Traumatic Injury Protection TSGLI provides financial support to severely injured service members, but many valid claims are delayed or denied. Our law firm has more than 30 years of experience helping injured service members secure the benefits they are owed. If your TSGLI claim was denied or undervalued, we can guide you through the appeal process and advocate for the full compensation you deserve.
What Is TSGLI
TSGLI is a rider attached to Servicemembers Group Life Insurance SGLI. It provides short term financial assistance to service members who suffer qualifying traumatic injuries on or off duty. Payments range from $25,000 to $100,000 depending on the type and severity of the injury. The benefit can be used for recovery costs, rehabilitation needs, home modifications, prosthetics, transportation, and other essential expenses.
How TSGLI Works
Eligibility Requirements
You may qualify for TSGLI if all of the following apply:
- You had SGLI coverage when the traumatic injury occurred
- The injury happened before your separation from the military
- You experienced a scheduled loss within two years of the traumatic injury
- You survived at least seven full days after the traumatic event
- You were an active duty service member, Reservist, National Guard member, or served on funeral honors or one day muster duty
Injuries Not Covered
You cannot qualify for TSGLI if any of the following apply:
- The injury was self inflicted or an attempt at self injury
- The injury involved illegal drug use or a controlled substance taken without medical direction
- The injury resulted from medical or surgical treatment of an illness or disease
- The injury occurred while committing or attempting to commit a felony
- The injury resulted from a physical or mental illness or disease unless caused by a wound infection, chemical, biological, or radiological exposure, or accidental ingestion of a contaminated substance
Retroactive TSGLI
You may qualify for retroactive TSGLI if you suffered a traumatic injury between October 7, 2001 and November 30, 2005 and you meet the standard TSGLI requirements. Retroactive benefits apply whether you were on or off duty and regardless of whether your SGLI coverage was active at the time.
Qualifying Injuries and Scheduled Losses
A traumatic injury must directly cause one of these qualifying losses to be eligible:
- Total and permanent loss of sight, hearing, or speech
- Amputation or loss of use of a hand, foot, fingers, or toes
- Extensive limb reconstruction surgery
- Complete paralysis such as quadriplegia, paraplegia, hemiplegia, or uniplegia
- Second degree or worse burns covering at least 20 percent of the body or face
- Traumatic brain injury or coma resulting in the inability to perform at least two Activities of Daily Living
- In patient hospitalization for 15 or more consecutive days due to a TBI or other traumatic injury
- Facial reconstruction surgery for traumatic defects
- Genitourinary losses resulting in anatomical loss or permanent loss of use
How Payment Amounts Are Determined
TSGLI payment amounts follow strict guidelines:
- Each scheduled loss has a fixed payment amount such as $25,000, $50,000, or $100,000
- A single traumatic event qualifies for only the highest valued loss up to $100,000
- Injuries from separate traumatic events at least seven days apart can qualify for separate payments
- Milestone payments may apply for comas or TBI related loss of ADLs at 15, 30, 60, and 90 day intervals
- The scheduled loss must occur within two years of the traumatic event
Why TSGLI Claims Are Commonly Denied
Common reasons for denial include:
- Missing or unclear medical documentation
- Incorrect injury classification
- Disputes about the cause or timing of the traumatic event
- Lack of a direct link between the injury and a scheduled loss
- Claims examiners overlooking key facts
- Misinterpretation of the Schedule of Losses
How to Appeal a TSGLI Denial
Your denial letter will explain whether you should use the TSGLI Appeal Request Form SGLV 8600A and how long you have to file. Appeals require strong evidence, detailed medical records, and a clear explanation showing how your injury meets the Schedule of Loss standards.
How Our Firm Can Help
With more than 30 years of experience, our legal team provides the focused support needed to navigate a denied or undervalued TSGLI claim. We understand the OPM processes, the Schedule of Losses requirements, and the detailed evidence needed for a successful appeal. Our firm assists by:
- Navigating the complex TSGLI appeals process and ensuring every deadline and procedural requirement is met
- Identifying errors in the denial, including misinterpretations of the Schedule of Losses or overlooked medical evidence
- Gathering and organizing all necessary medical records, including records from field hospitals and specialists
- Working with medical providers to secure examinations, expert opinions, and clear documentation of the scheduled loss
- Preparing a strong appeal packet that connects your injury and functional limitations to the TSGLI criteria
- Ensuring your injury is correctly classified so you can pursue the maximum benefit amount available
- Representing you throughout every stage of the appeal process, including hearings if required
- Handling all communication and administrative tasks with OPM so you can focus on your recovery
Organizing and presenting a TSGLI claim correctly often makes the difference between a denial and a successful result. Our team works to protect your rights, strengthen your case, and improve your chances of recovering the full benefits you are owed.
Contact a TSGLI Claim Denial Lawyer
If your TSGLI claim was denied or delayed, our firm is ready to help. Contact us to schedule a consultation and learn about your options.