ptsd Ptsd And Tbi

[signalsix]

is it possible to be rated for both TBI and PTSD or would that be pyramiding?

The reason I ask, when I meet with the Phycologist during my TBI testing she said I have both PTSD and TBI. But I asked her not to report the PTSD because of my job / security clearance. I have since been rated at 40% for Cognitive Disorder NOS residual of TBI and just wondering if the PTSD would even have an effect on my rating.

Thanks

[RockyA1911]

No Carlie,

I had previously been rated at 8045-9304, 10% 11-28-76, Residuals Post Concussion Syndrome with Brain Trauma, Temporal Lobe Contusion, Left, Chronic. It also stated this was done in absence of any objective finding. Yes I was aware, DC 8045 states just Brain Disease in 38 CFR, part 4 previously at that time also. To get higher than 10% under DC 9304, there must be Infarct Dementia (seizures and such) to get 40%. DC 8045 was not ever limited to 10%, it was DC 9304 and only then if there were no objective findings. There are folks that have gotten 100% under DC 8045 alone for such conditions as Encephelopathy (Crazy Chicks Disease) etc (Sp?)

And No you are wrong about the PTSD Part. I filed claim for PTSD in Mar of 2005. In Jan of 2007, I received the award letter wherein they stated I had two mental conditions and therefore they are combined, and stated that the evaluation is for 50% and previous 10% evaluation for the Residuals Post Concussion Syndrome with Brain Trauma, Temporal Lobe Contusion, Left Chronic is changed to read Residuals Post Concussion Syndrome with Brain Trauma, Temporal Lobe Contusion, Left, Chronic WITH POST TRAUMATIC STRESS DISORDER.

I had filed a NOD in March of 2007 requesting they evaluate the Post Concussion Residuals and PTSD separately and provide separate ratings.

In the mean time, the new TBI criteria evaluations came out in Oct of 2008 that now evaluates ratings at 0%, 40%, 70%, and 100%.

So they did not just now service connect the PTSD, it was service connected in March of 2005, but combined with the Post Concussion Residuals. I was RE-Evaluated for PTSD, and Re-evaluated or evaluated for TBI under new criteria. I had a C&P for re-evaluation of PTSD and also a separate C&P for the new TBI criteria and thus they were separate and both using the effective date of both the TBI (70%) and PTSD (70%) of 23 October, 2008.

I don't think any medical professional would argue that Post Concussion Residuals Syndrome with Brain Trauma, Temporal Lobe, Left, Chronic would not be considered TBI or category of Brain Disease.....just a shuffle of words. There are and were many Vietnam Veterans with severe head injuries along with open head wounds that were evaluated under 8045, only we called them head injuries, the medical folks or surgeons referred to them as TBIs///////

Six in one hand and half a dozen in the other.

[carlie]

No Carlie,

I had previously been rated at 8045-9304, 10% 11-28-76, Residuals Post Concussion Syndrome with Brain Trauma, Temporal Lobe Contusion, Left, Chronic. It also stated this was done in absence of any objective finding. Yes I was aware, DC 8045 states just Brain Disease in 38 CFR, part 4 previously at that time also. To get higher than 10% under DC 9304, there must be Infarct Dementia (seizures and such) to get 40%. DC 8045 was not ever limited to 10%, it was DC 9304 and only then if there were no objective findings. There are folks that have gotten 100% under DC 8045 alone for such conditions as Encephelopathy (Crazy Chicks Disease) etc (Sp?)

Rocky,

You were in receipt of 10 % SC for DC 8045 due to Brain Trauma.

VA did consider DC 9304 (by hyphenating it with 8045)for your claim in 1976 but did not SC or compensate for it because as you posted there was an "absence of any objective findings" this part refers to Dementia.

Pre Oct 2008 Rating Criteria Change DC 8045 (by itself) was

ALWAYS limited to 10 percent compensation.

This is the main reason the Criteria change is so valuable to

claimants with Brain Trauma - this change and this change alone

is what opened up DC 8045 to a rating percentage of more than 10 %.

The below is the DC 8045 Criteria prior to the changes taking effect

and this is the Rating Criteria that had to be applied to claims

for DC 8045 claims made and rated prior to the changes.

A 2005 BVA Decision that shows the Pre Oct 2008 Criteria

for Diagnostic Code 8045 -

http://www4.va.gov/vetapp05/files1/0504497.txt

"The veteran's service-connected residuals of skull fracture

are currently rated as 10 percent disabling under 38 C.F.R. §

4.124a, Diagnostic Code 8045, which provides the criteria for

evaluating brain disease due to trauma.

Under this provision, purely neurological disabilities such as

hemiplegia, epileptiform seizures, facial nerve paralysis,

etc., following trauma to the brain, will be rated under the

diagnostic codes specifically dealing with such disabilities,

with citation of a hyphenated diagnostic code (e.g., 8045-

8207).

Purely subjective complaints such as headache,

dizziness, insomnia, etc., recognized as symptomatic of brain

trauma, will be rated ten percent and no more under

Diagnostic Code 9304. This ten percent rating will not be

combined with any other rating for a disability due to brain

trauma. Ratings in excess of ten percent for brain disease

due to trauma under Diagnostic Code 9304 are not assignable

in the absence of a diagnosis of multi-infarct dementia

associated with brain trauma. 38 C.F.R. § 4.124a, Diagnostic

Code 8045 (2004).

In the case at hand, while the veteran has complained of such

subjective symptoms as headaches, balance problems and

insomnia, he has already been granted a 10 percent rating,

the maximum schedular rating under Diagnostic Code 8045 for

such subjective complaints.

The medical evidence of record

plainly does not show that the veteran is experiencing any

symptoms such as hemiplegia, epileptiform seizures, or facial

nerve paralysis. While the veteran has been diagnosed with

mild residual weakness of the right upper extremity and

sensory changes on the right side, both a VA examiner and the

veteran's private physician have attributed these

disabilities to the veteran's stroke in 2000, and not to his

service-connected residuals of skull fracture. Furthermore,

the veteran has not been found to have multi-infarct dementia

due to brain trauma. Therefore, the Board concludes that the

disability is properly evaluated as 10 percent disabling."

And No you are wrong about the PTSD Part. I filed claim for PTSD in Mar of 2005. In Jan of 2007, I received the award letter wherein they stated I had two mental conditions and therefore they are combined, and stated that the evaluation is for 50% and previous 10% evaluation for the Residuals Post Concussion Syndrome with Brain Trauma, Temporal Lobe Contusion, Left Chronic is changed to read Residuals Post Concussion Syndrome with Brain Trauma, Temporal Lobe Contusion, Left, Chronic WITH POST TRAUMATIC STRESS DISORDER.

Rocky,

You posted,

"PTSD and TBI are separate now as of 23 October, 2008. That was a change to the diagnostic code 8045, 38 CFR part 4 rating criteria. Prior to the new recent updated rating criteria I had just a 10% for post concussion residuals, left temporal lobe contusion chronic since 1976 up until March of 2005 when I was diagnosed with PTSD."

As I stated and have shown here in the pre Oct 2008 Rating Criteria

for DC 8045 - PTSD - PRIOR to 2008 was never even in the slightest

little way - EVER any consideration in the old DC 8045 - -

so there was no separation of the two as they were never rated

as one disability.

The new 8045 Criteria allows for several disabilities to be considered and rated as some together and some separetly, with much higher

evaluations than the former limit of 10 percent.

I don't think any medical professional would argue that Post Concussion Residuals Syndrome with Brain Trauma, Temporal Lobe, Left, Chronic would not be considered TBI or category of Brain Disease.....just a shuffle of words. There are and were many Vietnam Veterans with severe head injuries along with open head wounds that were evaluated under 8045, only we called them head injuries, the medical folks or surgeons referred to them as TBIs///////

Six in one hand and half a dozen in the other.

No - it's not at all "just a shuffle of words" it was one of the

most major changes of the Schedule for Rating Disabilities in

about 25 years.

All vets that had head injuries and were rated under the old DC 8045,

and only recieve 10 percent for it should go and get re-evaluated under the new DC 8045 criteria.

Prior to Oct 2008 - unless it was an extremely severe brain injury

the "medical folks" never referred to a head injury as a TBI.

This only came about from OIF/OEF veterans making claims for these disabilities - that is the reason for the change in the rating criteria.

In Rating Decisions it is never,

"Six in one hand and half a dozen in the other."

VA is only supposed to consider what is written in the schedule

at the time of the claim in comparison to when the Rating Decision is promulgated.

If there are vets out there that were Rated SC at 10 % due to

DC 8045 and their claim was active at the time this change was

made - if their C&P's shown the evidence they can also get

an earlier effective date (back to Oct 2008) for their higher rating.

carlie

[carlie]

No Carlie,

I had previously been rated at 8045-9304, 10% 11-28-76, Residuals Post Concussion Syndrome with Brain Trauma, Temporal Lobe Contusion, Left, Chronic. It also stated this was done in absence of any objective finding. Yes I was aware, DC 8045 states just Brain Disease in 38 CFR, part 4 previously at that time also. To get higher than 10% under DC 9304, there must be Infarct Dementia (seizures and such) to get 40%. DC 8045 was not ever limited to 10%, it was DC 9304 and only then if there were no objective findings. There are folks that have gotten 100% under DC 8045 alone for such conditions as Encephelopathy (Crazy Chicks Disease) etc (Sp?)

Rocky,

I am willing to pay twenty bucks each,for up to five links

to any Rating Decisions, that PRIOR to Oct 2008 as you post,

"There are folks that have gotten 100% under DC 8045 alone for such conditions as Encephelopathy (Crazy Chicks Disease) etc (Sp?)"

So if you can stand by this post it should be an easy 100 bucks

for you to make and I am surely willing to send it to you as soon

as you can provide support for this statement.

By the way - I paid you a big compliment in an earlier post in this thread, but I guess you were too busy to see it and just went into

the offensive mode.

carlie