Liberalizing Of Standards By Which Injuries Are Evaluated

[Rockhound]

In 1973 while still in the service, I was hospitalized for an unrelated psychiatric condition, I sustained a fall, due to a fainting spell, believed to have been caused by the psych drugs I was on at the time.

The result of this fall was a Fractured Nasal Bone and a minor cerebral concussion or closed brain injury of the frontal lobe of the brain. Further testing done shortly after the injury confermed this fact. Later the Fracture Nasal Bone was SC, yet the minor cerebral concussion was not.

Today, such head injuries are handled much differently and are more likely than not, with the similiar medical evidence I had back in 1973, the minor cerebral concussion would have also been SC, even if secondary to the actual skeletal injury.

My question is this, how would I use the new liberalized VA Rules, Regulations, and Laws to my best advantage to reopen and support a claim for the cerebral concussion/TBI, possibly secondary to the Nasal Bone Fracture, which caused the cerebral concussion?

Rockhound Rider

[timetowinarace]

My opinion is you need two things other than in service records.

1. Medicall documentation of complaints of residuals consistant with TBI back to within a year or two of injury.

2. The Neuro-psych tests that show functional impairment consistant with TBI. And maybe your possible MRI, EEG results.

[Berta]

I would use a print out from the VA themselves on TBI and how they now consider this disability and rate the residuals.

As long as you have documented diagnosis of TBI and possible residuals from it-you could use the new C & P exam criteria mentioned in this recent BVA decision:

"With an increasing number of traumatic brain injuries (TBIs)

due to improvised explosive devices, VA's Compensation and

Pension Services (C&P) has developed an examination worksheet

designed to adequately rate all potential residuals from a

TBI. See C&P Examination Worksheet for Traumatic Brain

Injury (added September 12, 2007). This examination is

designed to address the physical, psychological, and

neurological residuals that may arise due to this type of

injury. Furthermore, it recommends consideration of

neuropsychological testing when cognitive impairment may be

present."

Here is the new C & P criteria they mean:

http://www.vba.va.gov/bln/21/Benefits/exams/disexm58.htm

[Rockhound]

My opinion is you need two things other than in service records.

1. Medicall documentation of complaints of residuals consistant with TBI back to within a year or two of injury.

2. The Neuro-psych tests that show functional impairment consistant with TBI. And maybe your possible MRI, EEG results.

Most of my evidence is only suggestive of a problem and will need a forensic IMO to compare it all to the minimal amount of actual medical evidence I have from then till now. Reminder here is that the head injury went untreated after being transfered to the VA hospital and untill recently I had no concrete evidence that their were any problems associated with the head injury. I had been assuming that my psychiatric problems stemmed from my psychiatric problem I had while in the service, that was until I was able to get my VA Psychiatrist to have neuropsychiatric testing done after she told me I could probably more easily prove that my problems were the result of the head injury instead. The results showed cognitive dysfunctions or as you stated, functional impairment, that were probably the result of trauma to the brain. I'm hoping the upcoming MRI and EEG results will help bare this out, but not holding my breath.

Anyway, with the Neuropsychiatric tests done and the results that they show, my psychiatrist is now going to have to make a determination along with my Neurologist, whether my current psychological problems/conditions are caused by a psychiatric disorder or if they are the result of the head injury and since I have not been in any accident that resulted in an additional head injury since the one I had in service, then it must be as a result of that injury and thusly SC'd. although any subsequent head injury would only exacerbate the problems associated with the original one while in service.

I also got one of my psychiatrists to opinion that at the time, having evaluated me over a period of time, that she saw that I did not exibit any personality disorder as discribed by the standards set by the DSM IV. So If I don't have a personality disorder now, then I could not possibly have had a personality disorder for which the VA used, to not only change my prior diagnosis, but also for which I was denied SC for. With this new evidence, it could be shown that the personality disorder the VA C&P examiner saw at that time, could well have been residual effects of the head injury nine months earlier.

I just feel, IMHO, all I need to do is wrap this all up together with a nice IMO, maybe a treatise or two, and a nexus letter to put a pretty bow on top, before I send this claim to the VA.

Rockhound Rider

[timetowinarace]

Rockhound,

I went 12 years undiagnosed and untreated. However I did have 12 years of medical records stating my complaints as I sought treatment for them. These records, though full of misdiagnoses and no diagnoses, show that my residuals were present during that time.

I was diagnosed after neuro-psych testing showed cognative disorder consistant with brain injury. At the time, I had no idea I had any cognative disorder with the exception of poor memory. The psychiatrist that reccomended the testing, the psychologist that did the testing, and later the other psychiatrist that reviewed the testing all stated that all my residuals were likely due to TBI.

The way I see it, you have the proof you need. The neurologist will not comment on the neuro-psych testing results. He will only comment on the MRI, EEG results. So what you need is a psychiatrist to view the test results and state an opinion that you suffer the results of TBI and not PD or that any PD is likely the result of injury.

Open or re-open the claim with the test results for "cognative disorder due to trauma". If you feel more evidence is necissary, get an IMO from a psychiatrist or psychologist. It's not likely the neurologist will give an opinion based on neuropsych testing other than noting the examiners findings.

[john999]

Rockhound

I don't think you need to disprove you have a PD, but rather to prove you have residuals of your psychotic break from the service. I think you have a claim to reopen if you can get a shrink to say you have residuals of schizophrenia.

[Rockhound]

Rockhound

I don't think you need to disprove you have a PD, but rather to prove you have residuals of your psychotic break from the service. I think you have a claim to reopen if you can get a shrink to say you have residuals of schizophrenia.

I believe I have residuals of schizophrenia, at least enough symptoms that are mentioned in the DSMIV, but apparently not enough and/or exact enough for my VA Psychiatrists to opinion the diagnosis for residuals of schizophrenia.

I'm hoping that by the time I meet with my new/or Psychiatrist, I will be able to show and/or demonstrate to her that all or most of my problems had their begining from my psychotic episode while in service, also that the C&P diagnosed personality disorder was the result of my head injury while in service.

My new/old Psychiatrist was my psychiatrist from 2003, who took time off to have a kid and the VA wouldn't let her come back part time, so she waited until her kid was older and she could then come back full time. Now she is coming back and I have made arrangements to be reassigned to her since my current psychiatrist will be rotating out after our next visit. Not to mention that since her, all my psychiatrists have been interns and about every year they would rotate out and I would get a new psychiatrist to take over my care. I'll finally be getting a full fledged psychiatrist again and one I have had a good history with and a better understanding of my full medical history.

Rockhound Rider