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Reopening A Tbi Claim After A Year

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unclaoshi

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5Hi everyone. This is my first post here and but I have been following some of the topics on the forum and have found a lot of useful info. SO right now Im rated at 60%, 30% for PTSD, 10% for tinnitus 10% for an ankle injury and 10% for a shoulder problem. I had claimed TBI from when my vehicle was directly hit with an IED, it was denied due to no evidence of a TBI existing. After the exam I was refereed to neurologist. I went to the neurologist and did the testing, this was back in 2008. I figured that I would have heard something or had some sort of follow up if I had TBI. Well anyways a few weeks ago I ended up pulling all of my medical info because I am meeting with a DAV VSO. I was looking through my records and saw the VA did not have the results from the testing in my record. I ended up going to the hospital and got a copy of the test results and the doctor put in it that he was concerned about possible underlying mild traumatic brain injury and on the following page "Current findings are consistent with diagnosis of a mild traumatic brain injury, yes. . Its hard because a lot of the residual effects I have also seem to cross over with PTSD. Oh yes I also forgot one thing that doesnt cross over into the PTSD symptoms are I get horrible migraines 3 or 4 times a week and they always feel like they are in the same spot each time, right above my left eye and there is nothing I can do to make them go away. So Im looking for any advice on this for when I go to talk to the VSO. Should I ask for the claim to be reopened or a new evaluation and anything else I should arm myself ( I currently am bringing my medical records, the copy of the TBI test results and my c-file)with them I present her with all this information. I honestly, from what I have been read feel that I got low balled on my claim, I also have had 3 other denials like flat feet, I joined the army and didnt have them my arches collapsed. I claimed them the C&P exam said I didnt but they gave me a referral to a podiatrist for something else and she said that I did indeed have flat feet. Sorry its just frustrating and I know I should not have waited 3 years to check my test results but I wish I had know then what I do now about how screwed up things can get and how claimed get denied. Any advice is appreciated and sorry about the long rambling post.

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Welcome to Hadit.

Since the appeal time has lapsed on your denied TBI claim, you will have to re-open with "new and material" evidence. This new evidence, in your case, will be a diagnoses and treatment for TBI and residuals. So, I have some questions.

You said you did the testing with the neurologist. What was the testing? Describe it to me please. If the neurologist sent you to a neuro-psychologist and you did a full neuro-pshycological test taking several hours to complete, you may have good evidence to procede. If not, you will need to gather more evidence/medical conclusions. You probably will need more anyway.

I assume since you was not informed of the neurologist diagnoses that you are not currently being treated for TBI. Is that correct?

I also have severe chronic migraines often. Are you being treated for yours? A neurologist is the doctor best suited to treat migraines. These can be diagnosed as Traumatic Migraines, as mine are, meaning that they occur because of injury. Your migraines, whether diagnosed as traumatic or not, can be rated on their own up to 50%. If you have been being treated for them, have a diagnoses and the doctor concurs that they began in service or shortly after, you can and should file for them seperately and not wait for the tbi claim. If not, you need to see a neurologist for dx and treatment.

The key to VA claims is medical evidence. Even for the flat feet. Follow up on these items and get treatment, then you should have more success with your claims.

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Welcome to Hadit.

Since the appeal time has lapsed on your denied TBI claim, you will have to re-open with "new and material" evidence. This new evidence, in your case, will be a diagnoses and treatment for TBI and residuals. So, I have some questions.

You said you did the testing with the neurologist. What was the testing? Describe it to me please. If the neurologist sent you to a neuro-psychologist and you did a full neuro-pshycological test taking several hours to complete, you may have good evidence to procede. If not, you will need to gather more evidence/medical conclusions. You probably will need more anyway.

I assume since you was not informed of the neurologist diagnoses that you are not currently being treated for TBI. Is that correct?

I also have severe chronic migraines often. Are you being treated for yours? A neurologist is the doctor best suited to treat migraines. These can be diagnosed as Traumatic Migraines, as mine are, meaning that they occur because of injury. Your migraines, whether diagnosed as traumatic or not, can be rated on their own up to 50%. If you have been being treated for them, have a diagnoses and the doctor concurs that they began in service or shortly after, you can and should file for them seperately and not wait for the tbi claim. If not, you need to see a neurologist for dx and treatment.

The key to VA claims is medical evidence. Even for the flat feet. Follow up on these items and get treatment, then you should have more success with your claims.

Yes you are correct I am not being treated for any sort of TBI. We did some testing that took maybe about two hours it was some written tests and some physical tests. On the result sheet he recommend a formal neuropsychometric testing be conducted, so that maybe what you are referring to in which case no I didnt Im not sure if the VA got the results now or if they just didnt want to follow his recommendations. I am not being treated for the migraines at all. The furthest that I ever ended up talking to them was at the C&P exam when he asked how frequent they were and if aspirin helped. They happen 3 or 4 times a week seem to be in the same spot and I havent been able to find anything that will make them go away.

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Also when I was looking over my copy of my C-File I noticed that on my 21-526 claims form when I got out I did list the migraines on the sheet but it was never addresses my in C&P exam and was not ever denied or granted, what suggestions would you have for this? Just bring it up to my VSO?

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Okay, you need to see a neurologist for your migraines. There are many preventative medications to try that may reduce the amount and severity of the migraines. There are also medications that may help get rid of them when they do come. What works best for me to kill a migraine is Zomig. Preventatives have not helped. So, on your next PCP visit, or make an appointment now for PCP, explain the migraines and history and ask for referal to see neurologist. Also, I would file a claim for the migraines now.

For the TBI, I would not file a claim yet. Since you have been denied once and appeal(or NOD) time has lapsed, it will be more difficult to overcome prior C&P exam that was done. The neurologist report could be used as new and material to re-open but likely won't be enough to refute the C&P for a favorable rating. I'm guessing a bit here though as I have not seen the prior C&P report but it's fairly standard for VARO that you will need substantial evidence to overcome previous denial.

Yes, the "formal" neuropsychometric testing is what you need and what I was refering to. It will prove(or disprove) a claim for tbi that does not include paralysis. You need to show your PCP(preferably your psych PCP but your medical PCP too if you see them first) the neurologist report with the tbi probable diagnoses and testing reccomendation and get that neuropsych test done. Also request treatment. Once you have the results you can proceed with a claim.

I hope this helps.

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