Are Arachnoid Cysts Rated As

[PE1]

I had a Brain MRI which showed an arachnoid cyst in the left frontal lobe and one in the right temporal lobe. Are Arachnoid cysts rated as a benign new brain growth?

8003 Benign, minimum 60

Rate residuals, minimum 10

[Berta]

This is the most recent BVA decision I found on this condition:

http://www.va.gov/vetapp08/files2/0810082.txt

Although on remand and we cant determine the outcome of the claim-the VA re-characterised the vetera's benign arachnoid cyst into a TBI type of diagnostic code.That could be benefiticial to this vet as well as to you- if VA does this in your case.

The VA of course is looking for the effects of any trauma and residuals due to the cyst.

I am familiar with brain physiology and can see right away that with left frontal and right tmporal- involvement you could have problems that would be secondary to these cysts.

However- this is a new diagnosis?

Do you have a nexus to another SC condition for this?

With this as a new diagnosis- are you recently discharged OIF OEF veteran?

[Berta]

This is the most recent BVA decision I found on this condition:

http://www.va.gov/vetapp08/files2/0810082.txt

Although on remand and we cant determine the outcome of the claim-the VA re-characterised the vetera's benign arachnoid cyst into a TBI type of diagnostic code.That could be benefiticial to this vet as well as to you- if VA does this in your case.

The VA of course is looking for the effects of any trauma and residuals due to the cyst.

I am familiar with brain physiology and can see right away that with left frontal and right tmporal involvement you could certainly have problems that would be secondary to these cysts.But possibly not at ratable level-hard to say

However- this is a new diagnosis?

Do you have a nexus to another SC condition for this?

With this as a new diagnosis- are you recently discharged OIF OEF veteran?

[PE1]

I retire in 170 days. I hit my head during a bad military parachute landing fall in 1994 while stationed at Ft Bragg NC. I was diagnosed with ADHD 4 years ago and take Concerta for it. The Neurologist and the Neuroradiologist cannot tell for sure if the left frontal arachnoid cyst was congenital or if it was acquired. The Neurologist said that the right temporal arachnoid cyst is less likely to be congenital. The Psychiatrists says that there are cases where head trauma has caused ADHD or exacerbated it. Arachnoid cysts can be congenital or acquired after head trauma. Left frontal Arachnoid cysts are more common in people with ADHD. So, do I claim the Arachnoid cysts a benign new brain growth?

8003 Benign, minimum 60

Rate residuals, minimum 10

Or do I claim TBI residual???

Evaluation of Cognitive Impairment and Other Residuals of TBI

Not Otherwise Classified

Facets of cognitive

impairment and other

residuals of TBI not Level of

otherwise classified impairment Criteria

Memory, attention, 0 No complaints of impairment of memory,

concentration, executive attention, concentration, or executive

functions. functions.

1 A complaint of mild loss of memory (such as

having difficult following a conversation, recalling

recent conversations, remembering names of new

acquaintances, or finding words, or often misplacing

items), attention, concentration, or executive

functions, but without objective evidence on testing.

2 Objective evidence on testing of mild impairment of

memory, attention, concentration, or executive

functions resulting in mild functional impairment.

* 3 Objective evidence on testing of moderate

impairment of memory, attention, concentration, or

executive functions resulting in moderate functional

impairment.

0 = 0 percent; 1 = 10 percent; 2 = 40 percent; and 3 = 70 percent.

[Berta]

"The Neurologist and the Neuroradiologist cannot tell for sure if the left frontal arachnoid cyst was congenital or if it was acquired"

Seems to me the VA should consider that statement as basis for Benefit of doubt as to the origin of this cyst.

The other cyst definitely appears to have service nexus.

I suggest you claim both cysts and claim any other condition or disability you have that has a service origin.

Make sure you claim the parachute incident and that the VA has copies of these medical statements.

Also read the VA's TBI rating criteria-It is in that above BVA case I think -or should be in any recent TBI BVA case-

and ask the VA to give you a rating under the most favorable criteria.

I dont know what rating this will bring to you-

they will possibly set you up for a C & P involving a detailed cognitive function test unless you have had one done already.

"The Psychiatrists says that there are cases where head trauma has caused ADHD or exacerbated it"

Did your Mil psychiatrists say that?Did they write this down?

or do you have medical abstracts or texts to send to VA in support of your claim on this?

"The Neurologist and the Neuroradiologist cannot tell for sure if the left frontal arachnoid cyst was congenital or if it was acquired. The Neurologist said that the right temporal arachnoid cyst is less likely to be congenital. The Psychiatrists etc"

Did they document this in your SMRs exactly as you posted this here?

Did the Neurologist or NeuroRad make a statement that the

arachnoid cyst is more then likely or as likely as not due to the parachute accident?

Can you prove in your SMRs that the parachute accident occurred and that there are treatment notes there in your SMRs?

Brain injury from TBI, and head type of head trauma, strokes etc etc can be assessed as to residuals with many types of tests. The VA gave my husband 7 separate tests.

To determine level of brain trauma due to stroke andf then to separate those deficits from his PTSD.

[PE1]

The Psychiatrist and the Neurologist wrote everything down on paper. Saw both of them off post and I have the notes from them. And I have the ER note from the ER at Ft Bragg where it says it was head trauma due to airborne operation. I have the reading of the radiologist for the brain MRI. I have a follow up with the Psychiatrist on Monday morning. He is going to increase the concerta cr to 108 mg a day which is off label. Makes perfect sense to increase it. The FDA aproves 72 mg as the maximum dose but since adult ADHD is not in the DSM IV but it will be in the DSM V, I'm assuming that for an adult the maximum dose might be higher than 72mg.

[Berta]

Since you are still active Military- is there anyone in the transition program to help you with this?

Have you filled out a 21-526 yet?

I know you wont leave the Military without copy of your SMRs-and make sure before you leave that the SMRs contain all this info and that your discharge certificate notes all of your disabilities.

Also would your personnel records contain anything to show how this trauma might have affected your MOS performance?

During the transition process there should be VA briefings and someone (maybe some vet org reps)available for help with this type of claim-

It is good you are getting your thoughts together now-

and you can file while still in the military with the VA but I believe that is best done during the transition briefings.You are in excellent position now to make sure your Mil inservice records are accurate and up to date.

Unfortunately many vets have problems because their SMRs did not adequately reflect their inservice problems and thy never questioned their discharge certificate if it was wrong.