Cognitive Disorder Nos W/ Tbi Residual Rating Without C&p Exam

[signalsix]

So I applied for TBI Rating after failing the memory testing, etc, during the TBI screening and sebsequent testing. I had a C&P Exam scheduled in Aug but had to cancel it because my step-Father passed away. Then yesterday I received a letter from the DAV telling me the VA has awarded me 40% rating for Cognitive Disorder with residual TBI. DAV said I should recieve the offical paperwork from the VA soon. I am very surprised the VA settled my claim without a C&P Exam. The only thing I can think of, maybe they used the results from previous C&P exams for other ratings and combined them with the results of the TBI testing.

I am appreicative of the 40% rating, but after reading the rating schedule I believe I may be eligible for 70%. The difference is evidence of mild (40%) or moderate (70%) memory impairment from testing ..... with mild (40%) or moderate (70%) functional impairment. Does anyone have any idea how they quantify mild versus moderate on the test results and functional impairment? I might except this rating since I am able to keep my job.

Thanks

[JamesBreckenridge]

We can rate based on the evidence of record, usually Service Treatment records, and VA Hospital treatment records. If the evidence gives us what we need to rate on, we can go ahead. It's unusual, and some things we can't rate without a special C&P exam (PTSD for example), but it can be done. Example: Vet diagnosed with diabetes requiring medicine and diet in service confirmed by labs. That's a 20% grant, and I would schedule an at-once exam to evaluate for other additional complications of diabetes. I kind of surprised they granted TBI without the special TBI exam though.

Oh, wait. I see, you were SC for Cognitive Disorder (probably something in the 9300s like 9399-9304) with SYMPTOMS of TBI. What they needed to grant they must have had.

Reschedule your C&P exam for TBI. You may be entitled to a higher evaluation. Whether you can work has nothing to do with it.

So I applied for TBI Rating after failing the memory testing, etc, during the TBI screening and sebsequent testing. I had a C&P Exam scheduled in Aug but had to cancel it because my step-Father passed away. Then yesterday I received a letter from the DAV telling me the VA has awarded me 40% rating for Cognitive Disorder with residual TBI. DAV said I should recieve the offical paperwork from the VA soon. I am very surprised the VA settled my claim without a C&P Exam. The only thing I can think of, maybe they used the results from previous C&P exams for other ratings and combined them with the results of the TBI testing.

I am appreicative of the 40% rating, but after reading the rating schedule I believe I may be eligible for 70%. The difference is evidence of mild (40%) or moderate (70%) memory impairment from testing ..... with mild (40%) or moderate (70%) functional impairment. Does anyone have any idea how they quantify mild versus moderate on the test results and functional impairment? I might except this rating since I am able to keep my job.

Thanks

[bigoc]

So I applied for TBI Rating after failing the memory testing, etc, during the TBI screening and sebsequent testing. I had a C&P Exam scheduled in Aug but had to cancel it because my step-Father passed away. Then yesterday I received a letter from the DAV telling me the VA has awarded me 40% rating for Cognitive Disorder with residual TBI. DAV said I should recieve the offical paperwork from the VA soon. I am very surprised the VA settled my claim without a C&P Exam. The only thing I can think of, maybe they used the results from previous C&P exams for other ratings and combined them with the results of the TBI testing. I am appreicative of the 40% rating, but after reading the rating schedule I believe I may be eligible for 70%. The difference is evidence of mild (40%) or moderate (70%) memory impairment from testing ..... with mild (40%) or moderate (70%) functional impairment. Does anyone have any idea how they quantify mild versus moderate on the test results and functional impairment? I might except this rating since I am able to keep my job. Thanks

I don't know that I have an answer for you but I do have a similar experience.  I had a civilian neuro psych test done that referred to moderate and severe deficits that I submitted with my TBI clam.  The VA gave some weird excuses that explained away the civilian test results.  I am in the process of getting an IMO from the psychiatrist that administered the test.

The way I am similar is that the VA only gave me the screening and not the full C&P neuro test for TBI.  With that they threw me 40% as well.  I am not sure how they come up with the idea that we will just do the initial screening and not the full test.  It seems like if you show any kind of problems on the test know matter how severe they just throw the 40% rating at you and you have to fight for the 70-100% rating.

The only thing I can suggest is to go the civilian route for a neuro psych exam if you can afford it and an IMO from the same doctor.  It sucks but it seems the VA does not want to go over the 40% rating without a major fight no matter how bad your deficit is.

[Wings]

So I applied for TBI Rating after failing the memory testing, etc, during the TBI screening and sebsequent testing. I had a C&P Exam scheduled in Aug but had to cancel it because my step-Father passed away. Then yesterday I received a letter from the DAV telling me the VA has awarded me 40% rating for Cognitive Disorder with residual TBI. DAV said I should recieve the offical paperwork from the VA soon. I am very surprised the VA settled my claim without a C&P Exam. The only thing I can think of, maybe they used the results from previous C&P exams for other ratings and combined them with the results of the TBI testing.

I am appreicative of the 40% rating, but after reading the rating schedule I believe I may be eligible for 70%. The difference is evidence of mild (40%) or moderate (70%) memory impairment from testing ..... with mild (40%) or moderate (70%) functional impairment. Does anyone have any idea how they quantify mild versus moderate on the test results and functional impairment? I might except this rating since I am able to keep my job.

Thanks

Search the site (top right) for TBI; there have been some very recent posts with the schedule for rating this disorder --with explanations. ~Wings

P.S. http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

[signalsix]

I did the full tests at the VAMC, twice actually. The first was 2-3 hours and the seoncd was about 7 hours. Then went through the interviews with the Doctors and Speech Therapists. The testing was pretty significant and the results said 2 standard deviations below normal for immediate memory and 1.5 below delayed memory.

James, is the cognitive disorder NOS with residual of TBI, different than TBI (8045)? I specifically requested compenstation for TBI (8045) based on the test results and VA Doctor diagnosis. How do you request a C&P, if they didn't reschedule it after I had to cancel the first one.

Thanks again for the help.

[JamesBreckenridge]

Yes, it's different. One (Cognitive disorder) is rated under the General Rating Formula for Mental Disorders, and the other one is a really complicated mess (TBI). If I saw that it was going to be the same percentage evaluation either way, you better believe I'd rate it as Cognitive Disorder before I mess with TBI.

Also, remember the rule against pyramiding. You can't count the same symptoms twice. If you're SC for both PTSD and Depression, we just consider one of them, and the other one is considered "covered".

You need a TBI C&P exam to see if you are entitled to a higher evaluation for TBI than you are under Cognitive Disorder.

[signalsix]

Thanks James, I will try to get a C&P for TBI.