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Hello Everyone,

I need some advice. I put in a claim in Dec 2009 for TBI, Tinnitus in my left ear and hearing loss in my left ear. I received my award letter today. DENIED not service connected. In July 2006 my Humvee was hit by a RPG in Iraq. I was the passenger, the RPG hit the driver side. ( which would be my left side). We were not hurt just shaken up and disorentated for a few minutes. We didn't receive medical care therefore there is no record of it. I did receive a Combat Action Ribbon for this incident. How do I go about proving this?

In my letter from VA it says The recent examination for TBI porposes was essentually normal indicating either a very mild TBI or no actual TBI. What is that ??? My wife was siting in on the VA exam and the Dr. stated I had a mild TBI. I have no memory of Iraq, I can't remember what I did yesterday, I have a constant ringing in my left ear.

The ear exam states that based on the results of examination the examiner was unable to diognose tinnitus. How can they tell if your ear is ringing. I want to appeal this decission. Do I need to get DAV or other representation.

When I had my last exam in the military, I was unaware of what a TBI is. When I heard the different symptoms I connected it to TBI. I thought my PTSD was the cause of my memory loss and hearing problems. I am 50% service connected for PTSD.

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Hello Everyone,

I need some advice. I put in a claim in Dec 2009 for TBI, Tinnitus in my left ear and hearing loss in my left ear. I received my award letter today. DENIED not service connected. In July 2006 my Humvee was hit by a RPG in Iraq. I was the passenger, the RPG hit the driver side. ( which would be my left side). We were not hurt just shaken up and disorentated for a few minutes. We didn't receive medical care therefore there is no record of it. I did receive a Combat Action Ribbon for this incident. How do I go about proving this?

In my letter from VA it says The recent examination for TBI porposes was essentually normal indicating either a very mild TBI or no actual TBI. What is that ??? My wife was siting in on the VA exam and the Dr. stated I had a mild TBI. I have no memory of Iraq, I can't remember what I did yesterday, I have a constant ringing in my left ear.

The ear exam states that based on the results of examination the examiner was unable to diognose tinnitus. How can they tell if your ear is ringing. I want to appeal this decission. Do I need to get DAV or other representation.

When I had my last exam in the military, I was unaware of what a TBI is. When I heard the different symptoms I connected it to TBI. I thought my PTSD was the cause of my memory loss and hearing problems. I am 50% service connected for PTSD.

MarWar,

Welcome to Hadit.

By chance have you looked over your Rating Decision that granted PTSD at 50 percent service connected.

The VA may have considered these additional claims issues in the Reasons and Bases Section of that Rating Decision.

Yes, crazy things like this have been known to happen.

It is totally up to you whether you use the services of a VSO or not.

You posted, " When I heard the different symptoms I connected it to TBI."

It will be necessary for a doctor to connect your symptoms in writing, to the diagnosis of a TBI.

You posted, "I thought my PTSD was the cause of my memory loss and hearing problems."

PTSD itself,can be inclusive of the symptom of memory loss, but not necessarily any "cause" of memory loss.

PTSD itself, could not be a cause the "cause" of hearing problems.

but the "cause" of your PTSD could also be the "cause" of your "hearing problems".

You will need a diagnosis of Tinnitus from an Audiologist.

I would probably file a NOD on the Rating Decision that denied SC for TBI and Tinnitus.

If you could post exactly what is stated from the Reasons and Bases Sections of the Decisions

it would help others, help you.

jmho,

carlie

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I agree with Carlie's points.

Here is the Blank TBI worksheet - did they fulfill what they were supposed to do at the C & P exam?

http://www.vba.va.gov/bln/21/Benefits/exams/disexm58.htm

TBI is rated not on occurrence of TBI (which could be stressor for PTSD) but on the residuals.

"The recent examination for TBI porposes was essentually normal indicating either a very mild TBI or no actual TBI." I dont suppose they had a brain MRI to back that one up.

But even MRI sometimes doesn't reveal TBI.

It might help to go to the BVA web site (and even search under TBI here) to see what VA is considering as TBI residuals. The residuals also must be at a compensable level (at least 10% disabling for them to send comp.

WHat is the diagnostic code for the TBI on the decision and did they rate it at "0" NSC or "0" SC?

Or did they not rate it at all?

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Hello Everyone,

I need some advice. I put in a claim in Dec 2009 for TBI, Tinnitus in my left ear and hearing loss in my left ear. I received my award letter today. DENIED not service connected. In July 2006 my Humvee was hit by a RPG in Iraq. I was the passenger, the RPG hit the driver side. ( which would be my left side). We were not hurt just shaken up and disorentated for a few minutes. We didn't receive medical care therefore there is no record of it. I did receive a Combat Action Ribbon for this incident. How do I go about proving this?

In my letter from VA it says The recent examination for TBI porposes was essentually normal indicating either a very mild TBI or no actual TBI. What is that ??? My wife was siting in on the VA exam and the Dr. stated I had a mild TBI. I have no memory of Iraq, I can't remember what I did yesterday, I have a constant ringing in my left ear.

The ear exam states that based on the results of examination the examiner was unable to diognose tinnitus. How can they tell if your ear is ringing. I want to appeal this decission. Do I need to get DAV or other representation.

When I had my last exam in the military, I was unaware of what a TBI is. When I heard the different symptoms I connected it to TBI. I thought my PTSD was the cause of my memory loss and hearing problems. I am 50% service connected for PTSD.

First things first. File a notice of disagreement (an "NOD"). Simply file a Statement In Support Of Claim stating that you disagree with the denials (form #21-4136).

Do that NOW.

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This is what VA sent me...

DEPARTMENT OF VETERANS AFFAIRS:

Rating Decision

June 3, 2010

INTRODUCTION

The records reflect that you are a veteran of the Gulf War Era. You served in the Marine Corps from June 1995 to March 2008. You filed a claim for increased evaluation that was received on October 22, 2009. Based on a review of the evidence listed below, we have made the following decisions on your claim.

DECISION

1 . Service connection for traumatic brain injury (TB!) is denied.

2 . Service connection for hearing loss is denied.

3 - Service connection for tinnitus is denied.

EVIDENCE

• Hearing Examination. VA Medical Center dated March 6, 2010

• TB! Examination. VA Medical Center, dated March 29, 2010

We made a decision on your claim for service connected compensation received on December 9, 2009.

This letter tells you what we decided. It includes a copy of our rating decision that gives the evidence used and reasons for our decision. We have also included information about what to do if you disagree with our decision, and who to contact if you have questions or need assistance. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

What We Decided

We determined that the following conditions were not related to your military service, so service connection couldn’t be granted:

Traumatic brain injury (TBI)

We have enclosed a copy of your Rating Decision for your review. It provides a detailed explanation of our decision, the evidence considered, and the reasons for our decision. Your Rating Decision and this letter constitute our decision based on your claim received on December 9, 2009. It represents all claims we understood to be specifically made, implied, or inferred in that claim. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

What You Should Do If You Disagree With Our Decision

If you do not agree with our decision, you should write and tell us why. You have one year from the date of this letter to appeal the decision. The enclosed VA Form 4107, “Your Rights to Appeal Our Decision,” explains your right to appeal.

<B>DEPARTMENT OF VETERANS AFFAIRS <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break"></B>

Medical Description

Hearing loss

Tinnitus

Page 3

Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for traumatic brain injury (TBI) is denied at this time because their is no evidence in service of such an injury and you denied any such injury on both post deployment examinations, your initial VA examination and when seen at VA Medical Center. The recent examination for TBI purposes was essentially normal indicating either very mild or no actual TBI. When considered in total, the medical evidence of record fails to show that you experienced a TBI in service. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

2. Service connection for hearing loss.

Service connection may not be established for disability due to impaired hearing unless

the auditory threshold in any of the frequencies 500, 1000, 2000. 3000 or 4000 Hertz is

40 decibels or greater; or the auditory thresholds for at least three of the frequencies 500,

1000, 2000, 3000 or 4000 Hertz are 26 decibels or greater; or speech recognition scores

using the Maryland CNC Test are less than 94 percent. (38 CFR 3.3 85)

Your service treatment records note that you were exposed to loud noise in your work. Hearing examinations did not show any decibel losses which meet the criteria for a service connectable hearing loss for VA purposes.

Your hearing examination conducted March 6, 2010 at VA Medical Center. noted the following findings: Left ear with 96 percent speech discrimination. Decibel (dB) loss at the puretone threshold of 500 Hertz (Hz) is 10, with a 10 dB loss at 1000 Hz, a 10 dB loss at 2000 Hz, a 10 dB loss at 3000 Hz, and a 5 dB loss at 4000 Hz. The average decibel loss is 9 in the left ear. These findings do not meet the criteria for a service connectable hearing loss. The right ear shows the percent of speech discrimination is 100. Decibel loss (dB) at 500 is 10 Hz; with a 5 dB loss at 1000, a 10 dB loss at 2000, a 10 dB loss at 3000, and a 0 dB loss at 4000. The average decibel loss for the right ear is 6. These findings also do not meet the criteria for a service connectable hearing loss.

In this case, the evidence of record does not show audiometric findings which meet the criteria for a grant of service connection for defective hearing. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

3. Service connection for tinnitus.

To establish service connection there must be medical evidence of a current diagnosis and residuals of the condition claimed. There must also be evidence establishing a relationship between the current condition and your period of active duty. It is not sufficient to show that you sustained an injury or were treated for a condition in service. There must be medical evidence showing current residuals of that disease or injury.

• Orthopedic examination, Medical Group, dated March 5. 2010 (This Exam was not even for a TBI, it was for my back)

• Letters to you dated November 3, 2009 and December 30, 2009, advising you what information and evidence is needed and requesting any information or evidence you have or are aware of in support of your claim.

• Statements from you through February 15, 201 0

• Service personnel and treatment records from, 1994 through 2008

• Examination. Camp Lejeune Clinic, scheduled January 31, 2008

• Treatment records. VA Medical Center, from July 2, 2008 through April 21, 2010

REASONS FOR DECISION

1. Service connection for traumatic brain injury (TBI).

To establish service connection there must be medical evidence of a current diagnosis and residuals of the condition claimed. There must also be evidence establishing a relationship between the current condition and your period of active duty. It is not sufficient to show that you sustained an injury or were treated for a condition in service. There must be medical evidence showing current residuals of that disease or injury.

A review of your service treatment records finds no report, complaint, symptoms. treatment or diagnosis of a traumatic brain injury. Both post deployment evaluations are negative for any history or complaints of TB!. At the examination conducted January 31, 2008, you stated that you had been on three convoys, two of which were uneventful. On the third, your vehicle was struck in the rear by a small RPG and that no one in the vehicle was aware it was hit until after you returned to base. It was that event you stated which was the basis for your Combat Action Ribbon. At your recent VA examination March 29, 2010, you stated you were a passenger in a Humvee when an RPG hit the driver1s side. but only caused a dent and did not penetrate. You stated you were disoriented for a few seconds. You stated you developed problems with your memory after that. A review of your treatment records from VA Medical Center. Loma Linda notes that when initially seen in 2008, you denied experiencing any TBI related event during your deployment. Subsequently, after reading an article on TBI. you requested a TB! examination.

The VA examiner noted your medical history and complaints of headaches which began in 2008, occurring once a day and lasting 5-10 minutes. You also complained of dizziness sometimes when you start to stand up and difficulty concentrating. The examiner described your memory, concentration, social interaction, orientation, motor activity, visual spatial orientation, communication and neurobehavioral effects all being normal. While noting your subjective complaints of headaches and dizziness, the examiner observed that they do not interfere with work or other activities. The examiner noted that you are employed full time and have not lost any time from work due to the symptoms you describe as related to a possible TBI. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

Page 4

Your service treatment records do not contain any complaints, treatment or diagnosis of tinnitus. The records do show that you were exposed to noises and were counseled on hearing conservation. VA treatment records note your complaint of tinnitus; however, when tested. tinnitus could not be confirmed.

The VA examiner noted your medical history of gradual onset of tilmitus over the past 4- 5 years and complaints of tinnitus in the left ear, occurring 5-6 times a day and usually lasting for just a few seconds. Examination of your ears was unremarkable. Acoustic immittance testing indicated normal inner ear pressure and mobility. Acoustic reflexes were present. Hearing was essentially normal and word recognition was considered to be excellent. Based on the result of your examination, the examiner was unable to diagnose tinnitus.

In the absence of a confirmed diagnosis of tinnitus related to your period of service, service connection cannot be granted at this time. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

REFERENCES:

Title 38 of the Code of Federal Regulations. Pensions. Bonuses and Veterans’ Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations. please consult your local library, or visit us at our web site. www.va.gov.

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"I did receive a Combat Action Ribbon for this incident. How do I go about proving this?"

Check your 201 service personnel file to see if the write up for this award is there.

(or do you have a personal write up?)

Also you could contact JSRRC to see if they could search for the incident.

Their contact info is here under search feature.

You could also attempt to get buddy statements as your unit surely has a web site.

I need to add this-my husband was a decorated combat vet (Vietnam). When he served the USMC did not award the CAR. I have the form to request it posthumously.

This is the criteria for the CAR:

http://www.gruntsmilitary.com/combact.shtml

You might have been awarded the CAR for a combat incident unrelated to the TBI incident.

Do you have a copy of the actual exam results yet?

You have to get that from the VA where the exam was done.

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