Is VA Lying About The Severity Of Your Traumatic Brain Injury?
If you do not think so, you better double check.
I did not know about TBI until I was diagnosed with a memory deficit, which was connected to a head injury I had in service.
That was in 2006. Since that time, I have battled with VA over a proper diagnosis.
See, the trick VA uses is they try to pigeon hole every veteran into “mild TBI” which is labeled as mTBI. Sometimes, they try to call it “complicated mTBI.”
This is a make believe diagnosis that VA uses to avoid paying more in disability. It exists in the land of unicorns and tooth fairies.
You see, complicated mTBI is not found within the DSM-IV, which is the medical text a VA doctor must follow to diagnose TBI.
Most recently, in my own case, a VA Decision Review Officer claimed that VA does not use or possess any research or criteria to help doctors know how to rate the severity of your injury.
Without a proper set of criteria, VA is then able to maneuver their adjudication to decisions to avoid paying. In my situation, they claimed my doctor did not apply the proper criteria but then claimed they did not know what the correct criteria would be – they just knew my doctor was mistaken….
Sound familiar?
Just an FYI – if you have received a diagnosis from VA about your TBI severity, you may have been lied to as well.
The fact is, VA, DoD and CDC all possess specific criteria to help doctors know exactly how to diagnose your condition’s severity.
The difference between mild, moderate and severe TBI is significant. Not only are the symptoms somewhat obviously defined, but the monetary payout by VA is substantial.
However, instead of being honest about the injury severity, VA tries to hedge behind crafty wording and poorly written narrative reports from VA doctors.
Here is a breakdown of the disability percentage differences:
- 0% with head injury but no substantial impact
- 10% for mild TBI with no objective testing of impact
- 30% for mild TBI with objective testing
- 70% for moderate TBI
- 100% for total impairment
Rather than beat around the bush this Friday, I’ll just post links to the material.
Check these out and email me if you have been bamboozled by VA:
Department of Defense ICD-9 Coding Guidance for Traumatic Brain Injury – Pocket Card
Department of Defense Coding Guidance for TBI
From CDC: VA/DoD TBI Coding (www.cdc.gov_nchs_data_icd_Sep08TBI.pdf)
My head hurts thinking how I did not get my fair rating and then they lumped PTSD 6 years later keeping it at 70 before and then after the lump. I’ve been 70 since for my TBI since 2010 I know it should be higher I was in a coma for 26 day recovered spent another 1 year on limited duty before being deployed again. Which is where I had gotten the PTSD hate raters and there methodology
As a veteran having TBI, I got dizzy and confused just trying to understand the attached materials. @ Ruby take your friend to the VA and have him sign up for benefits, then get him assigned a doctor. Gather all medical records and file a claim. The Congress just passed a new law stating the VHA has 125 days to determine the compensation of a soldier with a a fully developed claim. You can use the DAV, VFW to get help filing the claim. The soldier is entitled to health care.
First your breakdown is incorrect. To simplify it the level of TBI (mild-severe) is determined based on the level of consciousness at the time of the injury. Percent wise the VA determines level of compensation based on a number scale for levels of impairment. 0 = 0%, 1 = 10%, 2 = 40% 3 = 70% and total impairment in any subcategory = 100%. There are 10 categories of evaluation. [(memory,attention, concentration, executive functions), judgement, social interaction, orientation, motor activity, visual/spacial orientation, subjective symptoms, neurobehavioral effects, communication, and consciousness(comatose state). For example you could get 2=40% for having frequent inappropriate social interactions, and have 0’s for everything else. However you may have two subjective issues that you complain of, tinnitus and moderate headaches. Only two subjective symptoms would warrant a 1=10%. Yet General Council gave us a tool and note one in 38 CFR 124a (Evaluation of Cognitive impairment and Subjective Symptoms) states that if symptom can be separately rated then the rater must. This means the afore mentioned tinnitus should warrant a stand alone 10% and headaches a potential 30%. With this done the previous 40% would hold a combined rating of 60%. This would be obviously more advantageous to the veteran, and is just an example, but one I see often as a Service Officer. My job is to keep the VA honest and correct with their work.
I don’t know who to talk to, but my friend is suffering badly from need of health care, and they are so far behind. He needs to see a heart doctor, needs shoulder sugery, his feet and legs swollen until they look like they could pop. It’s awful and they just keep putting him off. He gave 3 years of his life in the Army to protech America and now the vetrans can even get the medical help when they need it. It’s a shame.