Service members could claim tens of thousands of dollars in insurance benefits stemming from traumatic injuries if pending Veterans Affairs Department recommendations are finalized.
The changes, which stem from a VA report on the Servicemembers Group Life Insurance Traumatic Injury Program, would clarify what constitutes a traumatic event, expand the definition of some loss categories and update policies to include new medical terminology. These steps could make more policyholders eligible for payouts.
There is no statute of limitations on when a claim can be filed for TSGLI payments, which range from $25,000 to $100,000, so long as the traumatic event occurred after Oct. 7, 2001.
Service members covered under the Servicemembers Group Life Insurance program automatically receive traumatic injury coverage; the cost of $1 a month is included in their SGLI premium. For example the monthly cost for the maximum of $400,000 of SGLI coverage is $29, which includes the $1 for TSGLI .
Among the recommendations:
- Change the standard for burns to reflect the different levels of severity in second-degree burns and reflect current terminology. Some previously ineligible service members may become eligible for either a $50,000 or $100,000 payment.
- Clarify that bites, stings, frostbite and heat stroke are traumatic events.
- Change “limb salvage” to “limb reconstruction” and clarify that TSGLI benefits are available for surgical efforts to rebuild limbs. Some previously ineligible service members would qualify for a payment of $25,000 or $50,000.
- Expand the definition of “hospitalization” to include inpatient acute care and rehab, as well as skilled nursing facilities. This would allow patients, including those with traumatic brain injuries, to visit such facilities without breaking a requirement that mandates 15 straight days of hospitalization.
- Clarify that VA considers documented, nonpenetrating blast waves to be traumatic events. Losses occurring within two years of the last documented blast may qualify for a payment.
Officials are drafting a proposed rule to amend the TSGLI regulations. The recommendations were made by the Veterans Benefits Administration following a review of the first 10 years of the program.
As of Nov. 30, 2017, the program had paid more than $968 million in benefits to 17,541 beneficiaries, with an average benefit of $55,215, according to the VA report. Congress created TSGLI in 2005 to provide short-term monetary assistance ($25,000 to $100,000), depending on the type of loss, to lessen the financial hardships on troops and their families after a traumatic injury.
For more details, visit the TSGLI homepage.