Tbi Va Criteria Proposed Changes An-89

[Berta]

38 CFR Part 3

RIN 2900-AN89


Secondary Service Connection for Diagnosable Illnesses Associated 
With Traumatic Brain Injury

http://www.regulations.gov./#!documentDetail;D=VA-2012-VBA-0029-0001

This is a proposed rule to amend 38 CFR, regarding TBI secondary conditions in part thus:

(d) Traumatic brain injury. (1) In a veteran who has a service-
connected traumatic brain injury, the following shall be held to be the 
proximate result of the service-connected traumatic brain injury (TBI), 
in the absence of clear evidence to the contrary:
    (i) Parkinsonism following moderate or severe TBI;
    (ii) Unprovoked seizures following moderate or severe TBI;
    (iii) Dementias (presenile dementia of the Alzheimer type and post-
traumatic dementia) if manifest within 15 years following moderate or 
severe TBI;
    (iv) Depression if manifest within 3 years of moderate or severe 
TBI, or within 12 months of mild TBI; or
    (v) Diseases of hormone deficiency that result from hypothalamo-
pituitary changes if manifest within 12 months of moderate or severe 
TBI.
    (2) Neither the severity levels nor the time limits in paragraph 
(d)(1) of this section preclude a finding of service connection for 
conditions shown by evidence to be proximately due to service-connected 
TBI. If a claim does not meet the requirements of paragraph (d)(1) with 
respect to the time of manifestation or the severity of the TBI, or 
both, VA will develop and decide the claim under generally applicable 
principles of service connection without regard to paragraph (d)(1).
    (3)(i) For purposes of this section VA will use the following table 
for determining the severity of a TBI:

etc: includes the medical stuff.......

comments are being collected until Feb 8,2013

[Berta]

WOW!!!!! You took the Bull by the Horns here!

I sure commend you because I have learned that is what cutting through some of the VAOLA crapola really takes. I call it a sophisticated war maneuver aka TTOOB (taking thumbs out of butts)

"What do I tell the media relations office?? Not worried about confirmation as Congressman Wilsons office, The OIG, and my Attorney have already done so"

I would hold off on that at this point in time.......you might not need to use that approach at all. But save the contact stuff.

.I really didn't know how VA OIG would handle this. They made my day. And certainly So did YOU!!!!!

Now lets see if the results are going to be what you need.

Your lawyer is very young and inexperienced. I think she just learned something important from you about VA 101.

[PfcBrink65th]

She is young, The issue that got OIG interested was that discontinuing medications and treatment was a patient safety issue. It took several months to get congressman Wilsons office involved, hell I even recieved a letter from the white house 5 months ago saying they would "contact and inquire with apropriate agencies" ......that went nowhere...lol. UPDATE....Contacted Charleston VAMC yesterday....gave referal from OIG....My neurology appts. and SEizure medications will be dispensed from the Beufort SC VA clinic that is 30 minutes away. Congressman Wilsons' office has also requested my claim to be expedited

Thank You Berta

[Berta]

Thank YOU for your Service. I sure wish you didn't have to go through this VA rigamorale.

[carlie]

Called the OIG hotline they are contacting the Charleston VAMC to find out why my appts and meds havent been made or sent and ordering them to continue them after they looked up my VA file number to confirm they were stopped in april of 2012. It showed in the system a transfer request to SC but after that nothing. thank you. What do I tell the media relations office?? Not worried about confirmation as Congressman Wilsons office, The OIG, and my Attorney have already done so. Do I tell the media relations that the info is in regards to a media release. I have considered contacting the media. In regards to my attorney I spoke with her today also, I'm kinda PO'ed she waited almost 5 months after requesting to get my c-file before doing the Administrative appeal.

She told me when I hired her she would get results faster than the 2 years The VA told me it would take to add the epilepsy as secondary to the already awa

rded SC TBI. It was found and diagnosed and treated by the VA neurologists as a direct result of a TBI. The new mandates will make that automatic though so all I need is to get it expedited. Its amazing how much time you have to sit on the phone all day when you get a medical hold (seizures) on your license...lol

Seizures are addressed in the reg criteria, as a residual disability resultant from TBI,

(Oct 2008 - DC 8045 change in regs).

There is absolutely no way it would take

"the 2 years The VA told me it would take to add the epilepsy as secondary to the already awa

rded SC TBI".

Heck you can go on line to VONAPP and add your request to add seizures, secondary to SC'd TBI

in about 5 minutes and it will be of record.

https://vabenefits.vba.va.gov/vonapp/about_vonapp.asp

If seizures were a part of your medical evidence of record when they SC'd your TBI

it should have been included in the TBI SC awarded and rated as secondary to your TBI

at a compensable level, if the evidence met the criteria for that.

I think if they SC your seizures as secondary to TBI

down the road -

I feel you will have good chance for an earlier effective date

(if needed) due to the above.

I already posted links for you but here they are in case you didn't see them.

http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=520356037f6ae2686ef11674d5959120&rgn=div8&view=text&node=38:1.0.1.1.5.2.110.67&idno=38

8045 Residuals of traumatic brain injury (TBI):

Evaluate physical (including neurological) dysfunction based on the following list, under an appropriate diagnostic code: Motor and sensory dysfunction, including pain, of the extremities and face; visual impairment; hearing loss and tinnitus; loss of sense of smell and taste; seizures; gait, coordination, and balance problems; speech and other communication difficulties, including aphasia and related disorders, and dysarthria; neurogenic bladder; neurogenic bowel; cranial nerve dysfunctions; autonomic nerve dysfunctions; and endocrine dysfunctions.

The preceding list of types of physical dysfunction does not encompass all possible residuals of TBI. For residuals not listed here that are reported on an examination, evaluate under the most appropriate diagnostic code. Evaluate each condition separately, as long as the same signs and symptoms are not used to support more than one evaluation, and combine under § 4.25 the evaluations for each separately rated condition. The evaluation assigned based on the “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” table will be considered the evaluation for a single condition for purposes of combining with other disability evaluations

[PfcBrink65th]

They were in the initial claim as secondary to awarded SC TBI.( the residuals listed on the award letter were balance and memory, that was never diagnosed or even mentioned in C an P exam or by/to neurologist) The award letter says epilepsy was less likely than not a result of TBI because TBI was only moderate. I filed the claim for epilepsy as secondary in 2010 after being diagnosed and medicated by VA for seizures since 2004. The seizures got so frequent and meds were changed around between dilantin and depakote back and forth that after having a seizure in the VAMC. I was reported by neurologist to DMV and ordered not to drive for 3 years. Thats when I finally put in to add Epilepsy as secondary. SC TBI 30% was awarded by the Army during Retirement board when I was retired from active duty. When I filed with VA to add epilepsy the 30% was reduced to 20% I recieved a 100 dollar amonth pay cut, however I began recieving the 100 differance from DFAS (defense finance accounting service) who disagreed with the percentage redcuction. I now recieve 251.00 a month from VA and 100.00 from DFAS. The seizure I had in the VAMC was recorded during a sleep deprived EEG in which flashing lights were used to induce a seizure. The Record states " general epileptiform activity present" Dr Brenner St Louis VAMC 2004. I have appealed the decision made by VARO and it has been being processed for 2 years as of january this year

[MrPain7]

I have had a seizure disorder since 1975 because of a head injury I've been 100% service connected for seizures since 1984, I applied for TBI about 5 years ago and recieved 70% SC for TBI within a year.

My medical reports over the years state my seizure disorder is secondary to my TBI injury so it would seem to

me my TBI should be before 1984 so I requested an earlier effective date for my TBI award...