Denied a TSGLI Claim? What You Need to Know About Traumatic Injury Protection for Service Members
When a member of the U.S. military suffers a traumatic injury, they and their families deserve clear answers, prompt benefits, and respectful treatment. That’s what the TSGLI program—Servicemembers’ Group Life Insurance Traumatic Injury Protection—is supposed to provide. But in reality, TSGLI claims are often denied, delayed, or mishandled by the Department of Veterans Affairs (VA) and the insurance providers that administer the program. For injured service members and their families, this can add confusion and stress to an already devastating time.
TSGLI was designed to help military personnel who suffer severe injuries that leave them unable to carry out their duties. But despite its purpose, claims are frequently rejected due to narrow interpretations of qualifying injuries, paperwork errors, or insufficient medical evidence. If your TSGLI claim has been denied, you may still have a valid case—and a right to appeal.
Who Qualifies for TSGLI Benefits?
TSGLI is a rider attached to Servicemembers’ Group Life Insurance (SGLI) and is automatically provided to all service members enrolled in SGLI. Unlike death benefits, TSGLI pays out while the service member is still alive—if they experience a traumatic injury that results in a qualifying loss or severe functional impairment.
This includes injuries that result in:
Loss of limb or sight
Inability to perform Activities of Daily Living (ADLs) without assistance for 15–120 days
Hospitalization for more than 15 days due to a traumatic event
Coma, severe burns, or other “scheduled losses” listed by the program
The benefit amount ranges from $25,000 to $100,000, depending on the severity of the injury. While these amounts may be modest compared to traditional life insurance payouts, they can make a substantial difference in helping a wounded service member and their family cover medical costs, lost income, and home adjustments.
Why TSGLI Claims Get Denied So Often
Many injured service members are shocked to learn that their claims have been denied despite what they see as clear and qualifying injuries. Common reasons for denial include:
The injury does not meet the VA’s definition of a “scheduled loss”
Insufficient medical documentation supporting the severity or duration of impairment
Disputes over whether the injury was caused by a “traumatic event” as defined by the policy
Claims that the service member could still perform two or more ADLs independently
Administrative errors, such as missing deadlines or incomplete forms
These denials often boil down to paperwork and interpretation—not the actual facts of the injury. In many cases, the VA or insurer interprets medical records too narrowly or ignores the functional reality the service member faces. That’s where legal help becomes essential.
The Complexity Behind “Qualifying Injuries”
TSGLI requires that the injury result from a traumatic event and lead to a qualifying loss. But those terms can be misleading. For example, being unable to dress, bathe, or feed oneself for 30 days after surgery might seem clearly debilitating—but if the records don’t document that assistance was needed for exactly 30 consecutive days, the claim may be denied.
Similarly, injuries sustained during training exercises, car accidents while on leave, or even combat-related incidents can be questioned if they don’t fall neatly within the VA’s documentation standards. Many TSGLI denials come down to how well the claim form and medical evidence tell the story—not whether the injury was real or severe.
Why It’s Critical to Involve a TSGLI Attorney
The VA’s appeals process is layered and technical. It begins with a reconsideration request, but if that’s denied, service members can submit an appeal to the Board of Veterans' Appeals or file suit in federal court. At each stage, specific deadlines and documentation requirements apply. Without legal guidance, it’s easy to miss critical steps that can permanently bar recovery.
An experienced TSGLI attorney can help gather detailed medical records, secure expert testimony if needed, and present the case in a way that addresses the VA’s exact criteria. Many denials are overturned when a strong appeal is submitted—especially when the original denial was based on weak evidence or a narrow reading of the rules.
We work with veterans and active-duty service members nationwide to ensure they receive the TSGLI benefits they’ve earned. If your claim was denied, don’t give up. You may still have options, and we’re here to help.
FAQ: TSGLI Denied Claims
What does TSGLI stand for?
TSGLI is the Traumatic Injury Protection rider attached to Servicemembers’ Group Life Insurance (SGLI). It pays benefits to service members who suffer qualifying traumatic injuries.
How much does TSGLI pay?
TSGLI provides between $25,000 and $100,000 depending on the severity of the injury and the type of loss suffered.
Can you appeal a denied TSGLI claim?
Yes. You can request a reconsideration or file a formal appeal through the VA. Many initial denials are successfully reversed on appeal.
What injuries qualify for TSGLI?
Injuries must result from a traumatic event and cause scheduled losses such as amputation, loss of sight, paralysis, coma, or inability to perform ADLs for an extended time.
Why would the VA deny a TSGLI claim?
Denials typically occur due to lack of documentation, failure to meet the minimum number of days impaired, or disagreement over whether the injury was “traumatic” under the policy’s definitions.
Should I get a lawyer if my TSGLI claim was denied?
Yes. TSGLI appeals are complex and often require legal expertise to gather the right evidence, meet deadlines, and present the strongest possible case.
Let us help you protect your rights. Contact our TSGLI attorneys today if your claim has been denied. We know the system—and how to fight back.