological weapon; or “accidentally swallowing a contaminated substance.”

Retroactive TSGLI Options

Some may be eligible to receive retroactive TSGLI payments for a past traumatic injury. This applies to those injured between Oct. 7, 2001 and Nov. 30, 2005 and who meet ALL of the TSGLI requirements mentioned in the Who Qualifies For TSGLI section above.

Filing A TSGLI Claim

While you may be entered for coverage under SGLI, if you need to file a TSGLI claim the process requires action from you–these claims are not automatic. You’ll be required to fill out and submit the Application For TSGLI Benefits (SGLV Form 8600) provided by the VA official site. You can submit by fax, email, or regular mail. Addresses to send the completed form by U.S. postal mail are included on the form itself.

You will need to submit this paperwork for both “regular” and retroactive TSGLI claims.

Appealing A TSGLI Decision

If you were denied TSGLI benefits and want to appeal, the first thing to do is to re-read your denial letter, which will tell you whether or not you should complete and submit the TSGLI Appeal Request Form, and how long you may have to file an appeal.

You can get more information from the VA official site about TSGLI appeals, but in general be prepared to submit supporting evidence to prove you are entitled to be paid a TSGLI claim.

Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News