Frequently Asked Questions about TSGLI

General Information
Coverage
Premiums
TSGLI Eligibility and Claims
Payment of TSGLI Benefits
Contact Information
Changes to the TSGLI Program

General Information

What Is TSGLI?

The Traumatic Injury Protection Under Servicemembers' Group Life Insurance (TSGLI) program is a rider to Servicemember’s Group Life Insurance (SGLI). The TSGLI rider provides for payment to service members who are severely injured (on or off duty) as the result of a traumatic event and suffer a loss that qualifies for payment under TSGLI.

Who are TSGLI Payments Designed to Help?

TSGLI payments are designed to help traumatically injured service members and their families with financial burdens associated with recovering from a severe injury. TSGLI payments range from $25,000 to $100,000 based on the qualifying loss suffered.

Coverage

How Much Coverage Is Available?

TSGLI coverage will pay a benefit of between $25,000 and $100,000 depending on the loss directly resulting from the traumatic injury.

Who Is Covered Under TSGLI?

Every member who has SGLI also has TSGLI effective December 1, 2005.

Can The Service Member Decline TSGLI?

TSGLI coverage is automatic for those insured under basic SGLI and cannot be declined. The only way to decline TSGLI is to decline basic SGLI coverage.

Are Spouses And Children Covered By TSGLI?

No, TSGLI is not available to spouses and children under Family SGLI. It is available only to service members insured under SGLI.

Are Members Covered For TSGLI When They're Insured Under VGLI?

No. TSGLI coverage is not available to VGLI policyholders.

What Losses Are Covered and How Much Is Paid For Each Loss?

Covered losses and payment amounts are listed in the TSGLI Schedule of Losses. 
For example:

Follow this link for a complete listing of all losses that are covered under TSGLI and how much will be paid for each loss.

Are There Any Injuries Or Conditions That Are Not Covered Under TSGLI?

Yes, certain injuries and conditions are excluded from coverage. For more information on these exclusions, please contact your service department points of contact.

Premiums

How Much Does TSGLI Cost?

The premium for TSGLI is a flat rate of $1 per month for most service members. Members who carry the maximum SGLI coverage of $400,000 will pay $29.00 per month for both SGLI and TSGLI. 

The table below outlines the rates for various categories of SGLI coverage.

Note: These rates are determined by VA and are subject to change based on claims experience.

TSGLI Eligibility and Claims

What Are The Eligibility Requirements For Payment Under TSGLI?

To be eligible for payment of TSGLI, you must meet all of the following requirements:

• You must be insured by SGLI.
• You must incur a scheduled loss and that loss must be a direct result of a traumatic injury.
• You must have suffered the traumatic injury prior to midnight of the day that you separate from the uniformed services.
• You must suffer a scheduled loss within 2 years (730 days) of the traumatic injury.
• You must survive for a period of not less than seven full days from the date of the traumatic injury. (The 7-day period begins on the date and time of the traumatic injury, as measured by Zulu [Greenwich Meridian] time and ends 168 full hours later).

What If The Traumatic Injury Occurred Prior To December 1?

Congress directed that TSGLI would be retroactive to October 7, 2001, for members who incur a qualifying loss as a direct result of injuries incurred on or after October 7, 2001, through and including November 30, 2005, in Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF). For the purposes of TSGLI only, "incurred in Operation Enduring Freedom or Operation Iraqi Freedom" means that the member must have been deployed outside the United States on orders in support of OEF or OIF or serving in a geographic location that qualified the service member for the Combat Zone Tax Exclusion under the Internal Revenue Service Code.

How Does A Member Make A Claim For TSGLI?

In order to make a claim for the TSGLI benefit, the member (or someone acting on his or her behalf) should:

1. Download the SGLV-8600, Application for TSGLI Benefits . You can also obtain this form from the your service department point of contact or from the Office of Servicemembers' Group Life Insurance by toll-free phone at 1-800-419-1473 or by email at osgli.claims@prudential.com.
   
2. Contact your service department point of contact to begin the certification process.

The TSGLI Application has two parts:

• Part A is to be completed by the service member or, if incapacitated, by the member's guardian, or the member's attorney-in-fact.
  
• Part B is to be completed by the attending medical professional.

Once both parts of the application are completed, the application should be sent to the appropriate branch of service TSGLI office listed on the first page of the application.

Will The Service Member Ever Have To File More Than One Claim?

Yes. There are certain situations when the member will have to file more than one claim.

• For losses such as coma or traumatic brain injury, the TSGLI benefit is payable in $25,000 increments on the 15th, 30th, 60th, and 90th consecutive days of the member's inability to carry out activities of daily living. A separate claim for TSGLI must be filed at each time interval. For example, if a service member suffers a traumatic injury that leaves him in a coma, a claim for TSGLI should be filed after the 15th consecutive day of the member being in a coma for which $25,000 is payable. If the member remains in a coma for 30 days after the traumatic injury, another claim should be submitted and another $25,000 will be paid.
  
• If a member files a claim for an incurred loss and then subsequently incurs another loss as a result of the same traumatic event, a new claim must be filed for the subsequent loss. For example, if a member files a claim for losing one leg as a result of an explosion and four months later has the other leg amputated as a result of that same explosion, the member must file another claim for the loss of the leg.

May A Service Member Appeal If He or She Applies For A TSGLI Benefit And Is Denied?

Yes, a service member may appeal if denied TSGLI.

1. If the service member is appealing a decision based on eligibility criteria such as their loss or the circumstances surrounding the traumatic injury causing the loss, the service member should contact the appropriate service department point of contact.
   
2. If the service member is appealing a decision based on whether they had TSGLI coverage at the time of the traumatic injury, the service member should contact the Office of Servicemembers' Group Life Insurance at 1-800-419-1473 to file an appeal.

All appeals must be in writing and must be filed within one year of the date of the denial.

Payment of TSGLI Benefits

Who Is The Beneficiary Of TSGLI?

The service member is the beneficiary of TSGLI. The member cannot name someone other than himself or herself as the TSGLI beneficiary. If the member is incompetent, the benefit will be paid to his or her guardian or attorney-in-fact.

Is TSGLI Payable If The Service Member Dies As A Result Of The Traumatic Injury?

If the service member dies as a result of the traumatic injury, TSGLI is still payable if the member survived for a period of not less than seven full days from the date of the traumatic event and died before the maximum benefit for which the service member qualifies is paid. (The 7-day period begins on the date and time of the traumatic event, as measured by Zulu [Greenwich Meridian] time and ends 168 full hours later).

Does payment of TSGLI benefits reduce the amount of SGLI payable at the time of the service member's death?

No, payment of TSGLI has no impact on the amount of SGLI payable. For example, if a service member is insured for $400,000 of SGLI coverage and receives a TSGLI payment of $50,000 for a traumatic injury, that member is still insured for the full $400,000 of SGLI coverage, which will be paid upon the service member's death.

Who Will Receive the TSGLI Benefit if the Service Member is Deceased?

If the service member is deceased, the TSGLI payment will be made to the beneficiary or beneficiaries of the member's basic SGLI.

How Is The TSGLI Benefit Paid?

TSGLI payments will be made by one of the following methods:

• Electronic Funds Transfer (EFT) - Under this option, the TSGLI payment is electronically credited to the bank account specified by the service member. This option is available to the service member or the member's guardian or power of attorney.
  
• Prudential's Alliance Account - Under this option, an interest-bearing account will be established in the name of the member. The member can access the money immediately using the draft book (“checkbook”). There are no monthly service fees or per-check charges and additional checks can be ordered at no additional cost. If you have any questions about Alliance, please call Alliance Customer Service toll free at 877-255-4262.
  
• Check - Under this option, the service member's guardian or attorney-in-fact will receive a single check on behalf of the service member for the full TSGLI benefit payable. This option is available only to the service member's guardian or power of attorney.

Is The TSGLI Benefit Taxable?

The IRS has determined that the TSGLI benefit is not taxable.

Does The Member Have To Use The TSGLI Benefit To Assist With Recovery From Their Traumatic Injury?

No. The member may use their TSGLI benefit payment or payments in any manner they choose.

Is Beneficiary Financial Counseling Available To TSGLI Claimants?

Yes. TSGLI benefit recipients may take advantage of the Beneficiary Financial Counseling Services (BFCS) program, which is the same free counseling service to which SGLI or VGLI beneficiaries have access. Follow this link for more information on BFCS.

Changes to the TSGLI Program

I heard that there are changes to the TSGLI program.   Is this true?

Effective November 26, 2008, VA has increased the number of traumatic injuries covered under TSGLI as well as liberalizing the criteria of other injuries.  Follow this link for a summary of the expanded benefits.

The changes were the result of a "Year-One Review" (YOR) of the program completed by VA. The goal of the YOR was to consider whether the program was meeting its intended purpose, whether new injuries or losses should be added, and if improvements could be made in how the program is administered.  Follow this link to view the TSGLI Year-One Review Report which contains the full list of changes to the program, including the new losses.

When did TSGLI begin paying benefits based on the program changes?

The TSGLI Program began paying benefits on the program changes November 26, 2008.

Do the program changes include covering Post-Traumatic Stress Disorder?

No, by law TSGLI does not cover mental or physical illnesses or diseases.  This has not changed.

The TSGLI program is modeled after the dismemberment portion of commercial Accidental Death and Dismemberment (AD&D) policies, expanded to take into account the unique circumstances of military service.  AD&D policies typically do not cover illnesses, diseases or minor injuries.

Do these new losses have to be incurred in Operations Enduring Freedom or Iraqi Freedom (OEF/OIF)?  Are they retroactive to a certain date?

The program changes and additions from the review must still meet the requirements of the original law.  All new and changed losses are retroactive to the earliest eligibility date of the TSGLI program, October 7, 2001.  However, losses due to traumatic events from October 7, 2001 through November 30, 2005 must have been incurred in Operations Enduring Freedom or Iraqi Freedom, regardless of whether the member had SGLI coverage.
 For TSGLI purposes only, DOD has defined this as the member must have been deployed outside the United States on orders in support of OEF or OIF or serving in a geographic location that qualified the service member for the Combat Zone Tax Exclusion under the Internal Revenue Service code.
For losses due to traumatic events incurred from December 1, 2005 forward, the loss can occur anywhere, regardless of OEF/OIF status, as long at the member is covered by SGLI.   This applies to the new losses as well.

Who will make the decision on my TSGLI claim if I apply based on the program changes?

Your branch of service TSGLI office will determine your eligibility for a TSGLI benefit based on the program changes, just as they currently do under the existing program criteria. 

I believe I may be eligible for a TSGLI payment based on the program changes.  How do I file a claim?  And where can I obtain more information on doing so?

If you file a claim based on the program changes, you should  utilize the new TSGLI application where you can document your loss under the program additions and changes.  Your branch of service will determine your eligibility based on the program additions and changes.   Follow this link to download SGLV-8600, Application for TSGLI Benefits .

 I filed a TSGLI claim and was denied.  With the program changes, I believe I may now qualify.  Do I have to refile my claim?

Your branch of service TSGLI office is reviewing 100 percent of all denied claims to determine if any previously denied claimants would now be eligible for a TSGLI benefit based on the program changes and additions.

However, to be sure that your claim is being reviewed, you should contact your Branch of Service TSGLI office. 

If the information that you provided with your original claim documents your eligibility based on the program changes and additions, your branch of service TSGLI office will authorize payment of a benefit without the need for you to refile a claim.

If the information that you provided with your original claim does not document your eligibility based on the  program changes and additions, your branch of service TSGLI office may contact you for additional information to supplement your original claim.  You can also call your branch of service TSGLI office  to determine what additional information is needed.

In either situation, if your branch of service determines you are eligible for a benefit, they will contact you to confirm your current address and banking information.

I filed a TSGLI claim and was paid $25,000.  With the program changes, I believe I may now be entitled to more money?  Do I have to refile my claim?

Your branch of service TSGLI office is reviewing 100 percent of all approved claims where the service member was paid less than the maximum TSGLI benefit of $100,000 to determine if there may now be eligibility for an additional TSGLI benefit based on the program changes and additions.

However, to be sure that your claim is being reviewed, you should contact your Branch of Service TSGLI office. 

If the information that you provided with your original claim documents your eligibility for a higher benefit based on the program changes and additions, your branch of service TSGLI office will authorize payment of an additional benefit without the need for you to refile a claim.  If the information that you provided with your original claim does not document your eligibility for a higher benefit based on the program changes and additions, your branch of service TSGLI office will contact you for additional information to supplement your original claim.  You can also contact your branch of service TSGLI office to determine what additional information is needed.

In either situation, if your branch of service determines you are eligible for a benefit, they will contact you to confirm your current address and banking information.

Do I still forfeit my Combat Injury Pay if I file a TSGLI claim?

No, the Combat-related Injury Rehabilitation Pay Program (CIP) was terminated on May 15, 2008 and has been replaced by the Pay and Allowances Continuation Program (PAC).  Unlike CIP, the PAC program is not linked in any way to the TSGLI Program.  The CIP Program payments of $430 per month ended when a service member received a TSGLI payment.   The new PAC Program has no such limitation.   All of a service member’s incentive pays, bonuses, or similar benefits, and the incidental and expense portion of the temporary duty allowance for members deployed in a combat operation or combat zone may continue or resume for up to one year following initial hospitalization for treatment of a wound, injury, or illness incurred in the line of duty while serving in a combat operation or combat zone, while serving in a hostile fire area, or while exposed to a hostile fire event.

Who should I call with questions on the TSGLI program changes?

You may contact your branch of service TSGLI office.  

Contact Information

Where Can I Get More Information?

For more detailed information on the TSGLI benefit, you can refer to title 38, CFR, Part 9.20. You can also contact your service department point of contact or the Office of Servicemembers' Group Life Insurance by phone at 1-800-419-1473 or by email at osgli.claims@prudential.com.