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eli

TBI vet here, I think a miracle happened...

Question

I've been a reader here for years, rarely talk, took advice, filed my claim, was denied, appealed, you know the drill.  I'll try to give the basics of my story from hell.

During the Gulf War, stateside, I had an accident while we were loading aircraft and I was knocked unconscious.  Being the gentlemen that they were, my buddies carried me to the side and finished loading the aircraft.  Afterwards they laid me on the couch in the break room and I came to sometime later.  The accident wasn't documented,  But I did start showing up at the base hospital complaining of nausea, vomiting, headaches and sleep problems.  One doctor was so irritated at my complaints that she called my sup and told him to stop sending me to the ER and to tell me to suck it up.  I actually have a copy of her remarks in my file.  There was no way in hell I was going to admit to wetting the bed, but I was washing my bed sheets more often.  Several other odd things happened and at least one was documented thank God.  I had a seizure and wandered into a restricted area without my line badge on.  When I was addressed by the person in charge of the area I was incoherent and he told my sup to write me up for disrespecting him.  TG he did write me up, again I have a copy of this.  None of us thought, hey this is a seizure.

I get out of the service honorably and life goes on.  I don't drink, do drugs and at the time I didn't date and wasn't sexually active.  I eventually married and lived close to my family for several years, then we moved across the country to no man's land.  As the years passed I kept having various odd "spells".  My family, including my husband tried to explain the spells away, then we got used to them and pretty quickly I gave up driving as I kept having these "spells" while driving.

Years pass and my vet husband and I divorce.  Uho, I have to drive again.  I moved to a new city, found a job and then found an apartment within a couple of blocks of my job so  I could take the back streets to work.

Several years pass and I've relocated and married.  Hurricane Rita hits and wipes out my little town.  Uho, I have to make a major drive (yes I still have my vehicle but never drive) to the west coast with my husband where his family lives and we've decided to relocate to.  During the trip, we're both driving our own vehicles, him following me (he's smarter and more aware then my first husband re these "spells").  I have a seizure and go driving unconscious out into the desert.  Fortunately, my vehicle slowed and my husband was able to get to me and get the vehicle stopped.  He called 911, I'm taken to a hospital and we're all informed I had a seizure.

The next 5 years are full of seizures, med testing, just trying to deal with it.  Heads up, if you show up at the ER after having a seizure, they usually assume you're a drug addict or alcoholic and when your blood tests come back negative they're like, "hmm, don't know what to tell you, have a good discharge and here's my bill".

I finally had insurance and a great doctor.  An epileptologist, she said your MRI shoes major brain scarring, what building did you jump out of head first?  I told her about the accident in the military.  She said since you're a vet, get yourself into one of the new VA epilepsy centers of excellence.  At this point I'm averaging 55 seizures a month, can no longer work and have to file for ssdi.  Someone says why aren't you using vet benefits and why haven't you filed a claim.  "Huh?  You mean I have vet benefits?"

Fast forward...claim filed, claim denied, they say yes you have epilepsy but no record of accident.

I appeal.  Denied.

I track down one of my supervisors that was with me on the aircraft that night and he writes a witness statement re the TBI accident.  My current Epileptologist fills out the DBQ and writes a letter stating that I suffered a head trauma during the accident, that the spell I had (wandering into the restricted area) was indeed a seizure and that my epilepsy is the result of said head trauma.  Of course she didn't use the wording I tried to explain to her.  She's foreign and wrote it in medical terms.

They reopened my claim, new evidence?  This time my denial says we admit you had a head trauma accident but you haven't been diagnosed with a TBI and you don't show residuals of a TBI.  And the evidence wasn't good enough?

Me, last week when I got the denial....what???????????????????????????????????????  Although I'm not surprised.

I actually have another DBQ from my neurologist, yes I have both drs, but I didn't submit it since he didn't write a letter.  He also called my head injury a "head trauma" in the DBQ instead of a TBI.

So I go about getting an IMO for TBI.  I'm on a no show, then call me wait list to get into see my neuro and I already had an appt scheduled with my epileptologist this month.  I've contacted a doctor to do an IMO, thank you hadit members!

*****Ok here's the point to this entire story.  Given that I average 55+ seizures (and I don't even count the little partial seizures any more only the bad seizures) a month my health is horrible.  Digging through all these medical files is exhausting.  I have a care giver and they have been helping me digitalize the files so I can review them from bed.  I had downloaded my VA files from when I was at the VA Epilepsy center of excellence.  My caregiver scanned them for me and I was flipping thru it to make sure it was good to go so I could print off a copy.

Here's what I just happened, I mean ty Jesus, just happened to see.  And please let me know if this isn't important.  Esp since these are VA records and available to the raters...

VA Doctors notes, he's either a Neurologist or Epileptologist, I'll have to check:

Year event type started:  1991

Frequency: 12 per month (my comment-> of the worst seizure type)

Injuries from events:  Head trauma

Traumatic Brain Injury: YES

Traumatic Brain Injury Severity/Loss of Consciousness: moderate 30 min to 24 hours

Type of TBI: closed

***If this is the diagnosis from my VA doctor then didn't VA screw up with their denials?

Only 1 of my 4 denials was before I was seen at this VAMC.

My last denial letter dated 11/21/17 says, quote:

Evidence:  Treatment reports VAMC Durham, for the period June 19, 2013 thru Sept 3, 2015

My 2nd denial 1/28/16 doesn't list the Durham records at all.

My 3rd denial 2/13/17 does list the Durham records in evidence.

 

So yeah, I'd love some feedback on this situation.

I was planning on submitting the IMO's stating I have a diagnosis of TBI when I submitted my form 9 from this last denial, assuming I'd be heading to BVA.

Oh dear hadit experts, whatever if anything does this mean????

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22 answers to this question

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The C & P  expert is probably listed here somewhere:

https://www.google.com/search?rlz=1C1CHBF_enUS695US695&ei=VqklWtzfK8XAjwP8iZvgDQ&q=Directors+of+all+VA+Epilepsy+Centers&oq=Directors+of+all+VA+Epilepsy+Centers&gs_l=psy-ab.12...19388.61655.0.66238.32.31.1.0.0.0.1568.9866.5-2j5j2j1.10.0....0...1c.1.64.psy-ab..22.0.0....0.f9_aUf9fVR4

It does not matter as I assume his qualifications outweigh the qualifiations of the raters, who are not allowed to disregard evidence like that, nor come to their own medical conclusion.

Hopefully Alex will chime in....this is a beauty!

 

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13 minutes ago, Berta said:

Thank You - Alex (asknod is reading this even as I am posting)

Lots for me to look over again.  Sometimes I think I have seen it all... but then the VA gets creative again....

God has blessed me with the ability to help vets. And It was a promise I had to keep as well--- hours before my husband died, he told me to go after them on the 1151 he had filed ( did that)and also to help his brothers and sisters who have served.( still trying to do that) 

Lots here today and I have a prayer meeting tomorrow and we always pray for our nation's veterans.

"Do I file the form 9, lay out all this info and wait for my BVA hearing"

You have time- I will prepare a "GCY" claim for you- might not be until Wednesday-

GCY - go CUE yourself VA....and I have to finish my seond request to the Sec to make this tactic into a fast letter...

Three of us here have been successful with my tactic on that.The decisions came faster and they were (with a few skirmished in my case, correct.  Allan 2005 and SPO used my idea and I have used it many times.

Thank you for the wonderful feedback and God bless.  Take care of you and be safe! :)

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I spent time researching and reading the forums.  Using the supplied info and templates I created a CUE letter.  I dug through the medical records and actually found a 2nd visit with that Neurologist discussing my TBI so I've made copies of everything and will be cert mailing that out today.

I will post updates.

Thanks again to Berta and everyone here.  If we weren't collectively sharing our experiences and knowledge many wouldn't know where to turn.

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I wish you all the best and timely manner for your TBi treatment to commence... lol I know where we wouldn’t turn too 

Edited by jfrei

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 "wish you all the best and timely manner for your TBi treatment to commence... lol I know where we wouldn’t turn too"

Thank you jfrei and the same to you.  What a tangled mess this VA stuff is.

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It’s like a tangled web of guess and ducks.... but me and you are getting there slowly but surely now I’m going to my RO to get my first VSO after   7 years of angry emails I just want to someone to tell me what SMC I should be getting S is not going to make it when I head out to inpatient rehab. S is for a the birds.... especially after my 100 was made P and T and I’m 31 years old if I’m so broken I want everything I can get to make my life whole again for my family...I wish you all the best from one TBI to another Eli crazy that’s my sister in laws name lol small world. If you have any questions about your TBI I have one piece of advice as was my case did you get a SOC in your original denial sorry if I missed it file cue immediately and the rest comes in time unfortunately 

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