Traumatic Service Members’ Group Life Insurance (TSGLI)
U.S. Military service members who are traumatically injured may be eligible for a cash benefit of up to $100,000 under the Traumatic Service Members’ Group Life Insurance (TSGLI) program.
TSGLI provides automatic traumatic injury coverage to all service members covered under SGLI. TSGLI provides emergency short-term, lump sum tax free financial assistance from traumatic injuries on or off duty. The premium for TSGLI is a flat rate of $1 per month for most service members.
TSGLI coverage applies to active duty members, reservists, National Guard members, funeral honors duty and one-day muster duty. The TSGLI program covers service members either on or off duty. For example, if a service member is involved in a motorcycle or car crash and is traumatically injured, they may be eligible for TSGLI benefits even if off duty – just as if they were injured in an IED explosion while deployed on duty, or injured in a training exercise on base. These are just some examples, and there are many other circumstances that can make a service member eligible for TSGLI benefits.
Unfortunately, many service members are unaware of this coverage. To receive benefits, a service member has to meet certain eligibility requirements which can include hospitalization, difficulty performing activities of daily living (ADLs) without help during recovery from an injury.
The TSGLI program application process can be challenging due to the application and evidence requirements. Also, the Department of Defense is responsible for deciding who is eligible for benefits, and they often deny claims that should be paid.
Service members shouldn’t give up, they should reach out for help.
What is a Traumatic Injury?
A traumatic injury is physical damage to a living body that is caused by a traumatic event. A traumatic injury does not include a mental disorder or a mental or physical illness or disease, except if the physical illness or disease is caused by a pyogenic infection, biological, chemical, or radiological weapons, or accidental ingestion of a contaminated substance.
A traumatic event is the application of external force, violence chemical, biological, or radiological weapons, or accidental ingestion of a contaminated substance causing damage to a living being.
- If a service member is automatically insured under SGLI, they are automatically covered by TSGLI.
- Service members and veterans must meet all of the following requirements to be eligible for TSGLI payment:
- Must have incur severe losses as a result of traumatic injuries
- Must be insured by SGLI when you experience a traumatic injury on or after October 7, 2001 to present
- Must incur a scheduled loss and that loss much 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; and
- If deceased: must have survived for a period of not less than seven (7) full days from the date of the traumatic injury
What is Loss of Activities of Daily Living?
Loss of Activities of Daily Living (ADLs) is the primary grounds in which service members seek TSGLI benefits. A member will be considered eligible for TSGLI benefits if the member is unable to independently perform at least two of six ADLs, and the member’s inability lasts at least 30 consecutive days increments of 30 days up to 120 days in duration. Generally, inability means assistance to perform these activities safety as a result of the injury. A medical professional is required to certify the member’s ADL loss. The six ADLs are:
What are the Payment Increments for TSGLI?
TSGLI payments are given in $25,000 increments depending on the number of consecutive days of ADL loss:
- at 30th consecutive day of ADL loss = $25,000.00
- at 60th consecutive day of ADL loss = $50,000.00
- at 90th consecutive day of ADL loss = $75,000.00
- at 120th consecutive day of ADL loss = $100,000.00
What is the TSGLI Process?
The TSGLI process consists of four (4) administrative steps:
- First Submission
- Review Board
TSGLI Court victories by Johnson//Becker, PLLC:
Koffarnus v. United States, 3:2015cv00473 (W.D. Ky. 2016)
Carver v. United States, 3:15cv00401 (W.D. Ky. 2016)
Blackwood v. United States, 3:2015cv00402 (W.D. Ky. 2016)