Traumatic Brain Injury (TBI)
One of the signature injuries of the wars in Iraq and Afghanistan is traumatic brain injury (TBI). The reason for this is because of the frequent use of roadside improvised explosive devices and the resulting blasts. Keep in mind, however, that there are many TBI’s that have not come from improvised explosive devices in Iraq or Afghanistan. Other causes of TBI include an in-service motor vehicle accident, or an in-service fall where a Veteran hits his head. They may also come from a personal assault or any other type of trauma where the head is injured.
The consequences of traumatic brain injuries are far reaching and affect many areas of a veteran’s life. TBI’s often produce not only physical problems, but cognitive (aka thinking) problems, and behavioral problems. According to the RAND study, about 19 percent of troops surveyed report a probable TBI during deployment. Traumatic brain injuries are difficult to identify and are often not easily distinguished from Post Traumatic Stress Disorder or depression. In fact, tens of thousands of troops are suffering from PTSD and depression in addition to TBI.
If you have suffered a TBI and your VA disability benefits claim was denied,
call our offices today at (888) 878-9350 for a free consultation
to learn more about how we can help you.
Change in Rating Criteria for TBI
The old rating criteria for evaluating TBIs was clearly not sufficient to address the wide range of issues veterans face so VA revised the rating criteria in January 2008. This change became effective October 23, 2008.
Under the old rating system any one subjective symptom could not be given a service rating above 10%. A subjective symptom is one where severity depends on self-reporting by the Veteran. Subjective symptoms include things like severity of headaches, dizziness, or ability to concentrate. Under the new VA disability rating system, symptoms are evaluated in the 3 categories described below and the disability rating is based on the combined total level of disability in all areas.
Symptoms of TBI in Veterans
There are three main areas of dysfunction that need to be evaluated when considering veterans disability benefits for TBI.
Cognitive Symptoms of TBI
The symptoms of cognitive impairment include decreased memory, concentration, attention, and executive functioning of the brain. Executive functioning skills include goal setting, information processing, planning, organizing, prioritizing, problem solving, judgment, decision making, and mental flexibility.
Emotional & Behavioral Symptoms of TBI
Emotional symptoms of TBI include PTSD, depression, anxiety and other mental disabilities. Behavioral symptoms include irritability, aggression, withdrawal, and poor impulse control. Additionally, cognitive, emotional and behavioral problems can lead to social problems including immature behavior, over-dependency, excessive talking, inappropriate sexual behavior, and over spending.
Physical Symptoms of TBI
Common physical symptoms of a traumatic brain injury include vision loss, hearing loss and tinnitus, constant headaches, seizures, motor or sensory dysfunction, and perhaps pain in the face or other parts of the body. Some Veterans also report a loss of smell or taste and they may suffer from inability to communicate as they previously did before. There are also endocrine dysfunctions and bladder or bowel impairments and other autonomic nerve dysfunctions.
Diagnosing TBI in Veterans is Complicated
While the new VA disability rating system was expanded to acknowledge the complexity of TBI, it doesn’t necessarily make TBI easier to diagnose. TBI is a complicated disability to properly diagnose for several reasons.
- TBI symptoms overlap with other disabilities. As noted earlier, a Veteran with a TBI may also experience depression and PTSD.
- Each TBI is unique. The number and type of brain functions affected can vary widely from person to person. Additionally, some functions may be affected more severely than others. To further complicate the issue, symptoms may fluctuate in severity from day to day.
- Symptoms can change over time. The symptoms a Veteran experiences in the days immediately after a TBI may be very different from the symptoms they experience months down the road.
- VA uses multiple diagnostic codes. The cognitive symptoms of TBI are evaluated using one set of diagnostic codes. Physical symptoms are evaluated under another. And, emotional behavioral symptoms are evaluated using at least 2 different sets of diagnostic codes.
How the VA Handles TBI Claims
The way the VA handles TBI claims is that it first assigns an evaluation for all the separately diagnosed conditions. Then VA take the conditions that are not separately diagnosed and evaluated and classifies them under one of ten factors listed in the VA table.
The VA evaluators then assign a scale to the different components of cognitive impairment. This scale goes from 0 to 4. The VA evaluators determine which symptoms are to be classified under each component and then they assign the appropriate number. After each symptom has been classified and assigned a number, the VA takes the highest number assigned to any one component. Then the highest number assigned to each one of the components is the percentage evaluation that will be assigned. In practice, the VA should assign a 100 percent rating if any component is determined to be totally disabling.
Why You Need an Attorney
As you can see, TBIs are extremely complex disabilities and there is a lot of room for interpretation in the level impairment from your symptoms. A qualified veterans benefits attorney can connect you with the proper experts and help you make the strongest case possible.
In our experience perhaps one of the biggest issues involving TBI cases is the cognitive impairment. As a result, veterans with TBIs have an even harder time navigating the VA disability system. An experienced veterans benefits attorney can help you make sense of the VA system, the various reports and the process of dealing with the VA.
The bottom-line is that if you have suffered a traumatic brain injury in the service, you are no doubt experiencing a wide range of difficulties and you may need assistance with your claim. The law surrounding the grant of service-connection for these injuries as well as the law concerning the proper rating of them can be complex. We recommended that you hire a veterans disability attorney if you are trying to appeal the denial of a TBI claim or appealing a failure of VA to grant the appropriate rating for a TBI.
How can Gang & Associates help?
If we decide to work together, we promise that we will never hand your claim to a secretary or legal assistant, as many law firms do. Now isn’t the time to play those games. We will work together to build the strongest case possible. So when we come up against the government’s lawyers, we’ll be ready to shoot down whatever evidence and objections they raise. You can depend on it!
My No-Risk, No-Cost, No-Questions-Asked, Take-Your-File Commitment.
We commit that if you are not delighted with our services during the first 30 days, we will gladly give you your file – at no cost – containing all the work we’ve done to date – so you can hire another lawyer or law firm. It’s that simple.
(Read our full Veterans Disability Commitment here.)
Call our office toll free at (888) 878-9350 because you no longer have to “go it alone.”