ptsd Need Help Interpreting Va Speak On Tbi Claim

[vaf]

I'm trying to assist an Iraq war veteran who holds a rating of 50% for PTSD, among other problems. He was in a motor vehicle that hit an IED. The rating letter in part states the following:

"The evaluation assigned is based upon the highest level of severity for any facet of congitive impairment and other residuals of traumatic brain injury (TBI) not otherwise classified as determined on examination. Only one evaluation is assigned for all the applicable facets. A high evaluation is not warranted unless a higher level of severity for a facet is established on examination. Physical and/or emotional behavioral disabilities found on examination that are determined to be residuals of traumatic brain injury are evaluated separately."

I'm confused about what can vs. cannot be pursued for separate ratings outside of the rating for PTSD and the rating for residuals of TBI. What does this mean in relation to the following:

Discussed in the rating decision but not separately rated are problems with sleep interruption, which could be attributed to the PTSD, but also to the ongoing and steady pain from sciatic neuritis that prevents him from keeping still during the night. Also, the veteran has a sleep study for OSA scheduled for next week.

He also complained of blurred vision, but they didn't rate that at all.

I'm confused as to just what is included in "residuals of TBI" that have already been considered in establishing that rating, yet the migraines he experiences are rated separately. I want to know if I can pursue separate ratings for the veteran's sleep disorder (whether OSA or otherwise), blurred vision, memory and concentration problems (not mood, but more cognitive/intellectual in nature).

Can you help me understand this part of the rating decision? I don't want to pyramid his claims by mistake.

[Pete53]

I don't know much about TBI but a 50% rating is medium but the main question is can he work? Once you reach 505 and up that should be the first thing addressed.

Good Luck and thanks for helping a Veteran

I don't know much about TBI but a 50% rating is medium but the main question is can he work? Once you reach 505 and up that should be the first thing addressed.

Good Luck and thanks for helping a Veteran

[vaf]

This is the least I can do to express my gratitude to those who serve. Jim Strickland invited me to write a piece on his knol, the subject of which I could decide on my own. I decided to make a direct appeal to the friends and loved ones of veterans who need assistance filing their claims, for the exact reason Time mentions here -- because the veteran for various reasons cannot handle this task on their own.

I know it's not the sexiest subject regarding veterans benefits, but I think it's important.

Back to the subject at hand...

We've requested a copy of the C & P exams, and I'll ask the veteran if he's undergone neuropsychiatric testing. I don't think he's working, and I suggested that TDIU would be something to consider, but he wants me to pursue 100% schedular. With a sleep apnea rating with CPAP, he'll still be a little shy of the magic number (95 rounded to 100), but I'll do my best -- with the help of everyone here.

Thanks!

[carlie]

vaf,

There will be only one rating for a MH disability

even if there is more than one and they are comorbid.

carlie

[vaf]

vaf,

There will be only one rating for a MH disability

even if there is more than one and they are comorbid.

carlie

So Carlie, you're saying that the mood disorder rating is included in the PTSD rating, am I understanding you correctly?

[timetowinarace]

So Carlie, you're saying that the mood disorder rating is included in the PTSD rating, am I understanding you correctly?

Yes, I have diagnoses for MDD, Anxiaty and Dementia, all SC for TBI and I have one rating under the ratings for mental.

I'm rated under old law so I have the dementia rating for cognative dissorder because this was not included in the old 8045 code.

Under the new law I would have a rating under 8045 that includes the cognative disorder and a seperate rating for the MDD and Anxiaty. I would have another rating for migraines from the tbi.

Edited October 4, 2009 by timetowinarace

[bigoc]

I do not understand how working should effect a neuro psych test results and final TBI rating.  Just because you are working does not mean you are working to your full potential.  If you are going for a individual unemployability rating than that would seem like the way to go.  But I believe the VA rating codes state something to the effect of not using individual ability to overcome the disability in making a rating decision.  I will try to find this and quote it here.  

I second the idea of getting this testing done.  It is a must for anyone that has evidence of a TBI.  I had one done showing severe deficit and I am still locked in a battle with the VA.  I can not imagine fighting this without my neuro testing.