Mri Pending, Must Go To Tbi Screening Clinic First

[Rockhound]

Hell of a XMas Eve present, I am schedule for a TBI screening exam on Dec. 24. I had to find this out the hard way. I went in to discuss my most resent corresspondance from the VARO with my Service Officer, who has her office at the VA Hospital. While their I did some checking to see how much longer it was going to be before my Requested MRI would be scheduled so that I could then see the Neurologist about my cognitive dysfunctions and probable cognitive personality syndrome/disorder and cognitive depression disorder due to brain trauma.

Low and behold, no MRI was scheduled and I was told that a consult with the TBI screening clinic was pending. I'm glad I took my pills today before I left home or I would have probably ended up on the 5th floor psych ward again, But I kept my cool as it were and did some leg work of my own and was able to talk with the scheduling clerk who would have otherwise not gotten around to my appointment until after the new year. I had a choice of doubling back on back to back appointments next tuesday & Wednesday, 16th & 17th I believe, but I already have two days this week to go to the VA Hospital, so I took the only day they had the following week. I almost had a knee jerk reaction when she told me it would be on XMas Eve.

Anyway, long story short, does anyone know what goes on in a TBI Screening Exam? Is there an exam sheet, like their are for C&P exams?

Rockhound Rider B)

[Rockhound]

Cowgirl: The TBI screening clinic exam is specific to Irac and Afganistan soldiers who have been subjected to blast concussion from such devices as car bombs, close by exploding ordinance, suiside bombers, etc. The way he made it sound, if you were hurt in a fall or a vehicular accident, or physically assalted or just about anything along these lines, or even in a training exercise with dummy ordinance, then you don't qualify, expecially if it was outside a combat zone or if it was in a combat zone, then it must have been the result of a concussion blast. Otherwise it is considered under a different criteria as a simple cuncussion to major concussion and or open head injury. Even a bullet wound to the head would not qualify for the TBI Screening. It would be an open head injury even though similiar tests would be given to determine the residual effects of the head truama. Also PTSD is a part of this exam since the Veteran was subject to real threat of dying, being that close to a consussion blast.

Since I wasn't in Irac or Afganistan, I didn't meet the first and foremost requirement, so Idid not qualify on those grounds alone to be screened for a TBI. Nor did I meet the concussion blast criteria while in a combat zone either.

Like I noted, I did however get the Neurolgist to authorize/schedule a MRI and a EEG test. The EEG test is to be conducted while I have been sleep deprived for eight hours. I just got a call today that scheduled my EEG for Jan 08,09 at 0800 in the morning. I'm supposed to stay awake from Midnight until the exam. I doubt this will be a problem, since all I have to do is not take my medicine for sleep and I am assured of no sleep easily for that amount of time. I'm still waiting on my MRI appointment and If I do not hear from the scheduling clerk after the New Year, I'll be calling him to see why they are taking their time.

Once these tests are complete and I see what is written up about them, I will have a better working knowledge on what else I will need to support my claim to SC my concussion/TBI secondary to my SC nasal fracture and deviated septum due to trauma, or to have it SC on it's own merits causing cognitive brain dysfunction. Or rather just as soon as my current claims are accessed and hopefully, not have to appeal them.

Well, past my bed time again as usuall.

Rockhound Rider

[Wings]

I did however get the Neurolgist to authorize/schedule a MRI and a EEG test. The EEG test is to be conducted while I have been sleep deprived for eight hours. I just got a call today that scheduled my EEG for Jan 08, 09 at 0800 in the morning.

Once these tests are complete and I see what is written up about them, I will have a better working knowledge on what else I will need to support my claim to SC my concussion/TBI secondary to my SC nasal fracture and deviated septum due to trauma, or to have it SC on it's own merits causing cognitive brain dysfunction.

Rockhound, This approach to service-connection is all well and good, but what are you going to do with the mental disorder diagnoses? I'm hopeing you'll carry on that battle too? ~Wings

[timetowinarace]

What was the results of your neuro-psych testing?

Unfortunatly, MRI and EEG will do little to nothing to support a TBI claim.

Your fractured nazal bone and deviated septum due to trauma prove a closed head injury occured. The only question is if there is any functional impairment and how much. The neuro-psych testing is the only indicator of functional impairment and it can determine the likely cause of the impairment. Mine states my neuro-cognative impairments are consistant with head trauma.

I hate to see you wait for tests that will provide little to no evidence in your favor. It is possible(likely) that a neurologist will see negative mri and eeg results as proof there is no injury. I've had several neurologists and other doctors tell me no TBI occured because of negative results on mri. It took a Neuro-psychologist and two MD psychiatrists to prove my claim.

[Rockhound]

Rockhound, This approach to service-connection is all well and good, but what are you going to do with the mental disorder diagnoses? I'm hopeing you'll carry on that battle too? ~Wings

The answer to this is a resounding big negative. No I am not going to give it up. I am hoping to use the cognitive dysfunction due to head trauma to prove that any personality disorder I have or had, was the result or residual effect of the head trauma/cerebral concusssion. Having then disproved the VA's previous finding that my personality disorder was preexisting I can then seek SC for my inservice mental disorder.

However, if I am able to also get my current adjustment disorder with depression and anxiety SC combined with my cognitive dysfunction and/or SC for a cognitive personality disorder/syndrome and/or cognitive depression disorder SC, If all or part are SC to such a degree that gives me either TDIU or 100% scheduler, then seeking any further mental disabilities may be a mute subject. Only time and results witll tell.

Rockhound Rider

[Rockhound]

What was the results of your neuro-psych testing?

The results showed minor to moderate cognitive disfunction in most areas and severe cognitive disfuntion in executive function, stating the findings indicated it was probably due to truama, like what I had during my time in service. I've misplaced my copy of the test results and the discussion where the examiner explained the results to me. I hope to get a new copy after the holidays and can post the exact results and opinions.

Unfortunatly, MRI and EEG will do little to nothing to support a TBI claim.

You are correct and my Neurologist and I know this, but it can also be possible that they may show something. He and I felt it was worth the look see.

Your fractured nazal bone and deviated septum due to trauma prove a closed head injury occured. The only question is if there is any functional impairment and how much. The neuro-psych testing is the only indicator of functional impairment and it can determine the likely cause of the impairment. Mine states my neuro-cognative impairments are consistant with head trauma.

Basically, my neuropsychiatric tests state the same thing, that my neuro-cognitive impairment is consistant with head trauma, more specifically frontal lobe brain injury consistant with the trauma that caused my broken nasal bone and cerebral concussion.

I hate to see you wait for tests that will provide little to no evidence in your favor. It is possible(likely) that a neurologist will see negative mri and eeg results as proof there is no injury. I've had several neurologists and other doctors tell me no TBI occured because of negative results on mri. It took a Neuro-psychologist and two MD psychiatrists to prove my claim.

My Neurologist is not of the school of thought where by if their is no indications on the MRI or EEG that their is no injury, He feels the the neuropsychiatric test are more indicative of functional impairment and he says he usually relies on these tests more so than any other exams and/or tests.

If I don't have these tests done, the VARO may request them as part of a C&P exam. I am covering all my bases so that the VARO will not have any room the intergect their own findings. I prefer to seek my own findings outside the claims process as much as possible, VA Drs' seem to be more cooperative to right positive or rather more helpfull statements in your records when they feel they are not being asked to go up against the VARO and/or C&P exam dept.

I hope I have explained my process for getting probative evidence from my VA DRs' makes sense. If I told them it was for a claim, they would be less likely to offer any help. This way they think they are helping me to understand the why for and causation of my cognitive dysfunction to rule out an organic and/or psychiatric reason for it.

Rockhound Rider

[timetowinarace]

My Neurologist is not of the school of thought where by if their is no indications on the MRI or EEG that their is no injury, He feels the the neuropsychiatric test are more indicative of functional impairment and he says he usually relies on these tests more so than any other exams and/or tests.

If I don't have these tests done, the VARO may request them as part of a C&P exam. I am covering all my bases so that the VARO will not have any room the intergect their own findings. I prefer to seek my own findings outside the claims process as much as possible, VA Drs' seem to be more cooperative to right positive or rather more helpfull statements in your records when they feel they are not being asked to go up against the VARO and/or C&P exam dept.

I hope I have explained my process for getting probative evidence from my VA DRs' makes sense. If I told them it was for a claim, they would be less likely to offer any help. This way they think they are helping me to understand the why for and causation of my cognitive dysfunction to rule out an organic and/or psychiatric reason for it.

Rockhound Rider

Thanks for the clarification. I understand the idea behind the route your taking.

Take it for what it's worth but in my opinion you have the evidence you need for service connection. You have inservice records of trauma. You have medical proof of disfunction due to trauma. The VA nor any Doctor of any sort can dispute the neuro-psych testing. They will not request mri, eeg because a C&P for TBI will be done by a psychologist or psychiatrist. They will not re-do the neuro-psych testing as those results will not change.

A word about neuro-psych testing: What they are looking for with this testing is inconsistancies. They are not looking for an across the board decreased functioning as this can be seen in MDD, PTSD, Anxiaty, ect. What they are looking for as far as trauma goess are considerable drops in functioning in different area's. For example, my language abilities tested in the average 70 percentile but my verbal abilities tested in the 3 percentile. This shows trauma occured because had I been born with verbal abilities in the 3 percentile, my language abilities would not progress to the 70 percentile. My testing showed several of these types of dicrepancies. If your testing shows this type of abnormalities(not neccisarily in the same areas) no psych can dispute the findings, thus the va cannot dispute. Just like an x-ray of a broken arm. No radiologist can dispute a picture of a broken bone.

I don't know if any of this information is usefull to you, I can get a bit long winded. My short opinion is you allready have enough to go forward. The only thing you could add to support your claim is more psych opinions based on the testing.

Someone may want to disagree with me on this next part but as far as I am aware, mental disorders cannot be seperated for rating purposes. What I mean is, even if you had a previous PD diagnoses, once you are SC for cognative disorder due to trauma, you will be rated on the whole of your mental disfunction. You should not have to disprove any other mental disorders.

Edited December 31, 2008 by timetowinarace