Tbi Va Low Ball Help

[bigoc]

I am rated by the VA for TBI at 40%. I have had a neuro-psych exam and the findings fit the 70% criteria. The VA rated me lower because of a finding of a learning disability referenced in my childhood doctors files. Yes this is what they used to give me a lower rating. I guess it amounts to a preexisting condition. I filled a NOD stating and referring to the exam. I believe the time as passed to file another NOD. I should have asked for help earlier but it is what it is.

Is there anything I can do? Possible have another exam.

Also the neuro exam that I refer to was privately administered and submitted by me with my claim. The VA never sent me to have an exam other than meeting with a psychologist to answer a few questions. I am certain it was not an full neuro-psych exam.

[bigoc]

Thanks John. That is another option I am considering. I am still learning the different options for overcoming the VA. I am fortunate that my job has very good health insurance coverage and I may try to go back to a neurologist and get another neuro-psych exam completed since the VA want to play the "most current examination results game." I think I should be able to get another private exam and finding done that I believe may even be more in my favor than the last. The only thing I have going against me if you can look at it that way is that I have a good job. I have to compensate and improvise greatly to keep this job because of my TBI condition but I love the work I do.

Maybe starting off fresh with new neuro-psych exam results along with a private IMO from a neurologist would be a good direction? I am in a good situation to be able to do this right now. I am a little more experienced now and I think I could coach someone along to make sure I am properly documented for the 70% criteria that I easily fit. I fit this rating without even the slightest touch of embellishment. The only reason I think I missed it on my first try is sloppy paperwork and documentation and a lack of follow up on my part.

[timetowinarace]

Okay, that clears things up a bit.

It appears the VA did not lowball you because of the childhood diagnoses. They did the opposite and aproved your claim even though C&P exam said less likely as not due to service. That is rare in my opinion and you were saved some grief.

The VA didn't use the childhood diagnoses against you. They used the examiners low assesment at the time of the C&P. Common.

There are some points that could have been used in a NOD.

I'm wondering what was included in the private "treatment report" because it seems to not have included the actual test scores. Any examiner that is making an assesment needs to see the actual test results and not just an assement based on the results. The VA does not seem to have the actual test results.

I'd have to see both reports to know for sure but here is what I think went wrong and why the rater should not have used the more recent C&P over the private report for your rating. If the C&P eximiner did not have the actuall test results then the conclusion will be based on a subjective evaluation. The private exam was done with objective test results and would carry more wieght. Your cognative functioning as measured by tests is highly unlikely to change in ten months.

I think you can file for increase. If the VA doesn't have the actuall neuro-psych test results, you need to get them in so future examiners have access to them.

Actuall test results will have scores in it like 'fell in the 70th percentile on language comprehension'.

Sorry, I'm having trouble sumerizing so I'll take a break and try later, lol

[bigoc]

I think your explanation of the child hood issue makes sense and I was not understanding it correctly.

As for the neuro-psych exam having the results. I believe the private results include both the examiners findings and raw test results. I will include an example from the results and see if this would change anything:

Learning and Memory

Moderate-severe impairment in ability to learn and immediately recall simple familiar words from a list when given opportunities for rehearsal and repetition; notable inability to remember expected number of words on his initial effort and immediately recall expected number of words after five repetitions (CVLT Total List A < 1 st %ile), a significantly below-average performance in comparison to age and education cohorts

Attention and Concentration

Clinically significant problems on cluster of subtests related to attention and freedom from distractibility (WAIS3 Working Memory Index [WMI] =90 @ 25th%ile, Low Average Range) marked by weakness in attending to, storing and remembering rote numerical sequences and letter-number sequencing and average capacity for mentally conduction relatively simple arithmetic operations.

Again I may have been at fault for not filing a NOD in time, but can someone tell me if I am in ballpark with expecting at least the 70% rating with these exam results. I do not think I can use this test for a reconsideration as they already have this exam and raw test that I mentioned above and I let the time expire for a NOD. Maybe I am wrong and someone can clue me in.

Thanks again everyone I am understanding more every day.

[carlie]

The examiner opined that it was less likely as not that your mild neurocognitive dysfunction was attributed to your service during combat as you manifested abnormalities prior to military service, and have been able to maintain your same level of functioning (working , EMT/Fire Company, physical activity) subsequent to military service.

Ditto on time's post.

[timetowinarace]

My opinion is that you received a bad C&P. Something that is seen over and over agian in this forum. Either the examiner did not read the neuro-psych report or simply ignored it. I can't say for sure without seeing the C&P report. Did you get a copy of it? The C&P examiner should have referenced the test results in his own report as they are objective and carry the same weight as a x-ray, ct scan, mri, blood test or any other medical test.

To answer your question, yes 70% seems to be an easy to justify expectation for a rating. I would go even farther and say, in my opinion, it is possible for a 100% P&T rating based on your test scores that I've seen. I'll explain in next paragraph. Working is the only thing holding you back even though it is not supposed to.

I'll explain percentiles so you know what your looking at with your test scores. It explains much more than words like 'substantial', 'mild, 'moderate' and 'severe'.

A percentile is a comparison to the rest of the population that has taken the same test. A result like the one in your Learning and Memory section of "(CVLT Total List A < 1 st %ile)", the 1st percentile, means that 99% of the population scored higher than you in this area. This score alone should get you a 100% rating in my opinion.

You can file a claim for increase. You will not get the effective date of the original claim if you do get an increase but I do not see a successful CUE here so that is your only option really.

[bigoc]

Time,

Thank your for your information. I was not sure if you could still file for the increase with time so much time elapsed. It would be nice to have the effective date from the original decision but that is not a huge deal in my mind. I was more concerned that I would not be able to use the same information and exam results as I had used in the original claim. I do have the neuro-psych exam results in hand, hard copy. As far as raw results it is kinda of combination of summary and percentile scores together. I am not sure if that counts as the results but I believe that is the closest thing to results short of the examiners written notes on his note pad. I understand the working issue with 100% P&T and I am not unrealistic with how the VA rates things like this. But I still hope that since I objectively fit the rating criteria for 70% I could get that regardless of how much I have adapted to continue to work. I have made significant modifications to include writing the simplest task at work down all day long to continue to do my job. I basically have my head in a note pad all day long between jobs and when my boss is giving my something to do back into the note pad.

Thanks again and I will start putting together a claim for an increase. Is there anything specific I should include in this new claim?