Is A Head Trauma Seen The Same As A Tbi?

[skydealer]

I got whacked in the head while in the service and lost consciousness. Several months later my military medical records I was being treated for chronic headaches with migraine like symptoms though the medication I received looked like it was for tension headaches. Last military records shows me complaining of a dull headache.

That was 1983. I never knew about applying for anything with the VA and for the past 30 years I’ve been seeing civilian doctors for chronic headaches, memory loss, insomnia, but mainly for the bad headaches. A CT scan showed a brain cyst on the left side and I’m currently still being treated.

Should I be looking at this as a TBI? I did apply for compensation for the chronic headaches but I got denied as they said there was no current diagnosis so I was wondering if I labeled it wrong.

[Gulfvet45]

Do not do the TBI, a part of the 900 code for the reg on TBI has them max at 10% under TBI. What did your doctor call them? Send in the NOD stating that the service called them a migraine type headache DC 8100. you will have to also say how many per month, how much time lost from work and if you needed bed rest.

[Lenkl]

My dad was thrown from a gun jeep in 1978 he is now receiving 100% for a TBI injury I would file for a TBI rating ASAP.

[jbasser]

Folks remember this one important point. I know these new TBI regs sound good. The SMC is great for deserving veterans. Now as far as past injuries that happened inthe 80s, If you had an injury and say you filed a claim and were denied. You could re open the claim based on New and Material Evidence but I stress the regs in effect at the time of the original decision will take precedence.

J

[carlie]

DC 8045 - Brain Disease Due To Trauma - Pre Oct 2008

Diagnostic Code 8045,

which specifies that 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 10 percent and no
more under Diagnostic Code 9304.

This 10 percent rating will
not be combined with any other rating for a disability due to
brain trauma.

Ratings in excess of 10 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; 38 C.F.R. § 4.130, Diagnostic Code
9304.

Below is a link to a BVA decision that spells the criteria out pretty good

for the criteria in effect PRIOR to Oct 2008's changes.

The VBA has mailed out invitations to veterans that were previously rated under the

PRE Oct 2008 criteria, notifying them they can submit a claim for increase, under the

updated criteria if they want to.

http://www.va.gov/vetapp05/Files3/0520204.txt

"The RO has rated the veteran's service-connected concussion
headaches, from May 14, 1997 to March 12, 1998, as
noncompensable. Since March 13, 1998, the RO rated the
veteran's concussion headaches as 10 percent disabling,
pursuant to Diagnostic Codes 8045 and 9304.

The criteria for the assignment of disability ratings for
brain disease due to trauma are found in Diagnostic Code
8045, which specifies that 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 10 percent and no
more under Diagnostic Code 9304. This 10 percent rating will
not be combined with any other rating for a disability due to
brain trauma. Ratings in excess of 10 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; 38 C.F.R. § 4.130, Diagnostic Code
9304.

Initially, the Board notes that the veteran's concussion
headaches, from May 14, 1997 to March 12, 1998, were
manifested by symptoms of frequent headaches and insomnia,
and as such warranted assignment of a 10 percent disability
rating during this period. However, at no time since the
grant of service connection for this condition has the
evidence shown that the veteran has been diagnosed with
multi-infarct dementia associated with brain trauma. Thus, a
rating in excess of 10 percent for concussion headaches
(post-traumatic headaches) is not warranted under the above
provisions.

The evidence associated with the veteran's claims file does
not show that the criteria for a disability rating in excess
of 10 percent for concussion headaches have been met.
38 C.F.R. §§§ 4.87, 4.124a, Diagnostic Codes 8045 and 9304
(2004). There is no reasonable doubt on this issue that can
be resolved in the veteran's favor. His subjective
complaints of frequent headaches, nausea, and dizziness, as
they relate to the inservice brain trauma, can only be
assigned a 10 percent disability rating under Diagnostic Code
8045 unless there is a diagnosis of multi-infarct dementia.
A diagnosis of multi-infarct dementia has not been rendered.

The Board has considered all other potentially applicable
diagnostic codes. Diagnostic Code 8100 provides higher
ratings for migraine headaches; however, the veteran's
headaches are medically related to inservice head injury and
are properly evaluated under Diagnostic Code 8045. Moreover,
the headaches which he has reported are not shown to be
prostrating in severity.

Although the Board sympathizes with the veteran's
difficulties due to his condition, the Board is constrained
to abide by VA regulations. The Secretary has determined
that the maximum disability rating for headaches and other
subjective symptoms that result from head injury is 10
percent, and this evaluation encompasses a level of
compensation for persistent symptoms due to such injury and
for any impairment in earning capacity due to these symptoms.
Without a diagnosis of multi-infarct dementia, he simply is
not entitled to a schedular disability rating higher than 10
percent. The veteran does not meet these criteria, and there
is no reasonable doubt on this matter that could be resolved
in his favor. The Board has considered all potentially
applicable diagnostic codes, as discussed above.

The issue of entitlement to an extraschedular disability
rating pursuant to 38 C.F.R. § 3.321(b) for the veteran's
condition has been raised by his statements and testimony
herein. As discussed above, the veteran is receiving the
maximum schedular evaluation under Diagnostic Code 8045, yet
he asserts that he is entitled to an increased rating. A
claim of entitlement to an extraschedular evaluation is
implicit in his claim for an increase in such a circumstance.
The question of an extraschedular rating is a component of
the veteran's claim for an increased rating. See Bagwell v.
Brown, 9 Vet. App. 337 (1996).

In exceptional cases where schedular evaluations are found to
be inadequate, the RO may refer a claim to the Under
Secretary for Benefits or the Director, Compensation and
Pension Service, for consideration of "an extraschedular
evaluation commensurate with the average earning capacity
impairment due exclusively to the service-connected
disability or disabilities." 38 C.F.R. § 3.321(b)(1).
"The governing norm in these exceptional cases is: A finding
that the case presents such an exceptional or unusual
disability picture with such related factors as marked
interference with employment or frequent periods of
hospitalization as to render impractical the application of
the regular schedular standards." Id.

In this case, the RO has not expressly considered whether an
extraschedular rating is appropriate for the veteran's
condition. Nevertheless, the Board is not precluded from
concluding, on its own, that referral for extraschedular
consideration is not warranted. See Bagwell, 9 Vet. App. at
339 (BVA may affirm an RO conclusion that a claim does not
meet the criteria for submission pursuant to 38 C.F.R.
§ 3.321(b)(1) or reach such a conclusion on its own)
(emphasis added).

It does not appear that the veteran has an "exceptional or
unusual" disability; he merely disagrees with the assigned
evaluation for his level of impairment. The veteran has not
required any periods of hospitalization for this condition,
and there is no evidence in the claims file to suggest marked
interference with employment as a result of this condition
that is in any way unusual or exceptional, such that the
schedular criteria do not address it. His symptoms,
consisting of headaches, dizziness, and insomnia, are
contemplated in the disability rating that has been assigned.
In other words, he does not have any symptoms from his
service-connected disorder that are unusual or are different
from those contemplated by the schedular criteria. Loss of
industrial capacity is the principal factor in assigning
schedular disability ratings. See 38 C.F.R. §§ 3.321(a),
4.1. Indeed, 38 C.F.R. § 4.1 specifically states:
"[g]enerally, the degrees of disability specified are
considered adequate to compensate for considerable loss of
working time from exacerbations or illnesses proportionate to
the severity of the several grades of disability." See also
Moyer v. Derwinski, 2 Vet. App. 289, 293 (1992) and Van Hoose
v. Brown, 4 Vet. App. 361, 363 (1993) [noting that the
disability rating itself is recognition that industrial
capabilities are impaired].

The Board therefore concludes that referral for
extraschedular consideration is not warranted in this case.
In the absence of any evidence that reflects that this
disability is exceptional or unusual such that the regular
schedular criteria are inadequate to rate it, referral for
consideration of an extraschedular rating is not in order.

The Board notes that this is an initial rating case, and
consideration has been given to "staged ratings" for the
condition (i.e., different percentage ratings for different
periods of time based on the facts found) since service
connection became effective in May 1997. Fenderson v. West,
12 Vet. App. 119 (1999). However, the evidence shows that
since the effective date of the award, there have been no
identifiable periods of time during which the veteran's
residuals of head trauma with headaches have warranted a
rating greater than 10 percent.

The preponderance of the evidence is against the claim for a
rating higher than 10 percent for residuals of head trauma
with headaches. Thus, the benefit-of-the-doubt rule does not
apply, and the claim must be denied. 38 U.S.C.A. § 5107(b);
Gilbert v. Derwinski, 1 Vet. App. 49 (1990)."

[skydealer]

This is kind of an odd update, considering how long it has been... but I am now wondering if this is not that far from being out of the norm.

I think I filed back in 2011 - My military records show the head trauma and the months of medical before I was discharged. I never knew about the VA benefits until decades later so I filed a claim as I have spent way too much $$$ since the 80's dealing with my headaches and brain issues.

So - as I posted here a while ago I filed with the VA and got one of those personal from hell. Custer could have shown up with arrows sticking out of him and this guy would have denied the claim.

I filed appeals and presented additional doctor claims. I had the VA form filed out by a VA doctor describing the issues.

Getting a head trauma is hard because they want you to do all these things and I can't concentrate to do these sort of things. A neurosurgeon said I have a cyst on my brain which is in the same spot where I was injured on base.

But a few weeks ago I received a letter from the Department of Veteran Affairs that has the following:

"We have requested an examination through a private medical facility in order to determine the current level of your disability etc etc"

Does this mean that they have finally accepted that I did receive a TBI and they are wanting to determine the extent of the disability?

I was wondering what I should bring in or say? There are lots of issues -

24/7 headaches for the past 30 years.

Migraines that pop up at least once a week.

Concentration issues, sleep issues, I try to talk to people and to me it sounds normal but no one seems to understand what I'm trying to say.

Short term memory loss. Getting lost in a fog often.

Don't know how to handle this. Its frustrating because I used to be really good at dealing with this sort of thing.

Does the "We have requested an examination through a private medical facility in order to determine the current level of your disability" letter mean that I finally will be compensated for this and that the VA will be paying for the future treatments and meds, or am I reading this too far?

Thanks for any input.

[Berta]

"A neurosurgeon said I have a cyst on my brain which is in the same spot where I was injured on base."

There are different types of brain cysts , and some can be caused by trauma.

Did the neurosurgeon document what he said in your medical records?

Is the cyst going to be removed by the surgeon? Or is it treated as a benign cyst?

Do you have medical documentation of the issues you listed that you have, that you attribute to the inservice trauma?

Does the "We have requested an examination through a private medical facility in order to determine the current level of your disability" letter mean that I finally will be compensated for this and that the VA will be paying for the future treatments and meds, or am I reading this too far?

It only means they will give you a C & P exam to determine the extent of the disability. Closed head injuries are rated on residuals and the residuals can be rated even at 0 %.

I am not saying to expect only "0" %, but the VA needs to determine what residuals (to include the cyst) stem directly from the inservice incident and how disabling they are.

Perhaps your neurosurgeon would be willing to prepare an IMO for you as to what residuals you have from this incident, with a full medical rationale.

What is the medical term your doctor has used for the cyst?

Is the 10% you have now related in anyway to this inservice trauma?


"I filed appeals and presented additional doctor claims. I had the VA form filed out by a VA doctor describing the issues."

How long ago was the denial?

Have you presented them with new and material evidence and then reopened the claim?

or is this regarding the same 2011 claim that is still open ?

Are you able to scan and attach here the Reasons and Bases part of the denial? (Cover C file number, name, address first)

I know I am asking many questions , like the VA does, but if we know more here we can help more.