VA OIG TBI Residuals Exam

VA OIG Finally Issues Report On Traumatic Brain Injury (TBI) Disability Scandal

After three years, VA OIG finally issued its report into the traumatic brain injury (TBI) scandal where VA used unqualified doctors to perform exams.

As some of you may recall, since 2015, I began working closely with KARE 11 News reporter AJ Lagoe to investigate how VA conducts its disability compensations assessments for the initial TBI diagnosis and TBI residuals. The investigation resulted in VA admitting it used unqualified doctors or clinicians in exams of almost 25,000 veterans since 2007.

The Charles Gatlin TBI Residuals Story

The report curiously addressed two issues at once. The first is the well-known case of Charles Gatlin where a VA psychologist erred when using an RBANS to assess the extent of his executive functioning from TBI residuals, an assessment type RBANS is not able to evaluate.

The error resulted in Gatlin’s rating being reduced and the state of Montana penalizing the psychologist for the error. The psychologist can no longer perform TBI exams under his Montana license.

RELATED: VA Is Screwing TBI Veterans – Fight Back With This

TBI Diagnosis And TBI Residuals

The second part of the report addresses the finding that VA used unqualified doctors and clinicians to conduct TBI examinations. The report limits itself to 2015, which in itself is a curious selection.

The findings included that training was insufficient for clinicians who lack training on TBI assessments and residuals. It also concluded documentation provided by clinicians doing the exams. And, the manner Veterans Benefits Administration interprets the clinical findings of the exams is inadequate to appropriately compensate veterans.

That is basically the gist of it to this point. I plan to write more in a week or so once I have more time to digest the material.

Use The IG Report As Evidence

But, based on what I read here, I suggest all veterans fighting for a fair rating to submit this report as evidence against the presumption of regularity that your exam was conducted by a clinician who was not adequately trained.

My Own Story With TBI Residuals

For those of you who do not know, I am a TBI survivor with a 70 percent rating from the agency for my residuals of TBI.

I had to fight for years to get that rating, and I am now still fighting for the effective date. All in, we are looking at 17 years of pushback.

I first submitted evidence related to the TBI that was ignored by the agency.

Six years later, I resubmitted the same ignored evidence and received a rating for residuals of TBI of 10 percent. That rating disregarded a VA MRI showing gliosis and causation of certain symptoms.

I appealed, and one year later received a 40 percent rating. The backpay I received from that rating went to purchase the URL for $1,300. That was 2010.

Something about the rating did not make sense, so I started investigating how the agency interprets TBI residuals for disability compensation purposes. I also appealed the decision.

A few years later, I received a 70 percent rating after learning more about the condition and finding a neuropsychiatrist willing to evaluate my medical history and vocational rehabilitation history.

And now, a few years after that, I am still fighting for the effective date back to when I presented the agency with evidence about the head injury that caused the gliosis.

I took all the information I pulled from the agency using multiple FOIAs to create a database for veterans to help fight for fair ratings of their TBI residuals.

That information was also quite helpful in exposing the scandal through KARE 11 with AJ Lagoe, who was invaluable in linking my research to the national scandal he exposed.

And now, here we are, 17 years after my initial claim for benefits with a significant VA OIG finding that VA is poorly treating veterans suffering from TBI, the signature wound of our most recent conflicts.

VA essentially paid for this website. And, the agency also paid for my training to become an attorney and the law firm equipment I use to help veterans like you sue VA.

Talk about biting the hand that feeds you, right?

How long do you think it will take for VA to clean it up so veterans are treated fairly? Without the pressure from KARE 11, do you think Congress would have lifted a finger to pressure VA OIG to investigate?

What about the fixation on 2015? Why did IG stop short of investigating the entire period, 2007 to 2015?

Probably because the underlying numbers are very unfavorable to the agency, and, as you will see from the appendix of this report, IG is not truly independent but more of a CYA tool for the agency’s long-term mission to keep the money flowing in without holding specific VA official responsible for failing to treat veterans fairly.

If you are like me, plodding along for justice one day at a time, you will know better than to hold your breath.

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  1. Thanks for this one, Ben. I’ve filed a Pro Se case in the U S District Court for the Wyoming District, 17-CV-206-F over this same issue if you want to take a look at it. I began my effort 31 years ago. I finally got 40% for the TBI in September of 2010 as of July 2009.

    I’ve been an activist since 1987 on behalf of veterans with organic brain syndromes but was ineffective. I have residual atonic, partial and complex partial seizures which were erroneously treated with Tegretol for 5 months in 1990 making them worse and making me less effective and certainly unemployable.

    The problem began with the Naval Hospital Oakland’s minimization of the TBI in the Narrative Summary of the inpatient treatment. Leaving out the length of the 50 hours of unconsciousness followed by another 30 hours of amnesia, an initial diagnosis of post concussion syndrome, 2 episodes of complex partial seizures during the 30 day treatment. The TBI was diagnosed by neurobehavioral testing in 1985.

    I’ll email you a copy of my incomplete brief and the motion to dismiss by the U S Attorney. I’m citing Bivens and Citizens United’s push back against the erosion of Constitutional rights. I’m claiming veterans’ benefits are guaranteed by Section 4 of the 14th Amendment: ““The validity of the public debt of the United States, authorized by law, including debts incurred for payment of pensions and bounties for services in suppressing insurrection or rebellion, shall not be questioned.”

  2. Mr. Krause – I noted on page 37 (VBA Comment in response to Page 16)

    “However, if an examiner diagnosis a Veteran with a mental disorder as well as residuals of TBI, separate evaluations would be warranted in the manifestations could be clearly differentiated.”

    Have you noticed the VA combining TBI and PTSD or some other mental health instead of separating them? I imagine some examiners would claim symptoms overlap and therefore Veteran should only be awarded tbi or mental health.

  3. Mr. Krause,

    Thank you for sharing. I’ve met some VA peeps who although they have knowledge to share and should whistleblow on, are more worried about getting theirs and to heck with everyone else.

    Yea, I believe the VA hires a lot of flunky docs. I am also trying to see how I can get a doctor to evaluate me and counter them.

    The VA “somehow” doesn’t see a connection between feet, knees, lower back pain and upper neck/back pain because I didn’t fall and injured my back. Ok. Whatever. I left the service with crippling neck pain, which comes and goes…but unfortunately I need to throw myself on the ground or something so they can give me compensation for it.

  4. Great Update. In spite of the time warp challenge of initially being linked to the original article. Lord knows I don’t need any help trying to figure out what day it is.

    1. “[…It’s so dreamy, oh fantasy free me
      So you can’t see me, no not at all
      In another dimension, with voyeuristic intention
      Well-secluded, I see all
      With a bit of a mind flip
      You’re there in the time slip
      And nothing can ever be the same
      You’re spaced out on sensation, like you’re under sedation
      Let’s do the Time Warp again!…]”- “Time Warp”, ‘Rocky Horror Picture Show”-O’Brien

    This Video tells how cannabis is being used for all things that ails you. Read the comments. There is. Neurologist in the comments who tells why you should use it. VA won’t allow it because it means less money from the pharmaceutical companies.

    1. Shameful, the VA just doesn’t get it, no matter what they do, they just can’t get there head and ass wired together properly. Somehow the VA must have gotten there optical nerve crossed with there rectical nerve and keep comming up with a shitty outlook on life and health care.

  6. Good follow up Ben, and good summary of the fight you have put up.

    When you write more about this, I have a strong suggestion I hope you use when studying and writing about this again.

    PLEASE discuss the impacts of a veteran rated at 10% versus a veteran rated at 30% versus a veteran rated at 70% for a TBI…or for any injury.

    I very often see veterans ratings discussed as it relates to compensation, and while that is good to include, it does not tell the full story of how badly a 10% rated veteran is impacted versus a veteran properly rated higher.

    Yes, higher compensation is included with a higher rating, but there are other benefits that are allowed with a higher rating, and in my experience, that includes better medical care for that high rated condition.

    I bet every veteran commenting here can tell about going to the VA and hearing that a certain injury or illness is only rated at 10%, and that translates into an attitude of only receiving 10% medical care. A veteran with a higher rating is treated with a different attitude for that rating. This is not always the case, but I have seen it often enough in several VA clinics where VA staff think an injury or illness really is not that bad because it only has a low rating. Hell, my own PCP has that attitude during my yearly checkups when she only wants to focus on the highest rated problems. As if the others don’t contribute to a lower quality of life.

    On the IG report…Ben, do you have any way of knowing whether this IG report has resulted in changes for TBI veterans getting better exams? How do we know the VA will not just ignore the report?

    As for the IG only looking at a specific time period, I think that is irrelevant. Yes, it would have been great if they looked at all time periods going back years, but it took them 3 years just to issue a report on this short time period.

    Regardless of the time they looked at, I believe any TBI veteran from any period should he able to use this report as evidence in an appeal to get an exam by a qualified doctor.

    Whether the VA would still deny a rating is yet another battle for benefits and proper medical care that has been earned.

  7. va dc hq @dr david shitkin one big big big federal rico crime racket va budget 2018 is 186 billion $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ vets screwed agin @ agin !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  8. Another well written article Ben. I thought my 10 year battle was long. 17 yrs is insane.
    I called the White House hotline in Dec, in regards to my veterans choice treatments being cancelled in Sept due to non payments. Yesterday i received a call from a case worker, who stated she would get it all worked out. I asked her if she would also find out why my other specialist who has been turning in paperwork since last April, is still not registered into the system.
    I’ve written my congressman, even the White House about the Choice program as well as the appeals process. Last week I received a letter from the White House, addressed to me, and signed by the POTUS, addressing my concerns and the failures of the VA. He stated that his administration under Sec. Dr. David Shulkin would improve wait times and care, and dismantle the bureaucracy, that has plagued services at the VA for years. and thanked me for bringing up all my concerns, and promised they will all be addressed and taken care of.
    I was shocked when I got the letter, but even more shocked when I got the call from the VA in Denver yesterday. I’ve been under hardship for quite sometime now, if I said this has given me new hope, I would be lying, after all, those of us who have suffered for a decade or longer, know all to well just how deep the problems lie in the bureaucracy that is the VA.

  9. Two interesting articles out from;
    Dated: 27 Feb 2018
    By: Richard Sisk
    “Vets Groups Want A Meeting With Trump to Sort Out VA Choice Impasse!”

    Basically, the main VSO’s want VA to impose their beliefs on veterans “choice of private medical care vs VA medical care”; ie: “Privatization vs VHA’s medical care!”

    #2.) DoD Medical Records Transfer to VA Improving, But Long Way to Go: IG”

    At least they’re trying, lol!

    1. Yet, we can now in *3 Seconds* uplink/downlink an entire video file from the International Space Station to NASA JPL Labs using a laser/the atmospheric version of fiber optics, without the fiber.

      Yet, the DoD and the VA, which are around the same exact D.C. Swamp…on Earth, cannot (or will not) share data that we military/Veterans served…yet the VA somehow has the power to cockblock Veterans from these very records?

      I’m going with WILL NOT…after billion$ spent and no success…yet we can quickly and freely share data from deep in space, even outside the solar system at the moment by some probes to Earth…but not the freak’n DoD and VA.

    2. Great article on the Vets Groups dreams. Note the VSOs are not talking much about their meeting with Kelly. In all the Articles on the meeting with Kelly all the Big Six VSOs do is mention what they would like and complain about Concerned Veterans of America being at the meeting.

      Elf, did you happen to notice the resent pic of subby hubby cuckold McCain? It has Cindy McCain all snuggled up to an NFL player who also has his arm around wrapped around McCain. In the pic you can see just how brain dead he is. He propped up just staring off into space with his hands all balled up into fists and he is squeezing as hard as he can. The left side of his face is all droopy and swollen.

      Mean while Cindy McCain and the NFL player are all snuggled up with big bright smiles staring into the camera.

      McCain, What an embarrassment he is! Got to love how they propped him up to play the subby hubby cuckold role with a NFL player. To bad McCain couldn’t just take a knee.

      Source: “Larry Fitzgerald pays visit to Senator John McCain”


      1. On the second article you mentioned. It must mean that the DOD is also hooking up with Google to post our medical records online.

      2. Seymore,
        I’ll look up McCain’s wife in a little bit.

        I just got back from my PCP appointment.
        My PCP is pregnant and expecting in about 6 weeks. She will then, after the birth of her first kid, be back in around a few months.
        We talked a bunch about how the VA is screwing vets. She admitted the VA is also “…screwing the good physicians…” by NOT letting them do their best FOR vets.
        I gotta sneaky suspicion VA is going to lose her.

  10. Great work, Ben.
    Last night, on ABC or CBS, local news,
    There was an article on TBI’s concerning a young girl on a high school soccer team. Who was diagnosed with a TBI.
    I can’t remember all the details. Only, something was said about the “findings NOT being calculated correctly” due to something to do with all of the evidence!
    Sorry about not remembering everything!

    In my opinion,
    TBI’s have to do with the brain functioning properly!
    Since “modern medicine” doesn’t actually know what goes on in the brain, how can modern medicine diagnose anything to do with the brain?
    The human only uses a small amount of the brain. So, —– y’all are gonna have to finish this sentence.

    1. Crazy Elf, much reporting on NFL players suggest brain injury can only really be diagnosed in an autopsy.

      I believe a huge problem for veterans is many not having a baseline proving their ability before and after a TBI.

      Perhaps a veteran could point to attending college before their TBI and at the grades they got in school, but how many cannot prove a baseline?

      How many are denied because the VA ignores what evidence they can provide?

  11. Benjamin, dare I suggest that the NFL as of late has been performing WAY MORE research and results re: TBI or whatever the NFL is calling repeated impact and jiggling of the amygdala, than the VA has EVER done.

    I also will go as far as stating those same NFL players will and are getting results/relief yet the VA remains in denial and will keep dragging-out claims such as your 17+ years and counting, still waiting for the VA to do…the right thing…while all the NFL is addressing the TBI/Repeated Impact/Injuries with Godspeed.

    We’re only Veterans after-all, not NFL players that refuse to honor the USA flag and kneel. Go figure.

    1. Maybe research on NFL player’s helmets will trickle-down to military head protective gear down the pike?

      Bitter about the NFL over veterans? Hell YES!

      1. I did some research awhile back when the media was freaking out nationwide over an NFL player either committing suicide, killing someone else or doing some other thing that the media believed it was caused by TBI.

        What I found was less than 150 players that committed suicide for any reason dating back to 1900.

        …and the media was going apeshit.

        Meanwhile, 20-22 veterans per day were killing themselves, and the media in many places yawned.

        Granted, not all veterans committing suicide have a TBI, but it was shocking to see how they reacted to an NFL player that MAY have had a TBI killing themselves.

      2. @91Veteran- THEN you have that terrible Pat Tillman paradox…

        I don’t even like bacon like I used to because the pigskin reminds me of too many things that simply pisses me off to no end. Since the footballs are pigskin, at the NFL to that list of no longer a fan of.

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