Tbi Rating Erased Due To Pyramiding?

[Scout Swimmer]

Hi everyone.

I was awarded 40%.TBI back in 2009.

I put in for depression at the behest of my physician and was just awarded 70%

It would have brought my total points to 95 so I was really happy until I read the rest of the decision.

Essentially, they cited "pyramiding" and erased my TBI, which really screwed me.

Does this sound right? I thought that rule was for multiple MH contentions that overlapped, but how do they site pyramiding for a physical injury with an MH?

Do I fight this or is this a normal thing?

[Scout Swimmer]

I've tried to post VA stuff digitally but I'm a bit of an electronic caveman.

Navy, sounds like a solid plan. I have a copy of one of those C&P's. I'll have to go to the FOIA desk at the VA to get the other.

I will compare the two and keep you guys posted.

If I feel I do, I might even hire an Attorney since I've had bad representation with DAV, basically rep'd myself last go around

[HorizontalMike]

I think you should be made aware of this, concerning TBI and Depression:

Secondary Service Connection for Diagnosable Illnesses Associated With Traumatic Brain Injury

https://www.federalregister.gov/articles/2013/12/17/2013-29911/secondary-service-connection-for-diagnosable-illnesses-associated-with-traumatic-brain-injury

As best as I understand this, if it is a secondary service connection, they should be required to rate it separately. How else would it be "Secondary SC"?

Edited August 8, 2014 by HorizontalMike

[carlie]

Hi everyone.

I was awarded 40%.TBI back in 2009.

I put in for depression at the behest of my physician and was just awarded 70%

It would have brought my total points to 95 so I was really happy until I read the rest of the decision.

Essentially, they cited "pyramiding" and erased my TBI, which really screwed me.

Does this sound right? I thought that rule was for multiple MH contentions that overlapped, but how do they site pyramiding for a physical injury with an MH?

Do I fight this or is this a normal thing?

Can you post us all of and the exact wording from the Reasons and Bases Section ?

Keep any personal info such as claim #, Name, address,etc... out of it.

That's what's really needed to help answer your question/s.

Without that, it's kind of a crap shoot.

jmho

[NavyWife]

If you're having trouble scanning it, then maybe you could retype what they said, word for word. Just from the section where they say WHY they are combining them.

Fwiw, I agree with your attorney it will probably be faster and easier to go for an increase in one of your other issues, to get you to 100%. I would make that your 1st priority, then this your 2nd priority.

[Scout Swimmer]

REASONS FOR DECISION

Service connection for adjustment disorder with depressed and anxious mood; with postconcussive

syndrome (claimed as acquired psychiatric condition to include depression and

anxiety; and traumatic brain injury).

You requested reconsideration on Januaty 9, 2014 for service connection for the claimed

condition of acquired psychiatric condition to include depression and anxiety. The condition was

previously denied on a direct basis by the rating decision completed on January 6, 2014.

The St. Cloud VA Medical Center mental examination dated April 24, 2014 provided a diagnosis

for adjustment disorder with depressed and anxious mood. The examination provided the

medical opinion that it is at least as likely as not that your diagnosed psychiatric condition

is secondary to your service connected traumatic brain injury, and your migraine headaches.

The examination also stated that it is not possible to differentiate the symptoms between the

previously diagnosed post-concussive syndrome and the diagnosed adjustment disorder with

depressed and anxious mood condition. VA regulations state these two conditions must be rated

together when it is not possible to differentiate the symptoms in order to avoid pyramiding.

You were previously rated 40 percent for post concussive syndrome. The evaluation assigned

for post concussive syndrome is based upon the highest level of severity for any facet of

cognitive 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

higher 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. A severity level of

2 for a facet was the highest level reported on the St. Cloud VA Medical Center traumatic brain

injury examination dated May 20, 2009.

We are combining the diagnosed post-concussive syndrome with the diagnosed adjustment

disorder with depressed and anxious mood, and evaluating this under the mental rating criteria.

We have determined this will be of greater benefit to you as this will establish the higher

evaluation. Service connection for adjustment disorder with depressed and anxious mood; with

post-concussive syndrome (claimed as acquired psychiatric condition to include depression and

anxiety; and traumatic brain injury) has been established as related to military service, effective

April 16, 2013, the date of receipt of your claim for acquired psychiatric condition to include

depression and anxiety.

[Scout Swimmer]

Sorry so late.