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Oh, also, he never filed for this before. When he was discharged originally, he had only a 20% rating. I did not know him at the time. He basically holed up in a studio apartment for several years, letting his depression grow and grow. He did not associate with anyone, and mostly sat in bed all day every day. He moved to another city and worked for a short time (approx. 6 months) which is where I met him. The more time I spent with him, the more I realized something wasn't right. He had a hard time remembering things, and even had to call me several times for directions to his own house. And the constant urinating... It just seemed strange to me. So i encouraged him to go to the doctor (he hadn't been in years) and that is when he was finally diagnosed with the DI (in 2007) and it was so bad by that point that they found they can't even control it with medication. So, once we got the DI diagnosis, we filed for an increase. They approved it the first go-round, but definitely low-balled us. The C&P examiner wrote over 7 pages about his DI and how debilitating it was. He was definitely on our side. But for whatever reason, they only gave him 20%, though we had evidence to support at least a 40% rating. It's all very frustrating to me, as i just don't understand how they can get away with this. Some people laugh it off and say "it's no big deal, he just pee's a lot" but it is SO much more than that... It's humiliating for him. Not to mention that he is constantly dehydrated. If he gets a simple stomach virus, he could die from dehydration quickly. What makes me the most upset is that if this had been caught before he was discharged, we could likely manage it with medication. But since it went on so long undiagnosed, his body won't even respond to the DDAVP, and he is taking 4 times the maximum dosage! I just wish I could look these people in the eyes and tell them that because of them, this man's spirit is practically dead. Sorry for ranting... I just don't know what else to do.

Berta, I apologize, I am just now seeing this. He is not currently working, and has not in several years. He has not formally requested TDIU. I have suggested that he do so, but I think he is nervous. He feels shame over his condition and so badly wants to be "normal". I think, in his mind, TDIU is "giving up". I don't know what to do. :-( He has not applied for SSA either. He was granted service connection for the DI, and there were in-service medical notes showing clinical dehydration. This was some months after his head injury, so it makes sense. He would have been showing the symptoms of DI at that time. He gets a total of 90%, though he is only rated at 20% for his DI. I wish there was more I could do for him, but it sounds like we have no choice, other than to file unemployability. I wish he would do it, but he is only 32 and seems to have great anxiety whenever I mention this to him...

Carlie, He is not directly rated for his head injury... Below is his original award (granted in 2003 upon discharge): Left upper extremity weakness due to herniated disc, cervical spine, with radiculitis-- 10% Post-concussive Syndrome with chronic headaches, cognitive disorder, and mild dysthymia-- 10% Plantar fasciitis, right foot-- 0% Nuralgia, right sural nerve-- 0% Now, here is his current rating (as of Feb 2008): Diabetes Insipidus-- 20% Dysthymic Disorder due to post-concussive syndrome/cognitive disorder-- 50% Degenerative disc disease with cervical spondylosis C4-C7-- 10% Plantar fasciitis-- 10% Neuralgia, right sural nerve-- 10% Left upper extremity weakness-- 10% Migraine headaches-- 50% We are filing a NOD because we disagree with the 20% rating for DI. In order to qualify for 40%, he had to show 1 occurence of dehydration within the past year. We provided 4 labs that showed dehydration. What I don't understand is why they do not have to compensate him for something they completely missed. They should have caught the DI early on, and because they didn't, he suffered for almost 6 years before he finally went to the doctor and got diagnosed. Now it has progressed to the point that he has to take 4 times the normal dose of DDAVP and he still urinates at least once every 30 minutes (including during the night). Why can't the VA be held accountable for missing this diagnosis? To answer Berta's questions: He is not currently working. His head injury has affected him quite a bit. He has almost zero concentration, and because of his DI he is constantly in the bathroom. His problem is not with the pituitary, but with the hypothalamus (which a PET scan documented damage to). I have encouraged him to request to be rated for TBI as well, but I am not sure if that is the right course to take. Oh and Carlie, in reference to your last post, glucose has nothing to do with DI. He has "water diabetes" and not "sugar diabetes". The only causes of DI are congenital, brain tumor and head trauma. They have acknowledged that the head injury caused the DI. but the onset would have been almost immediate. If he was in the military over the year after the accident, it certainly would have presented itself in that time. He complained of frequent thirst, not being able to sleep due to urination, etc, and they still missed it. It just breaks my heart for him because now he cannot live a normal life. He is grateful for the 90% he got, but somehow it still doesn't seem fair. This could have been well controlled if caught early. But it will only get progressively worse from here. Also, I'm sorry that I don't know all the vocab here. i don't know anything about diagnostic codes, etc, so I hope this is enough info. I just want to help him...

So we could file for a CUE at any point? As far as the DI goes, they recognized it and rated him for it at his last C&P, so at least we have that covered. I believe it should be higher, based on their own rating criteria. But if we send in the NOD, we can still file for CUE at a later date? I just want to make sure I am doing this right since I have no knowledge of the inner-working of the VA. Even if his DI gets increased, it probably won't help him since he is already at 90%. I just want them to know that we disagree and that he qualifies for the higher rating. In my (completely untrained) opinion, they have made a CUE because of the fact that he exhibited symptoms of DI while he was in service. Since they have connected it directly to the head injury, I would think that we'd have a pretty solid case.

Hello all! I am in the process of filing a NOD for my finace. He has been rated for Diabetes Insipidus (DI) secondary to a head injury he obtained in service. As I have been researching his disease, all the research has shown that DI presents itself almost immediately after the injury (within 3-5 weeks). He was in service for more than a year after the accident (which occurred in 2002) and the DI diagnosis was not awarded to him until 2008--when we requested that he be formally evaluated for it. He was not back-dated for it. Since the disease is directly related to the head trauma (by their own admission) and it would have presented itself within weeks of the accident, could this qualify as a CUE? I even have lab results from 6 months after the accident showing that he was clinically dehydrated, yet the military never followed up on this. He should have been diagnosed while he was in-service. Is it appropriate for me to point all of this out in his NOD, or is there a completely different process that I have to go through? I don't want to put the cart in front of the horse if it is going to hurt him... Thanks in advance for your help! Jami

Thank you for your reply. I have been searching all over the web for answers, but I am having a hard time... He does have a VSO, but evidently he is not being incredibly helpful. I will encourage him to make contact with the VSO again though. I guess my next step is finding a doctor that specializes in TBI to give him a good write up. I just want to make sure we get this right, because he deserves it. He has sufferred for 7 years now without much recognition from the VA... Thank you again!

:P Can anyone help? I don't want to get bumped off the first page...

My boyfriend is in the process of doing an NOD, and I am trying to help him with it. But in the process, I am getting quite confused... When he was discharged in 2001, he was rated at 10% for "Post-Concussive Syndrome with chronic headaches, cognitive disorder, and mild dysthymia" He went in for a C&P about a year ago, and they changed his rating to 50% for "dysthymic disorder due to Post-Concussive Syndrome/cognitive disorder" He also has a new rating for chronic migraines/headaches, instead of it being lumped together as it was before. What confuses me is that it appears that they have seperated the headaches and are lumping PCS and cognitive disorder into the same category, whereas before the cognitive disorder was a consequence of PCS. Is there a seperate rating for PCS? Or would this qualify as a TBI since it has been 7 years, and he is still struggling? It is my understanding that PCS and Mild TBI are one in the same. In fact, in the actual write up from the Doctor that did the C&P, it states several times that he displays evidence of TBI. But this isn't included in the rating... I am not sure how to proceed from here. Should he see a new doctor? He is fine with most of the ratings, but doesn't understand why he was not rated for PCS or TBI seperately. Is there no such thing? If there is, would he be able to gather evidence of TBI and present ONLY that for a new C&P, or would they re-evaluate the original conditions as well? Please excuse me for being ignorant about this whole process. I appreciate any help you can provide.