timetowinarace

Treatment records for deployed soldiers during the Gulf War were NOT put in SMR's. Mine were "missing" as well (many denials for "there is no record of head injury in service"). They are found with the records of the treating facility. They must be requested by facility and aproximate treatment date. This does not apply to non-deployed soldiers. This is a well known secret by the VA and DOD. No one seemed to know this. Not at the Vet center, not any POA I used, and the VA pretends not to know. If your husband was treated while deployed, he may call the records center and give them the facility and date treated so they can search for them. They will send the filled out request forms to be signed and sent back to release the records. Be advised, I did recieve records from one of the three treating facilities but not the other two. One that I did not find was treatment records from the unit medics that sewed my head and assesed and transported me from the field. There is, or was a number to call for GW era veterans to find these records. I will try to find it and post it if it will help. Let me know.

The rating board thing. A rater will make a decision based on the medical evidence. The doctors, private and C&P do not make a decision but only give their opinion. When they say your claim is at the rating board, it simply means your c-file(evidence) is being or waiting to be reviewed by a rater who will make a decision on the claim. On a side note: The VA will err on the side of protecting the veteran. (at least in this one area) Given two sources of evidence, one with the opinion of competency and one with the opinion of incompetency, I'm quite sure there will be a finding of not competent in most cases. My finding of not competent was based on one comment by the C&P doc. "Because of his memory problems, he may forget to pay his bills." I don't completely agree with the VA on this issue. It seems to me that those that need this kind of intervention would be quite obvious cases of veterans that are recieving full benifits or financial support yet still homeless and hungry. Not those that may have to pay a late fee once in a while on their cable bill. My biggest disagreement with it is that the VA forces this on the veteran and then makes the veteran pay the fiduciary if there is no close family that can do it. Effectively making the veteran pay someone so the veteran can recieve his own bennifits.

It could take 4-6 months. It depends on how soon you and your fiduciary can be interviewed. As a side note, you should be able to recieve your monthly comp with only your backpay withheld untill a fiduciary is appointed if financial hardship is established. I did. Not competent to handle funds does not entitle A&A benifits on it's own as far as I know. I don't have A&A. I fought the competency proposal and like you wasn't given P&T when awarded 100%. After a C&P for competency and a desision of not competent I was awarded P&T. The interview will consist mostly of financial questions for your situation. A set of financial goals will be established and how your award will be applied to live off of and meet the goals. Such as X amount in savings ect. How often your husband will have to report will depend on your situation. My wife rarely has to fill out forms but the interviewer felt I was competent to handle my own affairs and disagreed with the decision. We hear very little from him.

Vet's already rated under the old rules will retain their ratings under those rules unless the Vet requests re-evaluation under the new Code. A Veteran may request re-evaluation under the new reg's no matter of the date of injury or prior rating. If a re-evaluation under the new reg's produces a lower rating, the Veteran will retain the higher rating obtained under the old regs.(I would be carefull not to rely on that too much) This is how I understand it. Hope it answers your question.

Okay, here is a website to visit. Having a TBI, I found the information here very usefull. TRAUMATIC BRAIN INJURY SURVIVAL GUIDE

BamaCoast, I'm not sure if I can help you understand better what your son is going through. But I am a son of parents who don't fully understand either. I suffered a closed head injury in '91 and have struggled ever since. I would be happy to help in any way. I'm looking for TBI information I have that I thought was the best that I have read. When I find it, I'll see what I can do to get it to you. Meanwhile, you are on the right track to get help. But you will need to be very insistant(without getting upset with them) about getting him the treatment he needs. Time

I've read the new regs and am not impressed. While as stated in the article, many will get an increased rating, most will still be seriously lowballed. As an example, if I was re-rated under the new rating criteria, I'm not sure my rating would reach the 100% I am currently rated. I beleive it would not. Why? Because residuals will be averaged together to determine a rating. Meaning if an individual has residuals that are 70%, 50% and 30% disabling each, it is quite certian the combination of conditions would leave that person in very poor overall health. Yet the rating will be 50% even though the most disabling condition is 70% on it's own and the total added together is 150%. My experience with my brain injury is that, using the percentages given(if they applied to me), is that I would be 150% disabled and not 50% disabled. The reason many will get an increase with the new rating scheduall is not because the scheduall is more accurate in determining the disabling effects of brain injury. It is simply because the residuals are now recognized as being real. Averaging rather than adding the accumulation of these residuals assures that ratings will remain low. I'm sorry but someone losing 50% of one arm and 30% of the other does not add up to a 40% loss of both arms. Even VA math, where 50% and 50% add up to 75%(then round) is better than 50% and 50% adding up to 50%. Just my thoughts.

Here is the site I recomend anyone with possible TBI visit. Defense and Veterans Brain Injury Center (DVBIC) Also from my experience, if I could do it all over again starting after the injury and these resources were available to me, I would do everything possible to be evaluated at one of these centers. With the exception of one C&P Doctor that pointed me in the right direction, I have yet to be properly evaluated nor treated by the VA. Five years after diagnoses.

VHA DIRECTIVE 2007-013 1. PURPOSE: This Veterans Health Administration (VHA) Directive establishes policy and procedure for screening and evaluation of possible traumatic brain injury (TBI) in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. 2. BACKGROUND a. TBI is a common form of injury in service men and women serving in OEF and/or OIF. Details on the screening and management of TBI can be found in the Employee Education System Veterans Health Initiative (VHI) module (see par. 5). As experience with this condition in OEF and OIF veterans accumulated, it became clear that screening for possible TBI in OEF and OIF veterans could contribute to ensuring that cases are identified and treatment implemented. b. In response to this need, VHA established a task force including members with expertise in Physical Medicine and Rehabilitation, Neurology, Psychiatry, Psychology, Primary Care, Prevention, and Medical Informatics to develop a screening tool and evaluation protocol. Although TBI is a significant public health problem, currently there are no validated screening instruments accepted for use in clinical practice. Therefore, the task force reviewed existing literature on screening for TBI, examined the efforts of individual military Medical Treatment Facilities and Department of Veterans Affairs (VA) Medical Centers that had implemented TBI screening locally, consulted with the Defense and Veterans Brain Injury Center (DVBIC), and considered data on the natural history of TBI. Based on these efforts, the task force developed a screening instrument to assist in identifying OEF and OIF veterans who may be suffering fromTBI, and a protocol for further evaluation and treatment of those whose screening tests are positive. c. A national clinical reminder, VA-TBI Screening, was built incorporating this screening instrument. The reminder has several elements, as follows: (1) The first step of the reminder is to identify possible OEF and/or OIF participants based on whether date of separation from military duty or Active Duty status occurred after September 11, 2001. Similar to the OEF/OIF Post-Deployment Screening Reminder, the initial questions address location of deployment. The definition of OEF and/or OIF participant is the same as used for the OEF/OIF Post-Deployment Screen with OEF which includes service in: Afghanistan, Georgia, Kyrgyzstan, Pakistan, Tajikistan, Uzbekistan, the Philippines, and an “other” category; and OIF which includes service in Iraq, Kuwait, Saudi Arabia, Turkey, and an “other” category. The screening is done once for all individuals who report deployment to THIS VHA DIRECTIVE EXPIRES APRIL 30, 2012 -------------------------------------------------------------------------------- Page 2 VHA DIRECTIVE 2007-013 April 13, 2007 2 OEF-OIF Theaters, to be repeated if the date of separation has changed due to repeat deployment. The reminder recognizes if screening was completed prior to the most recent date of separation. (2) The reminder then asks whether the patient has already been diagnosed as having TBI during OEF or OIF deployment. Positive answers can be based on patient or caregiver self-report or health records from VA or non-VA sources. Positive answers lead to an option to order a referral for follow-up if the patient does not have current follow-up and wants assistance. (3) For those who confirm OEF or OIF deployment and do not have a prior diagnosis of TBI, the instrument proceeds using four sequential sets of questions. If a person responds negatively to any of the sets of questions, the screen is negative and the reminder is completed. If the patient responds positively to one or more possible answers in a section the next section will open in the reminder to continue the screening process. The four sections are: (a) Events that may increase the risk of TBI. (B) Immediate symptoms following the event. © New or worsening symptoms following the event. (d) Current symptoms. (4) If a person responds affirmatively to one or more questions in each of the four sections, the screen is positive and arrangements for further evaluation is offered. The reminder prompts the user to place a consult for further evaluation, or documents refusal. d. Not all patients whose screen is positive have TBI. It is possible to respond positively to all four sections due to the presence of other conditions, such as: Post-traumatic Stress Disorder (PTSD), cervico-cranial injury with headaches, or inner ear injury. Therefore, it is critical that patients not be labeled with the diagnosis of TBI on the basis of a positive screening test. Patients need to be referred for further evaluation. e. The VHA task force also developed a defined protocol for completing the additional evaluation by a specialized team. It includes the completion of a twenty-two itemneurobehavioral symptom inventory. (1) When any symptom is positive, the protocol provides recommendations on physical examination, diagnostic testing, and recommendations for initial treatment interventions and referral pathways for persistent symptoms. (2) It is possible that patients may have co-existing diagnoses, such as PTSD and TBI, and these must be appropriately evaluated. Given the expertise required to establish a diagnosis of TBI and implement appropriate treatment, the protocol must be completed by Component II Polytrauma Network Sites or Component III Polytrauma Support Clinic Teams existing within the VHA Polytrauma System of Care (see Att. A). If there is no Component II or Component III -------------------------------------------------------------------------------- Page 3 VHA DIRECTIVE 2007-013 April 13, 2007 3 Team at the medical center, the medical center has the option of having the evaluation completed by a specialist with appropriate background and skills, such as a neurologist, who has also had training in the evaluation protocol. f. Between 24 and 59 percent of patients with traumatic spinal cord injury (SCI) have a concomitant TBI. The SCI system of care has the extensive multidisciplinary expertise needed to provide the required evaluation and care. Screening and evaluation are handled by the SCI team for patients followed in the SCI system of care and the initial treatment is provided by SCI Center personnel. 3. POLICY: It is VHA policy that all OEF and OIF veterans receiving medical care, within VHA, must be screened for possible TBI; those who, on the basis of the screen, might have TBI must be offered further evaluation and treatment by clinicians with expertise in the area of TBI. 4. ACTIONa. Veterans Integrated Service Network (VISN) Chief Information Officer. The VISN Chief Information Officer is responsible for ensuring that all medical centers install patch PXRM*2.0*8 which installs the VA TBI Screening clinical reminder and reminder dialog. This patch was made available April 2, 2007. b. National Director for Primary Care. The National Director for Primary Care is responsible for ensuring that: (1) Screen captures and training material for the current version of the VA TBI Screening reminder are posted at http://vista.med.va.gov/reminders/index.html . (2) The reminder is kept up to date and modified, as needed, in the face of advancing clinical knowledge. NOTE: Any updates in the reminder will be implemented using a national IT patch. c. National Director for Physical Medicine and Rehabilitation. The National Director for Physical Medicine and Rehabilitation is responsible for: (1) Maintaining a defined protocol for evaluation of those who might have TBI, based on responses to screening. This protocol must include initial treatment interventions and must be posted at the Physical Medicine and Rehabilitation TBI website at: http://vaww1.va.gov/rehab4veterans/page.cfm?pg=20 . (2) Providing training materials in the protocol for Component II and Component III polytrauma team members and any other specialists who will be completing the protocol. (3) Working with each VISN Chief Medical Officer to develop clear referral protocols, identifying which Component II or III team(s), or other specialists, are to complete the secondary specialty evaluation for each VA medical center. -------------------------------------------------------------------------------- Page 4 VHA DIRECTIVE 2007-013 April 13, 2007 4 d. SCI Center Chief. Each SCI Center chiefs is responsible for ensuring that their staff has been trained in completing the evaluation protocol and for making it available at their SCI Center. e. Facility Director. Each Facility Director is responsible for ensuring that: (1) The National VHA TBI Screening clinical reminder is assigned at the “system” level, or “division” level at all divisions, in the Computerized Patient Record System (CPRS). It is to be available to all users and must be “locked” so that it is not removable by individual users. (2) The reminder is completed for all OEF and OIF veterans who present at the facility for medical care, regardless of the clinic in which they are seen, or the reason for presentation (see Att. B for a flow chart demonstrating the process). (3) When a veteran screens positive for possible TBI, the findings are discussed with the patient by an appropriate clinical staff member and further evaluation is offered. Consults for further evaluation must be submitted, but only after discussion with and agreement by the patient. The clinical staff member must document refusal by the patient within the progress note (using the clinical reminder dialog) if further evaluation is declined. (4) A medical center service is clearly identified for initial management of the consults generated by positive screens. Generally this service is located at the facility; however, it is acceptable for the service to be located at another facility, such as one where the covering Component II or III polytrauma team is located. (5) The identified service initiates contact with the referred patient within 1week, to assist in arranging the recommended evaluation. If initial contact effort is unsuccessful, follow-up efforts must include at least two telephone calls 1 week apart followed by a certified letter. These efforts and any refusals by patients to participate in the recommended evaluation must be documented in the progress notes of the patient’s health record. (6) The patient with possible TBI is offered a comprehensive evaluation by a Component II or a Component III polytrauma team. For sites that do not have a Component II or Component III team and wish to complete the evaluation protocols locally, other specialists such as neurologists can be identified to complete the evaluation protocols locally after completing training. For patients in the SCI system of care, the evaluation protocol is done by a designated SCI team. (7) All staff at the facility involved in completing the evaluation protocol have completed the recommended training on the evaluation protocol. 5. REFERENCES: Veterans Health Initiative (VHI) teaching module, “Traumatic Brain Injury,” found at http://www.va.gov/vhi/ -------------------------------------------------------------------------------- Page 5 VHA DIRECTIVE 2007-013 April 13, 2007 5 6. FOLLOW-UP RESPONSIBILITY: The National Director for Primary Care (11PC) and Chief Consultant for Rehabilitation are responsible for the contents of this Directive. Questions should be referred to (202) 273-8558 (Primary Care) or (202) 273-8484 (Rehabilitation). 7. RECISSIONS: None. This VHA Directive expires April 30, 2012. Michael J. Kussman, MD, MS, MACP Acting Under Secretary for Health DISTRIBUTION: CO: E-mailed 4/13/07 FLD: VISN, MA, DO, OC, OCRO, and 200 – E-mailed 4/13/07 -------------------------------------------------------------------------------- Page 6 VHA DIRECTIVE 2007-013 April 13, 2007 A-1 ATTACHMENT A VETERANS HEALTH ADMINISTRATION (VHA) POLYTRAUMA SYSTEM OF CARE 1. COMPONENT I: Polytrauma Rehabilitation CentersFour regional Polytrauma Rehabilitation Centers (PRCs) provide acute comprehensive medical and rehabilitation care for the severely injured. They maintain a full team of dedicated rehabilitation professionals and consultants from other specialties related to polytrauma. These PRCs, serving as resources for other facilities and assisting in the development of care plans, are located at Richmond, VA, Tampa FL; Minneapolis, MN; and Palo Alto, CA. 2. COMPONENT II: Polytrauma Network SitesTwenty one Polytrauma Network Sites (PNS) provide specialized, post-acute rehabilitation services in consultation with the PRCs in a setting appropriate to the needs of veterans, service members, and families. There is one PNS in each of the twenty-one VHA Networks, including one at each of the four Component I PRC sites. Each PNS has a dedicated interdisciplinary teamwith specialized training, providing proactive case management for existing and emerging conditions, and identifying resources for Department of Veterans Affairs (VA) and non-VA care. 3. COMPONENT III: Polytrauma Support Clinic TeamsPolytrauma Support Clinic Teams (PSCT) are local teams of providers with rehabilitation expertise who deliver follow up services in consultation with regional and network specialists. They are located at many, but not all, Medical Centers that do not have a Component I or Component II center. PSCTs assist in the management of stable polytrauma sequelae through direct care, consultation, and the use of telerehabilitation technologies, as needed. 4. COMPONENT IV: Polytrauma Points of ContactPolytrauma Point of Contacts (PPOC) are present in facilities that do not have Component I, Component II, or Component III services. Facilities that do not have the necessary services to provide specialized care must have a designated PPOC to ensure that patients are referred to a facility capable of providing the Component of services required. PPOCs commonly refer to the PNS and PSCTs within their network. -------------------------------------------------------------------------------- Page 7 VHA DIRECTIVE 2007-013 April 13, 2007 B-1 ATTACHMENT B FLOW CHART FOR SCREENING AND EVALUATION OF POSSIBLE TRAUMATICBRAIN INJURY (TBI) IN OPERATION ENDURING FREEDOM (OEF) AND OPERATION IRAQI FREEDOM (OIF) VETERANS -------------------------------------------------------------------------------- Page 8 VHA DIRECTIVE 2007-013 April 13, 2007 C-1 ATTACHMENT C FREQUENTLY ASKED QUESTIONS REGARDING TRAUMATIC BRAIN INJURY IN OPERATION ENDURING FREEDOM (OEF) AND OPERATION IRAQI FREEDOM (OIF) VETERANS 1. Do patients who are coming only for compensation and pension examinations, but are not receiving any medical care within the Veterans Health Administration (VHA), need to have the screen completed?No. Patients who present solely for compensation and pension exams do not need to have the screen completed. These patients are not being seen in VHA for medical care, but are being seen only for a specified disability assessment at the request of Veterans Benefits Administration (VBA). 2. Do active duty military personnel who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) need to have the screen completed?No. The screen is not mandated for such patients. Screening is optional. Follow-up of positive screens for this population may require referral back to their usual source of care in the military health system, depending upon the authorization received for VHA care. 3. Is screening to be done only in Primary Care or only in the “nexus clinics?” No. Screening is required for all patients receiving medical care within VHA, not just primary care or the nexus clinics. Patients seen in Dental, Emergency Room, or Urgent Care, and any other specialtyclinic; or receiving inpatient care are to have the screen performed and the reminder completed. 4. Can patients with positive screens be referred to local non-VA practitioners or clinics for further evaluation? All evaluations for positive screens are to be done by designated specialists who have completed training in the evaluation protocol. Most commonly these are VHA Component II or Component III teams, or Spinal Cord Injury (SCI) teams. They have the multidisciplinary skills to complete the thorough evaluation required, and have been trained in the evaluation protocol. For medical centers that do not have a Component II or Component III team, it is possible to identify other staff specialists, such as neurologists, to have received, or will receive, training in the use of the evaluation protocol. Data is collected systematically on the results of the evaluations as well as the screens. NOTE: This allows VHA to understand the breadth of the TBI problem in the OEF and OIF veterans, and allows VHA to continuously improve its services. 5. Are only physicians and other practitioners with independent privileges allowed to complete the screens and submit referrals?No. Other clinical staff members are allowed to perform the screens and complete the reminder. However, this staff needs to have completed the Veterans Health Initiative (VHI) Traumatic Brain Injury(TBI) module. They need to understand the basics of TBI and what the evaluation protocol involves, so that they can respond to veterans questions knowledgeably and accurately. NOTE: Medical Centers can allow such clinical staff members to submit referral consults through approved standing orders approved by the medical staff.

Cowgirl, Yes the testing was lenghty. It is mostly a battery of IQ testing. Often the MMPI or other 'personality assesment' is given also. They are looking for cognative disorder but not generaly low numbers across the board. It is low results in different areas that don't make sence that point to TBI. An example is my language scores were a bit above average in the 70 percentile range but my verbal scores are extremely low in the 3 percentile. Since language and verbal abilities are intertwined the scores are not normal. Things like MDD will cause reduced IQ across the whole range. The VA refused to test me, I had to get it done privatly. I would not be the least surprized that your tests could have shown signs of head trauma but at that time most docs did not understand the signifacants. Many TBI sufferers have spent time in mental institutions for years. It has only been in the last few years things have changed. For twelve years I had told many docs of my head injury both inside and outside the VA. Not one even pursued the issue saying it could not cause the problems I was having. Sandbox, I will do some research and see if I can get you some links. I don't know where you are located or what your status is but some places in the VA are better than others for TBI evaluation and treatment. Time is very important for treatment.

It's been quite a while since I visited the board. Hello to all. For cowgirls question, I'm 100% P&T from TBI. My injury was a closed head injury, meaning no skull fracture. I was not knocked out. However I was hospitalized for a couple weeks for "post concussive syndrome" after a somewhat severe reaction several days after the injury. From there I was given a clean bill of health but within a year problems developed. 12-14 years of misdiagnoses, no diagnoses(malingering accusations) followed. Eventually one good psych Doc got it right at a C&P. In summery, no a tbi does not have to be severe(skull fracture) to be SC, and if you can prove symptoms were occuring within a year or two of injury, treatment for a tbi is not neccisary for SC. What I mean by that is, if you had sought treatment for depression and/or other symptoms that can be attributed to the tbi but were not diagnosed as such, it can be proven that those symptoms were/are a result of the tbi. That is how I did it. For Berta, MRI rarely shows this type of injury. Neuropsychological testing is usually the determining factor. In my case, MRI's show nothing. Neuropsych testing reveals severe functional limitations. The basis for my rating.

Ummmmmm, my daughter IS in college. She gets chapter 35 benifits wich helps of course. It still cost me $3,000.00 for tuition and books THIS semester. The Oregon law is great, except I'm a GW1 vet. I would have to think that most college age children of veterans were born well before 9/11. Therefore, there will be fewer college age children that qualify for this program than those that do not. At least for another 10 years or so. That said, my state isn't even offering the restricted program, sooooo. Time

Is your service comp for knees?

Your SO is correct, you need a psych doc to say you are competent to handle your funds. The VARO has proposed incompetent because a doc stated you cannot handle your funds. I doubt a CPA will help much unless you give a statement from him/her to a doc. Then the doc can use that to determine competency. The reason I believe this is because my VA fiduciary councilor wrote a statement that I am competent and asked the rater to re-open my case. He is the one that visits with the veteran and fiduciary, discusses financial situation and sets goals. I had a C&P for this issue in wich the examiner stated that because of memory problems due to my TBI I was not competent to handle my funds. No matter that the VA's own councilor says I'm competent, the fact that I'm in good shape financialy within my means, and that I handle the funds for a non-profit group, the C&P docs opinion that I might forget to pay a bill was the deciding factor. The proccess for competancy determination is the same as any claim. The VA proposes a finding of not competent then gives you time to dispute the proposal, provide evidence, and a C&P is likely. As with any claim, more weight will be applied to medical evidence. I believe you will be found competent simply because the next C&P (I'm sure you'll have one) will be about competancy and you will be given the chance to show the examiner that you are aware of your financial situation and in control. It really is that simple. I think you can relax a little but stay proactive. I don't think I'd spend the money on a CPA though. Show a doc your credit score. It could be better than theirs. My case is different because I DO have measurable memory problems and did not fight the issue much. My funds go into the same account it did before, direct deposit, so there has been no change and because the councilor feels I am competent he does not dictate spending or savings goals. There is also the added security that future rating re-evaluations are unlikely. Time

Very good and helpful information. Thanks Allan

But, that is not the situation the original poster is in. We should be helping him get a proper rating wether he is working or not. He should be encouraged to fight for a proper rating rather than being told he can't get one while working. The fact is, all rating criteria are based on functional IMPAIRMENT and not on employment. iraqx2, Sorry for the bantering on your thread. Time

Your right, this has been discussed many times. However, this forum prides itself on providing facts to the best of our ability. It is a prevailing OPINION that 100% schedualler vets with mental disabilities cannot work. Fact 1. PART 4_SCHEDULE FOR RATING DISABILITIES--Table of Contents Subpart A_General Policy in Rating Sec. 4.15 Total disability ratings. The ability to overcome the handicap of disability varies widely among individuals. The rating, however, is based primarily upon the average impairment in earning capacity, that is, upon the economic or industrial handicap which must be overcome and not from individual success in overcoming it. However, full consideration must be given to unusual physical or mental effects in individual cases, to peculiar effects of occupational activities, to defects in physical or mental endowment preventing the usual amount of success in overcoming the handicap of disability and to the effect of combinations of disability. Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation; Provided, That permanent total disability shall be taken to exist when the impairment is reasonably certain to continue throughout the life of the disabled person. The following will be considered to be permanent total disability: the permanent loss of the use of both hands, or of both feet, or of one hand and one foot, or of the sight of both eyes, or becoming permanently helpless or permanently bedridden. Other total disability ratings are scheduled in the various bodily systems of this schedule. ----------------------------------------------------------------- fact 2. We get compensation for our loss, not dissability pay. There is a difference in the two. Fact 3. impairment and unemployable are not the same thing. Why is there a seperate rating for IU? Fact 4. There are 100% schedualar PTSD veterans that are employed. I do personally know one. Two others have posted here in the past. I respect those that have posted concerning this a great deal for the knowledge and insight they hold (Testvet, T-bird, Pete). I would not object to a post that said something like "it is next to impossible to get a 100% schedualar rating for a mental disorder while employed". However, being unemployed is not a requirement for any 100% schedualer rating. I will not revisit this thread again so as not to be tempted to continue this subject. However, unless someone can show me the word unemployable/unemployed in the rating criteria (not IU) I reserve the right to dissagree in future threads. Time

Not true. There is no requirement that a veteran be unemployable for any schedualer 100% rating (except IU). Even PTSD. There 100% PTSD veterans that have gotten there ratings while working. There have been a couple that have posted on this board on this subject. Those with mental disabilities are likely to be lowballed if they are working, but it is lowball ratings and not requirements or US Code that causes it. It is a myth that employed veterans with mental disorders cannot get a 100% rating. It is a fact that employed veterans will likely get lowballed rating. Time

I have ben found incompetent for VA purposes. I'll try to answer your questions. The proposal by the VA to find a person incompetent for VA purposes works about the same way as a claim, proposal to decrease a rating or whatnot. You have 30 days to object to the proposal. As far as what it means to find a veteran incompetent, it has only to do with the veterans ability to handle finiances. However, if found incompetent there are other factors involved. The name of the veteran will be sent to the FBI and that veteran will be barred from purchasing firearms. There will also be increased scrutiny at airports and such. If you object to the proposal you will be given a C&P. The examiner will give an opinion on your competancy. A rater will make a decision based on this and past exams. If you are found competent that is the end and backpay will be released. If you are found incompetent for VA purposes, you can request a fiduciary of your choice, or one will be appointed. If you request a fiduiciary of your choice then a field examination will be given at your home with your requested fidiciary. If the fiduciary is approved, your funds will be realeased to that person. If a fiduciary is appointed, the fiduciary will deduct a percentage of your award as payment for the job. I do not know exactly how the proccess works if a fiduciary is appointed for you. This proccess is long and drawn out. If you plan on disagreeing with the proposal and can show hardship, you will want to request that your monthly beniffits be released to you. They should only hold backpay untill a fiduciary is established. Chances are, a C&P examiner gave the opinion that your incompetent for VA porposes. I recomend getting a copy of your c-file and seeing for yourself where this proposal came from. It will give you an idea of what to expect for the C&P for competency. Hope this answers some questions for you. Time Competency issue is highly subjective. A C&P examiner opinioned that I am not competent due to memory problems. The field examiner (case manager) opinioned I am competent. I am the President of a non-profit organization (volunteer) and have the checkbook for it. A second C&P examiner was wishy washy about the subject but stated I may forget to pay bills. Found not competent for VA purposes, wife was appointed fidiciary. SSD did not propose incompetency for me but did for my wife(who is my fidiciary) for her SS benifits.

I think the chances of getting your origanal effective date are pretty good. I don't think the review council remands claims without good cause. I won my second ALJ hearing after a remand from the review council. There is that chance of losing your benifits, but I believe it is small. Only you know how good your evidence is to make that decision. Time

I agree 100%.

Well, it does sound like the claim is moving but then it could be in rating for awhile yet. You should know if he had a C&P. The appointment letter says C&P. In Salt Lake, all C&P's are done in a seperate area with rooms only used for C&P exams. If you have been as thourough as it appears and treating Docs assement is clear, he may not need a C&P. It doesn't happen very often though. Ummm, if things don't go your way, it's important to not look at it as a failure. It's better to look at it as just another step in the proccess and not give up. The VA screws up, and it doesn't always matter how hard you've worked on it. Again, for peace of mind, it's better to look at it as another step in the proccess. That said, I think your on top of it and should be successfull. Time

I don't agree with much of of this study. They are downplaying the role of TBI to some degree. For one, their subjects had not had Neuro-psych testing to verify cognative deficits. Yet they claim that psychological factors are likely to be causing the majority of the problems. Two, a person with MTBI can have PTSD symptoms without having PTSD. I have classic PTSD symptoms. I don't have PTSD. I do not have a stressor. Three, to suggest that "soldiers should not be led to believe that they have a brain injury that will result in permanent change", because of a fear that it will cause another "so called Gulf War Syndrome" is dangerous. I had my symptoms for 12 years before I found out it could be TBI. Had I known that it was possible, I would have followed up on it. It is this way of thinking that causes all of those misdiagnoses and undiagnoses. Then again, my opinion is "lay evidence". Time

The MMPI is a personality assesment. Meaning it is a test for depression, anxiaty, somatiform, paranioa and such. By itself is not NP testing. Push for full NP evaluation. Or get it done yourself. It is cheaper, more available and in my opinion better than the PET for your purposes as it measures functional ability. I had insurance and had mine done privetly. The VA did not do it even though the C&P examiner directly stated in his report that it must be done in order to give a definitive diagnoses and he would have to add an addendum to his report after recieving the results. The VARO simply denied my claim without a diagnoses. Very illegal, obviously. But, they get away with it. Time

I don't know of the cost of a PET, only that it is expensive. That is why some of those that must 'prove' their injury opt for the SPECT. Both of these are fairly new imaging devices/technics and are not widely available. I have not had neither. The EEG is more likely to give false negatives that false positives. Your three tests are positive for abnormalities. The problem is that EEG is rarely used to determine functional loss due to organic brain damage. It's common use is to diagnose siezure dissorders or brain death. It does little to nothing to diagnose functional impairment, which is what you need proof of. What I mean is, even though there is a slow wave form in the frontal lobes, it does not necissarily have to have been caused by TBI. Meditation can produce slow wave forms in the frontal lobes. You haven't listed your symtoms/difficulties so I don't know excactly what to recomend pertaining to your claim for TBI.(if you have in other posts, I'm sorry, I don't remember) Also, what was the reason given for your denial? EEG is not neuro-psych testing. Neuro-psych is the most available, and irrefutible proof of functional loss. Functioal loss is what the VA rates on. Under current regs, you will not get a higher rating than 10% for TBI without a diagnoses of multi-infarct dementia(cognative dissorder). You are not likely to get a cognative dissorder diagnoses without neuro-psych testing. I suggest only using the EEG results as a stepping stone to further evaluation as it serves no purpose for rating and little for diagnoses. Also, neuro-psych testing can find deficits that even the PET cannot. Time