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Proving TBI

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K_C

Question

I have a question about proving my particular TBI and nexus. Looking for any help. All advice is welcome. Thanks in advance.

  1. No in-service diagnosis of TBI
  2. Was a passenger in an auto-accident while on active duty, was unconscious for an unknown amount of time (likely 5-10 minutes), and both myself and the driver (who was also active duty) experienced what I now understand to be symptoms of TBI following the accident.
  3. Did seek medical attention for several weeks following the incident, and the auto accident is documented there. However, I was only seeking help for an eye and vision issue that persisted after the accident. We never even discussed other symptoms, just the eye issues.
  4. There was no diagnosis of TBI and I was never even evaluated for it. 
  5. I plan on having a sworn statement from myself and the driver, and possibly a coworker/room-mate at the time, entered into the claim detailing the event and what followed.
  6. I have a photo of the front of the wrecked car, and another of the front with me and the driver kneeling in front of it, but they are not dated and I'm not sure if/what weight it has as evidence.
  7. I have been trying to get some record of the accident, particular one listing me as a passenger, but thus far it's been fruitless. I have reached out to all law enforcement agencies I believe would have covered that jurisdiction and they could no locate any record of the accident, though having more information for their search to begin with might help (such as the date and exact location). The driver of my vehicle was not at fault and therefore not cited, which seems to make it harder to find.
  8. The driver has contacted the auto insurance company he had at the time, but they no longer have any records. My currently-pending research is focused on obtaining vehicle history for his car, as well as his driver's record. He is fully cooperative in this endeavor.

Knowing the above information, and given any experience you've had with scarcely documented events or similar claims, any advice on proving the event and TBI?

Is there any evidence I already have that should be emphasized?

Is there any evidence which could be harmful, or assertions I should avoid making that might muddy the waters?

Is there evidence I don't seem to be considering that might be worth seeking out?

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You "prove" your claim using the basics:  The 3 Caluza elements are  exactly like it says:

1.  CURRENT DIAGNOSIS.  You dont need an "in service diagnosis".   You need  "current" diagnosis.  

2.  In service "event" or aggravation.  

3.  Nexus, or a doctor saying your "in service event" (auto accident) is "at least as likely as not" related to your "current diagnoisis" (of TBI).  

    Look in your records and see if all this is documented.  Dont leave it to chance, get a copy of your records, read it and see if it has these 3 Caluza elements.  

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10 minutes ago, broncovet said:

You "prove" your claim using the basics:  The 3 Caluza elements are  exactly like it says:

1.  CURRENT DIAGNOSIS.  You dont need an "in service diagnosis".   You need  "current" diagnosis.  

2.  In service "event" or aggravation.  

3.  Nexus, or a doctor saying your "in service event" (auto accident) is "at least as likely as not" related to your "current diagnoisis" (of TBI).  

    Look in your records and see if all this is documented.  Dont leave it to chance, get a copy of your records, read it and see if it has these 3 Caluza elements.  

Thanks broncovet. I appreciate the info.

This is my hang up: I need a current diagnosis of "Traumatic Brain Injury"? Is there even such a thing, since the TBI event was years ago? Like my analogy, if I broke my ankle ten years ago, but today have ankle problems, I wouldn't have a current diagnosis of broken ankle. This is where I am still confused. Do I need to ask my doctor to specifically diagnosis a TBI right now, or just draw a nexus from TBI event to migraine diagnosis?

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Yes, there is a "current diagnosis" of TBI, and I have no idea if you have this or not.  Check your records to see if you do, or ask your doctor(s).  

I do see your point, that TBI could be made at that time, but, depending upon "when" this event happened, they may or may not have referred to this event as a TBI at that time.  This does not mean a doctor can not examine you and say..."gee, your symptoms are consistent with TBI..did you get a knock in the head?"

"  Oh, yea, I had a car accident in service where I hit my head."  

The doctor can then run applicable tests, MRI, brain scan etc, etc, and determine if you have TBI.  

Incidently, many/most NFL players have TBI, BUT they may/may not have diagnosed "TBI" then...the symptoms may have showed up later, sometimes much later, and the doc may say, "Gee those blows must have caused your TBI."  

Im not an expert in TBI, and a doctor familiar with that will have to diagnose you.  

TBI may be confused with other stuff/depression/PTSD etc.  

In other words, new technologies may change your diagnosis.  This is why you need a current diagnosis, and you should check your records and see what if any diagnosis you have.  

Your doc may/may not tell you what your diagnosis is.  But it should say so in your records.  

 

  

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The 3 Caluza elements is how all claims are proven.  Or, the VA

will  deny you if you lack one or more Caluza elements.    Sometimes, Vets go appealing their claims, sometimes for years, for example, missing a nexus.  Dont go there.  

It will cause you years of frustration, and wont be a good result.  

If you are missing either a "current diagnosis" or a nexus, then a IMO can supply same.  However, a doctor can not "supply" you with an "in service event".  This either happened in service or it did not, and if you lack an "in service event or aggravation" then hiring a doctor for his or her opinion wont help that.  

To verify an "in service event" you will need some documentation of your "in service event", that is, your auto accident.  

While you are checking on your records, make sure the doc did not say something  like, "willfull misconduct".  

"Willful misconduct" is a deal breaker.  For example if your auto accident was caused by your excessive alcohol consumption, then you are gonna have problems.  

(If it was caused by someone elses' drinking, well that is not your fault")

Willfull misconduct is a determination made by a doctor AT the time of the accident.  

I had an accident in service and my doctor specifically stated it was NOT due to my willful misconduct.

If a doctor stated it was due to your willful misconduct, then you are gonna have a hard time getting it service connected.    

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Thanks @broncovet

I didn't realize that (an old TBI diagnosis can have a current diagnosis). I'll have to check with my neuro or IMO provider to see if this is something they can diagnosis currently despite the event being years ago. I did read that TBI can show on MRI, but diagnostic tests are not guaranteed to uncover a TBI.

I have no diagnosis of TBI, ever. I have the in service event (auto accident) and some loose documentation in my service records (because I was having persistent issues with my eye and vision after the accident).

I was a passenger, no alcohol or any kind of misconduct involved. The other driver was at fault too.

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You misinterpreted what I posted.  You may or may not have had an "old" TBI diagnosis.    A "diagnosis" is a determination made by a doctor.  Chances are good there were no doctors around when you hit your head in the car accident!!!

So, the doctor may diagnose you, later.  

Rather than guess at what your diagnosis is, GET YOUR CFILE and read it.  See what the doc wrote down.  However, regardless of whether or not your doctor, at the time you got injured, made a diagnosis of TBI is irrelevant.  But it is relevant that a doctor NOW says:

"You have TBI" or "You are diagnosed with TBI".  

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