VA Questioned Over Bad TBI Denials, Botched Exams
Lawmakers are in the US Senate are pushing back against VA for traumatic brain injury (TBI) denials due to the agency’s botched disability exams.
Unresolved questions about Department of Veterans Affairs efforts to squash a massive 25,000 veteran scandal have resurfaced.
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Originally exposed by Kare 11 News resulting in a nationwide overhaul of VA’s compensation system, Senators Tammy Baldwin and Tammy Duckworth are calling the agency on the carpet on behalf of veterans still suffering.
These lawmakers are demanding answers on how well VA actually cleaned up the last scandal involving TBI. Hint, it did not go that well.
On VA TBI Denial Scandal
The bad TBI denials scandal first surfaced when I started independently investigating how the agency trains its disability examiners for traumatic brain injury exams.
Agency documents and veteran reports revealed the Department of Veterans Affairs used unqualified doctors and nurses to conduct initial disability exams for traumatic brain injury from 2007 to 2015.
VA TBI Specialists
For initial TBI disability exams, VA’s own policy required the agency to examine the veteran first with a neurologist, neurosurgeon, psychiatrist, or physiatrist. Residuals post-TBI diagnosis could be assessed by other clinicians like nurses (this often results in a bad outcome).
TBI Demential Screening
The catch at the time was that even if VA fixed the issue of unqualified examiners, veterans were sometimes evaluated using inadequate exams such as dementia screening exams like MoCA or RBANS without a neuropsychological screening by a psychologist once a TBI was documented.
It is one thing to use a screening tool for a screening it was designed to detect. It is another to rely on that screening tool to evaluate all residuals of a TBI.
TBI Imaging Studies
Other veterans would receive inferior imaging like a CT scan years after the head injury instead of an MRI to detect brain damage. A CT scan is good to evaluate an active brain bleed, not long-term brain damage years later.
I brought the information and the data to AJ Lagoe at Kare 11. From there, AJ with his team blew the scandal wide open through his coverage and field research. It led to a congressional investigation and watchdog investigation involving VA Office of Inspector General. AJ’s team even won some awards for the important work.
RELATED: Who Is Behind TBI Scandal?
Due to public pressure, VA eventually agreed to issue an equitable relief plan where veterans that did not receive an exam from one of the four specialists would qualify for a new exam. If the outcome was favorable, VA promised to grant an effective date back to the date of claim.
Nearly 25,000 veterans were affected, and there were likely many more veterans whose conditions were implicated but not notified.
That was 2016. Veterans had one year to request the new exam whether they received the notice or not.
Bad TBI Denial Tomah VA
Now, these Senators are demanding answers in the wake of the case of Brandon Winneshiek. The Marine veteran’s claim examination was handled by the Tomah VA located in Wisconsin.
For Winneshiek, he persisted after an exam from an unqualified examiner to then be seen by a neurologist years later – one of the four specialists – in 2016. The outcome was not great.
That neurologist used an inadequate dementia screening tool for the exam resulting in an incorrect outcome. The veteran was denied the benefits he sought.
Only in 2021 was the veteran able to get examined by a qualified psychologist to assess the veteran using tools with better fidelity than a dementia screening tool.
Winneshiek then won his benefits, but VA only granted him a 2020 effective date, not the date he first filed for the claim back to 2011.
Is this fair? No, it means the equitable relief plan as implemented did not fully address the problems. While it corrected, in theory, the unqualified examiner issue, it did not address the use of inferior exam tools.
The veteran seems to agree, and at least two Senators are pushing back against VA to learn more. In their letter to Secretary Denis McDonough, they highlight the problems veterans reported:
Our offices have since been contacted by Veterans reporting inconsistencies with their TBI diagnoses, specifically, within the Tomah and Minneapolis Health Care Systems. Some Veterans recount only receiving brief screening tools without undergoing significant diagnostic tests, such as CT scans. Others opted to seek care outside of the VA health care network and, after imaging and testing, were found to have a TBI, despite previous VA denials. Consequently, these Veterans missed out on vital treatments in order to mitigate their symptoms as well as receive disability benefits.
They asked the Secretary to provide a response to clarify how well the equitable relief addressed the underlying problems to get benefits the benefits they are owed:
1. Have the VBA and VHA implemented all recommendations included in the September 2018 0IG report and has the VA taken any additional steps to ensure Veterans are receiving adequate TBI medical examinations?
2. How many Veterans requested reexaminations for TBI-related issues? Of those, how many were granted relief?
3. How many Veterans were denied equitable relief due to missing the one year deadline?
4. If a Veteran believes they did not receive an accurate TBI diagnosis, what is the process for receiving a second opinion, specifically in rural VA facilities where only one TBI specialist is available?
After six years, VA has yet to provide public accountability for that relief package.
RELATED: Off-Label Treatment For PTSD
Current TBI Denial Issues
One of the biggest problems I’ve seen and heard from other attorneys is VA’s use of contracted examiners who frequently co-mingle PTSD with TBI.
This frequently results in a lower overall disability rating. Or, it will prevent the veteran from securing Permanent & Total due to (im)possible improvement of PTSD.
Is the commingling, anti-pyramid approach correct, here?
Frequently not.
The reality is medial science has the ability to differentiate between many of the symptoms of TBI and PTSD. However, examiners frequently claim (falsely) that such symptoms cannot be differentiated without “mere speculation.”
Remember. A TBI disability is a physical disability to the brain. PTSD is a mental health disability. These are not the same types of conditions, but they sometimes share symptoms.
Is there a way to win. Yes, but it’s risky to go it alone.
To win in these scenarios, veterans are frequently required to hire an attorney who in turn will hire an expert to evaluate the medical evidence. Those veterans who go it alone frequently get caught up in the appeals hamster wheel or give up.
Giving up is the most tragic outcome, especially since certain forms of health care may only be available through VA with a rated TBI. For these veterans, they frequently go without the care they need and deserve because VA is trying to save Uncle Sam a bucks on the backs of vets.
Anyone with questions about these wrong TBI denials and bad exams can feel free to reach out to us at Krause Law PLLC by phone (612) 888-9567 or at [email protected].
Oh yes the more veterans they keep sick the more money they can ask Congress for. Instead of trying to apply the most appropriate care they try to create botched situations that dismantles the veterans even more. Benjamin they can never get enough money it seems to do anything right. However, they do not want it fixed or right which is the more reason to dismantle the whole agency.
The problem with the way the federal government does business is their actions burden the system which could be prevented. By keeping veterans sick when they could truly help them burdens the system Ben. Cancer can go into remission if the appropriate care was delivered. As for Mental Health Diagnoses, look at Rosanne Barr history. Look at how sick she used to be and she became a success story. One difference though is she has been in the private sector and not controlled under the federal government. Many in the state hospitals could be helped to becoming able to live independently and probably could be retrained to hold employment. The federal government is against LIFE period. This is the problem. A private sector physician had made the comment to me that the state hospitals are shameful. This is even in Florida right now. This would be similar to what you are discussing in this article. Physician stated the problem lays with the politicians. VA denies benefits when they should not be more than likely. This is wrong. Another point is Veterans maybe too sick to handle the claims process just to get into the VA for healthcare. The leadership fails to pay attention to this. Some veterans may not have a military hospital nearby and I do believe Tricare in the last couple years eliminated veterans to receive care on military bases. What helped my situation is the Navy Hospital. The Navy Hospital provided care and assistance long before I was put into the VA. Many veterans may not have anything if the military just threw them out. Having to hire attorneys to get help is a disgrace. Though Ben risk is happening in every industry. I have been having semi trucks run me off the road. Not my fault at all. Florida is a no fault insurance state but of course that is for injury. Commercial Truck insurance company defrauding in fixing my car. Having to get pro bono attorney to sue the company. Trucking company and the insurance company. I have pictures of it all and experts have mentioned this truck driver is not telling the truth. This truck driver has tags in his docket that the public does not have access to. Only a couple numbers of his information in relation to his truck matches what is in his docket. DOT number and MIC number. I am bringing this up because the defrauding and the lawlessness is everywhere. The attorneys are part of the problem too because they are about money and not doing the right thing. Attorney says 10000 here and there to do x y or z and then they may say I need now 40000 to do a. This is why I say this country has become a disgrace. Same as what the VA does to the veteran community. What I have mentioned is just the tip of the iceberg that I have been involved with. Do I truly want to vote? No
Because most of the politicians and the unelected government officials and the special internets groups and some of these larger companies are the cause of all of this.
Benjamin when I mentioned organic in nature this was their terminology back in the day. Back in the day I did not know what the hell they were talking about. This is what they thought back then based on the testing and the cognitive impairment and speech impairment and the psychosis. They mentioned developmental back then after this has happened. However I am not developmental anything today nor am I impaired. The issue of employment has little to do with me.
It has all to do with the failing system around me that I have had to help pick up the pieces. Of course they would like me to reapply for Chapter 31 Vocational Rehabilitation. But when the world is collapsing around me and others it is hard to get anything done. The VA does not even take into account for any of this. Why is this? Because they are disconnected and having had even contributed to some of it. No I am not old. I have friends who are working full time at my same age. And some older than me in schools. Leadership likes to pigeonhole people and use age as a factor when in reality there are many young people who are not well. So age should never be used as a factor. Chronological age is different from physical age. Country is collapsing unless leadership chooses to do what is right.
I don’t see TBI and PTSS (which I still call it) as mutually exclusive. You can have either or both simultaneously. On March 30, 1971, a Katyusha 122mm rocket exploded in my motor pool in Quang Tri. Thankfully, nobody died, but I suffered a TBI and hearing loss that are both permanent, because I was closest (about 20 feet) to the blast. It occurred in the exact spot I was standing five minutes before. Now, I shake like a leaf when I am upset, and suffer from misophonia, which is an almost total aversion to almost all sound. I eventually wound up with 70/30 TDIU after taking over my own case in 2008. But vets like me should have been awarded service connection IMMEDIATELY, not 38 years late! The V.A., D.O.D., etc. continue to cheat us RAW, without even an afterthought!
I agree with you Rick.
Typo Before the Navy had exited me, they did lots of testing. The VA in Providence did also.
However
Ben it did not matter if they did testing or not the evidence was front and center. They tried their best to put me into assisted living back then. There were civilians in the community who were helping me. I can look to see what testing they used back then both the Providence VA, the Navy Hospital, the private sector Neuropsychologists, and private sector physicians at the state hospital in Bangor Maine. Who is to say the testing was done correctly with the way these bureaucrats manipulate numbers and statistics. I believe the testing though Benjamin was more accurate than their write ups. Because these physicians can say whatever they choose with the MD beside their names. I just know what they did I was dismantled for a long time. It has all been building back incrementally. And what finally delivered me forward was when the VA denied me Chapter 31 Vocational Rehabilitation in summer of 2015 and shortly afterwards I had to travel to Atlanta to assist my sister who had almost died. I had to stay in Atlanta into 2016. I was living out of a hotel because I could not get into her home. She was in ICU for over two weeks. My parents could not remain in Atlanta. I could not speak to her to ask for keys to her home. She was on machines. Her husband left her after 27 years of marriage and had taken up with my sister’s nurse. This is no joke Benjamin. See how the Medical ethics in this country is a disgrace. No morals and no values..,My point of bringing this up was the problem solving that occurred when I was thrusted into this position is what delivered me forward to a much higher level of functioning. Problem solving on the feet is a skill that is developed and not all people exhibit this skill. Thinking on the feet is another way to define it. And Benjamin the hell that I experienced from the VA due to this. The VA slammed me for assisting my family. It was not too long after that I hauled ass out of the VA. I moved all my care out. They kicked me down the road even more. All of this is past. Ultimately I have nothing positive to say about the VA or the federal government.
Benjamin
before the Navy was exited me and they had tested me for a good 2 to 6 years years before they retired me. And when this initially went down this was not substance related at all. This was pure physical impairment due to what happened. They had lied about my eyes for the Medical Enlisted Commissioning program that slammed my application.
Other actions too that happened by them of which the substance did not align.
I was tested by Neuropsychologists, psychologists, and medical physicians. And some were done by private practice neuropsychologists. Do you see Fetterman? I was similar but worse. Cognitively impaired and speech impaired. The tests during that time show developmentally impaired with being organic in nature. How could I have been selected to the National Beta Club in high school? This is what the actions by the Navy delivered at that time. And today how I am is far beyond how the Navy retired me. And when you ask is the VA intentionally sabotaging? I tell you yes. I can give you plenty of substance. But Benjamin they go both ways private sector and the VA. Government has their hands in everything is the problem. They would never admit and display the high functioning today. This has to do with all these situations that I have had to straighten out and correct. And the private sector does the same. Intentional medical errors in some cases. For example how can a physician miss diagnosis a broken foot? Benjamin if a physician cannot diagnosis a broken foot then he does not warrant a MD license. Most physicians are delivering against the Hippocratic Oath. Just look at the mutilation of the kids. Most of the system is a pile of crap. It all needs to be dismantled and overhauled. Look at what Elon Musk is doing to Twitter. Firing employees..,Maybe this should be applied in the government from top to bottom.
Certain parts of the brain heals. Hippocampus is one area that heals where the memory is located. The speech can become more fluent over time with much practice. Pencil to paper reinforces learning and relearning. Problem solving and writing. I am serious Ben. Benjamin the federal government is not about improving people’s lives or health.
The system is not set up for veterans or anyone to improve.
I have been countering the system for years. Laws need to be changed.
As for the testing, Chapter 31 Vocational Rehabilitation used to use all kinds of testing back in the day. Today they do not use jack shit. No credibility anywhere. Yes a surprise is coming. I kind of glanced at one of your other headlines with it stating VR&E counselors monitor everything about the veterans. Communism not Bill of Rights.
I am not so sure why they are observing they understand. Do you know why I say this? Because the veterans who are trying to get retrained are focused on the truth. What the counselors are looking for are vulnerabilities with the veterans so they can exert over the top control over the veterans in efforts to sabotage them. Population control
The VA is not about successes at all for veterans. Might have been at one time a little more investing but today the elites want to destroy everyone except themselves. Profit is the product. Should not be this way.
Great information thanks for updates
Hi. Disappointed to see this nonsense still happening.
Did want to address one paragraph in your article.
“The reality is medial science has the ability to differentiate between many of the symptoms of TBI and PTSD. However, examiners frequently claim (falsely) that such symptoms cannot be differentiated without “mere speculation.””
Owing to the profound overlap between the two conditions, the research community has yet to discover a viable way to differentiate TBI from PTSD. Unfortunately, studies trying to ascribe one or more symptoms characteristic of persistent post concussive syndrome to one condition over the other continue to support PTSD as the main contributor.
I’ve been working as an editor for the Tampa VA on their papers specific to TBI and I’ve addressed this issue several times. Based on the discussions I’ve had, it seems that the tools to definitively diagnose PTSD are more sensitive to the tests used for TBI and the greater sensitivity of the PTSD tests shifts the power away from TBI.
It’s exactly as you stated in your article, the tests are imperfect and not standardized. And until there is either a better test or greater awareness of the limitations of existing tests, examiners will continue doing what many have been doing.