Please help me understand this

[Okemos_Veteran74]

Background:I am rated at 70% for TBI. The doctor performing my C&P stated that he did not expect my TBI to improve because of the interrelated PTSD symptoms (which are permanent and total).

 

I went to the traumatic brain injury clinic at the Ann Arbor VA. The doctor there told me that he did not believe that I was having any symptoms related from a traumatic brain injury that occurred over 20 years ago. He stated it was not just his opinion but it was the Medical Science Community behind him.  

  I went to a VA social worker and asked to go to a different VA because I said I wanted to be seen by a VA doctor that believed they could treat me. Or I said I wanted to use veterans choice to be seen at a local brain injury Clinic in my area (which is also a private facility).  Both requests were denied.

I guess I'm a little bit of a loss because if I'm rated at 70% for a brain injury by the VA how can a VA doctor disagree and say that I am no longer experiencing symptoms from the TBI. What am I missing here?

Another social worker tried to explain it to me by saying that he believed the VA doctor was saying that my conditions were being caused by mental health concerns not necessarily by traumatic brain injury symptoms.

[Berta]

https://www.usatoday.com/story/news/politics/2018/06/06/trump-signs-law-expanding-vets-healthcare-choices/673906002/

The link has POTUS's voice ( and probably the blip I saw on TV when he signed the Mission Act -is on the net as well.)

The regulations to support the Mission Act have not been prepared yet- *

 

"Another social worker tried to explain it to me by saying that he believed the VA doctor was saying that my conditions were being caused by mental health concerns not necessarily by traumatic brain injury symptoms."

Are you rated for PTSD?  Are they treating your mental health issues?

 "Both requests were denied."

Do you have those denials in writing?

I suggest- to contact the SW and the doctor to get this in writing-

Also I suggest sending an IRIS , telling them what you told us here and that you need the denials of services in writing as you are conacting the White House.

And by all means call the Veteran's White House Hot Line-  855-948-2311-

* we have no idea how these regulations will be prepared- but the Mission Act appears to give too much power to the VA to decide who they will apply to-

It is possible, maybe , that your symptoms are being caused by an additional MH or even physical issue-

but VA should either rule out those other causes or properly treat you for them.

Was the " VA doctor" you mentioned a psychologist or psychiatrist?

 

 

[Berta]

I found some of your past posts:

"I just learned something from a vso, and I'm checking it. I have always found that I get really good advice on this site thank you all

I have a PTSD rating of 70% which gives me tdiu and is permanent and total. I have a TBI rating of 70%.

I do not qualify for SMC s because the PTSD is secondary to the TBI. Is this correct?"

October 23, 2008 the regulations for TBI and PTSD changed.

They are here:

https://community.hadit.com/topic/33642-tbi-dc-8045-new-criteria-oct-2008/

"I do not qualify for SMC s because the PTSD is secondary to the TBI. Is this correct?"

Did the VA state that in any letter to you? or did this come from a VSO?

TDIU for PTSD - a mental disability plus 70 % for TBI- physical trauma disability -in my opinion, definitely qualifies you for SMC.

Has VA denied SMC to you?

Unfortunately we are at a loss here when we need to read the actual words of VA, from their actual decisions.

 

Do you have an award letter stating the TDIU rating for PTSD as well as the  separate 70 % TBI rating?

Can you possibly scan and attach it here?

(Cover c file # etc prior to scanning it)

 

[Berta]

This is a long BVA decision- but the results involve the point I am trying to make regarding TBI and PTSD :

 

https://www.va.gov/vetapp18/files4/1823008.txt

 

ORDER

Service connection for right knee meniscal tear is denied.

An evaluation in excess of 10 percent for benign positional vertigo is denied.

An evaluation in excess of 10 percent for bone loss of the skull is denied.

An evaluation of 70 percent for PTSD with anxiety disorder, OCD, and cognitive disorder for the entire period on appeal is granted.  

An initial compensable evaluation for residuals of a TBI prior to September 23, 2015 is denied.  

An initial 70 percent evaluation, but no higher, for residuals of a TBI from September 23, 2015 is granted.  

An effective date prior to October 26, 2012 for the grant of the separate rating for TBI is denied.  

An effective date prior to October 26, 2012 for the grant of a separate 30 percent rating for skull defect scar is denied.  

Entitlement to SMC based on aid and attendance is granted."

The 70% PTSD triggered TDIU, and then  the 70% for TBI triggered SMC

 the rest below is just a duplicate I dont have time to delete...................

"ORDER

Service connection for right knee meniscal tear is denied.

An evaluation in excess of 10 percent for benign positional vertigo is denied.

An evaluation in excess of 10 percent for bone loss of the skull is denied.

An evaluation of 70 percent for PTSD with anxiety disorder, OCD, and cognitive disorder for the entire period on appeal is granted.  

An initial compensable evaluation for residuals of a TBI prior to September 23, 2015 is denied.  

An initial 70 percent evaluation, but no higher, for residuals of a TBI from September 23, 2015 is granted.  

An effective date prior to October 26, 2012 for the grant of the separate rating for TBI is denied.  

An effective date prior to October 26, 2012 for the grant of a separate 30 percent rating for skull defect scar is denied.  

Entitlement to SMC based on aid and attendance is granted.

[Buck52]

I agree with Ms berta 

''Do I have the symptoms that follow a TBI or PTSD - or both?''

''You may notice that many of the symptoms that follow a TBI overlap with the common reactions after trauma (en Español). Because TBI is caused by trauma and there is symptom overlap, it can be hard to tell what the underlying problem is. In addition, many people who get a TBI also develop PTSD.''

It is important to be assessed because:

People with TBI should not use some medications.

No matter how mild or severe the injury itself was, the effects could be serious.

Although TBI screens are used, a screen is not used to diagnose TBI. Even if your TBI screen is positive, that does not mean that you have a TBI. It means that you should be assessed further.

Diagnosing a TBI is hard because there may not be any physical signs of injury. Details of the trauma may be hard to pin down. Sometimes right after the injury the effects are so brief that they are not noticed. You may go to the doctor some time later when details of the injury are not as clear. TBI can occur in confused times of crisis, such as combat. In the heat of events the injury may be ignored. Many of the symptoms that can result from a TBI are the same as the symptoms of PTSD. For these reasons, the best way to diagnose a TBI is an interview by a skilled clinician. 

Source: Dept of Veterans Affairs

[Berta]

Dont forget -the Veterans Affairs made a mess of TBI claims some years back-

The VA IG report came out a few monthd ago:

In Part:

"After three years, VA OIG finally issued its report into the traumatic brain injury (TBI) scandal where VA used unqualified doctors to perform exams.

As some of you may recall, since 2015, I began working closely with KARE 11 News reporter AJ Lagoe to investigate how VA conducts its disability compensations assessments for the initial TBI diagnosis and TBI residuals. The investigation resulted in VA admitting it used unqualified doctors or clinicians in exams of almost 25,000 veterans since 2007."

https://www.disabledveterans.org/2018/02/28/va-oig-report-traumatic-brain-injury-disability-tbi-scandal/

 

[Buck52]

We have a TBI-PTSD veteran here on hadit that has ongoing claims for SMC , Member jefri or something close to that screen name?...not sure if he is in appeals or awaiting a decision.?

he should see this post and comment.

Edited June 20, 2018 by Buck52
TBI not TBT eh!