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

[eli]

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 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.

 

Here's what  just happened, I mean ty Jesus, I just happened to see.  And please let me know if this isn't important.  Esp since these records are listed as evidence on my SOC.

VAMC Doctors notes, he's a Neurologist:

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?

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

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

My 2/13/17 denial/SOC also lists the Durham records in evidence.

 

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

I was planning on submitting 2 more 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????

Edited January 10, 2018 by eli
Clarity

[eli]

On ‎1‎/‎10‎/‎2018 at 6:25 AM, eli said:

Update:

I'd called the White House VA hotline in December and they gave me a call case#.  I called back Monday and was told that my file is "ready for review" and that my file is now flagged as TBI.  I asked the vet rep what that meant.  He said I'm also a TBI vet, if your file is flagged as TBI then they recognize that you have a TBI diagnosis. 

I said, well I sent in a CUE because they denied me for lack of a TBI diagnosis and my neuro at the VAMC Epilepsy center clearly states I had a in service TBI in 1991 and have epilepsy because of it.  And those records were listed under evidence, but apparently no one read them.  So is the flag a good thing?  He said "yes!"

Feel free to opine if you're familiar with the VA terminology.  Where is it sitting if it has a diagnosis, im flagged TBI and "ready for review"?

Todays update:  Called WH hotline for update:

CUE received by WI intake 12/12/17.  After having my file flagged as TBI and ready for review (as of 1/8) it was sent to VBA on 1/10.  It is now with a "resolution team at the VBA, under secretary of VA." (Special note)

The gentlemen told me to call back next week because he said, due to where it is he can't access their notes/file info.

Hopefully this means I'm at least at prep for decision or pending decision approval.  It's only one contention.

As always feel free to opine. :)

Edited January 19, 2018 by eli
clarity