Important For Tbi Vets

Berta · July 18, 2007

NEWS FROM THE RANKING MEMBER OF THE U.S. SENATE COMMITTEE ON VETERANS’ AFFAIRS

CRAIG’S TRAUMATIC BRAIN INJURY AMENDMENT ADOPTED

Legislation will also help with homelessness, dental and mental health care

July,17,2007

Media contact: Jeff Schrade (202)224-9093

(Washington, DC) Legislation offered by U.S. Senators Larry Craig and Daniel Akaka to provide better treatment for those with traumatic brain injuries (TBI) was unanimously adopted last week on the floor of the U.S. Senate. Their amendment is now a part of the National Defense Authorization Act currently being debated on the floor of the Senate.

"I recently visited with wounded troops at the Landstuhl Army Medical Center in Germany. The vast majority had been injured by roadside bombs and some were clearly suffering from head trauma. Making sure that our troops receive the best treatment we can provide is my goal as a legislator. I believe the language we adopted will help us achieve that objective," said Craig, the lead Republican on the Senate Committee on Veterans' Affairs.

Under the amendment, VA officials would be able to place veterans with brain injuries into medical facilities outside the VA hospital system. "We want those with TBI to receive the best care available. The focus must be on providing the best care we can, wherever that may be," Craig said.

The amendment also calls for VA to conduct more research into the treatment of serious brain trauma and would establish a pilot program for assisted living services for veterans with severe brain injuries. The amendment also requires VA to provide age-appropriate nursing home care to veterans with severe TBI.

In addition to improving care for veterans with traumatic brain injuries, it also requires that an initial mental health evaluation be provided to veterans or returning servicemembers no later than 30 days following a request for such an evaluation. The legislation would also create a demonstration project to identify members of the Armed Forces on active duty who are at risk of becoming homeless upon discharge or release from active duty, and to provide referral, counseling, and support services to prevent them from becoming homeless.

The legislation also enhances the importance of the National Guard and Reserve in VA's outreach programs. In addition, the amendment would expand the window of time servicemembers have to seek dental care from VA upon their release - from the present 90 days to 180 days following discharge from active duty. The bill also extends the period of eligibility for health care for combat veterans from two years to five years after discharge or release.

"Right now combat veterans - whether injured in combat or not - are given priority status when going to a VA hospital or clinic. Under our legislation, they will continue to be a priority for a longer period of time to address any latent emerging medical needs," Craig said.

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RockyA1911 · July 18, 2007

They still need to do something about the VA combining TBIs and PTSD into one rating and calling it two mental disabilities. 50% TBI and 50% PTSD is still just one rating of 50% when it should be separate ratings for each that would be assigned a combined rating of 80%. It is appalling how the VA get's away with that stuff. They did it to me and I am still fighting it.

Vike17 · July 18, 2007

Rocky,

We've discussed this before. The VA isn't trying to screw the veteran here. Remember, the VA pays compensation for residuals of injuries and diseases suffered to any particular bodily etiology.

The VA only combines TBI residuals with mental disorders if there is only subjective complaints such as headaches, insomnia ect..., which is rated under dementia. Keep in mind Dementia is a menatal disorder or residual caused by physical trauma. In more cases than not this results in a 10% evalution.

Any residuals that result in neorological disabilities are rated seperately, such as hemiplegia, epileptiform seizures, facial nerve paralysis, etc.

Vike 17

RockyA1911 · July 19, 2007

Vike17,

I have to respectfully disagree with the same body etiology for TBIs. I received separate award for skull loss, and separate award for surgical scar. The MRIs show a "clear focal slowing" in the left temporal lobe are with post-traumatic encephalopathy. Encephalopathy is a far cry from PCS residuals, it is a organic brain disease due to trauma and is listed under DC 8045 as such.

Also attached is my NOD of 2 June with an exhibit of BVA decision that ordered PTSD and Post Concussion residuals be separate even though they may have been the result of mortar attack, etc and the same body etiology.

Please read the attachment. Help me out here and tell me what your thoughts are after reading the whole thing.

NOTICE_OF_DISAGREEMENT_2_June_2007__edited_names_removed_.doc

A copy and paste from 38CFR4, Diagnostic Code 8045 Brain Disease Due to Trauma.

Organic Diseases of the Central Nervous System

-----------------------------------------------------------------------

Rating

-----------------------------------------------------------------------

8045 Brain disease due to trauma:

Purely neurological disabilities, such as hemiplegia,

epileptiform seizures, facial nerve paralysis, etc.,

following trauma to the brain, will be rated under the

diagnostic codes specifically dealing with such disabilities,

with citation of a hyphenated diagnostic code (e.g., 8045-

8207).

Purely subjective complaints such as headache, dizziness,

insomnia, etc., recognized as symptomatic of brain trauma,

will be rated 10 percent and no more under diagnostic code

9304. [u]This 10 percent rating will not be combined with any

other rating for a disability due to brain trauma. Ratings in

excess of 10 percent for brain disease due to trauma under

diagnostic code 9304 are not assignable in the absence of a

diagnosis of multi-infarct dementia associated with brain

trauma.

Previously the TBI was under DCs 8045-9304 and rated at 10% since 1976 for Brain Trauma, Left Temporal Lobe Contusion Chronic.

In Dec '06 I was awarded 50% for Brain Trauma, Left Temporal Lobe Contusion, Chronic WITH Post Traumatic Stress Disorder. 30% for skull loss (that should have been 50% as 20.25 sq cm exceeds the criterian for 50% by almost 3 times under DC 5296) and 10% for post operative surgical scar.

So what will the DCs be now? PTSD is 9411, and the previous 10% for TBI was under DC 8045-9304 of which the CFR states that the 10% under 9304 WILL NOT be combined with ANY other rating for a disability due to brain trauma. Certainly you can see my side of this after all this.

Also look at this attachment which is more official.

Brain_Trauma_and_PTSD_NOD_EXHIIBITS_CFRs.doc

Edited July 19, 2007 by RockyA1911

Vike17 · July 19, 2007

Rocky,

Here we go again with this!

I wasn't talking about your specific situation. I was talking about the rating criteria as a whole! Like I've said countless times here, the VA may have made a mistake in your case, I don't know, I don't have your C-file in front of me to say one way or another. Submit the NOD and se what the DRO or the BVA has to say!!!!!

"I received separate award for skull loss, and separate award for surgical scar."

The skin is considered a seperate bodily etiology.

"Previously the TBI was under DCs 8045-9304 and rated at 10% since 1976 for Brain Trauma, Left Temporal Lobe Contusion Chronic...In Dec '06 I was awarded 50% for Brain Trauma, Left Temporal Lobe Contusion, Chronic WITH Post Traumatic Stress Disorder. 30% for skull loss (that should have been 50% as 20.25 sq cm exceeds the criterian for 50% by almost 3 times under DC 5296) and 10% for post operative surgical scar"

We have discussed your claim numerous times here and I have already given you my take on how and why things are as they are. Submit the NOD and see what happens!

"So what will the DCs be now? PTSD is 9411, and the previous 10% for TBI was under DC 8045-9304 of which the CFR states that the 10% under 9304 WILL NOT be combined with ANY other rating for a disability due to brain trauma. Certainly you can see my side of this after all this."

The regulation states that the 10% cannot be combined with any other ratings that are the result of the brain trauma. For example, you cannot receive a seperate rating for headaches under DC 8100 if you are rated at 10% under DC 8045-9304. Keep in mind this based on subjective complaints, not on any objective findings. If there are any objective findings of any neurological disabilities, such as hemiplegia,

epileptiform seizures, facial nerve paralysis, then one can receive seperate ratings for these. I suspect your combinded 50% evaluation for brain trauma with PTSD has something to do with either the provision of

"Ratings in excess of 10 percent for brain disease due to trauma under diagnostic code 9304 are not assignable in the absence of a diagnosis of multi-infarct dementia associated with brain trauma."

...or they made a mistake as I previuosly stated in earlier posts to you.

"Please read the attachment. Help me out here and tell me what your thoughts are after reading the whole thing"

I hate to be an ass about this, but I'm not going to continue to beat this dead horse. We've discussed this so many times on this board. You either need to go back a re-read the prior posts we exchanged and go from there, or ignore me and stop asking me for advice and take a different course of action with your claim by following someone elses suggestions.

I'm really sorry if this seems harsh, but I simply do not have the time to keep re-hashing subjects that have already been answered countless times on the board.

Vike 17