PTSD/TBI, Headaches, and bad back

[Vet Dog and wife]

Hello, I have posted on this subject in the past. We are still living abroad.

We have a psychologist, a physiatrist, a neurologist, and a general practitioner that are wanting to help my husband with his VA claim. These doctors said they would write letters and fill out any necessary DBQs, and they asked me to what I needed and to bring any forms to them, and they will get it done. Could anyone let me know exactly what I need to do from here?

Some doctors agree that my husband is severely disabled for both TBI and PTSD. they also agreed that he needs daily aid and attendance.

My husband had to be admitted to the hospital due to his PTSD and will be there for a few more days.

 My husband is a 100 percent, permanently and totally, Service-connected, disabled veteran. In 1980 he opened a claim and was rated 0% service-connected for a scar for occipital area scar, skull. code 7805 (according to his service medical records, his scar is from a blow to the head with a pickax while serving in the Marines.)

During his time in the marines, he was a full-time boxer.

 In his 1980 claim, my husband was denied service connection for headaches because he hadn’t provided evidence. He filed a notice of disagreement (in 1981?) but, as always, he never followed through, nor was he mentally capable. Nor did the veteran’s service officer work hard to file a complete and proper disability claim. (This claim was again lacking most of my husband’s problems.) Along with his cognitive and emotional issues, we believe my husband may have been homeless, jobless, separated from his wife, and having marital problems at the time.

 In 1997, My husband reopened his claim and received 100% P&T VA service-connected compensation, and he was rated totally and permanently 100% disabled with TBI; he also has service-connected PTSD, which is combined under his TBI. This combined rating falls under his TBI rating. His 100% rating is service connected.

 His C-File and VA medical records show that he has also been diagnosed with Dementia pugilistica, TBI, PTSD, severe depression, generalized anxiety disorder, debilitating headaches, hearing problems and tinnitus, stiff neck, stiff and sore hands, and sore feet, his ankles sometimes fail, he has lower back issues, and other problems. Most of these issues were listed by the nurse when he was discharged, but the doctor threw the documents in the trash.

 Found in my husband's Claims-File: The VA said that on 07/29/1998 my husband was awarded 100% Service Connected, permanently and totally for dementia due to head trauma with mood disorder and PTSD code 9304.

 We were told by Berta and others that we need to get separate ratings for his TBI and PTSD. Since he is already rated for PTSD and TBI what DBQ do we use? What does the letter need to say for a proper separation?

 He also suffers from severe migraine headaches several times a month cause him to stay in bed. Does he just need a DBQ for his headaches or also a letter, and from what kind of doctor?

Any other advice would be much appreciated.

Thank you again for all Your help

Edited November 16, 2018 by Vet Dog and wife

[broncovet]

There is a difference between A and A and SMC S.  

Yes, its CUE for VA to not consider SMC, when eligible for it.  You aren't supposed to have to apply for SMC...the effective date is the date you met the criteria for SMC.  

This sounds like an "on the ball" VSO..most of them avoid CUE like the plague.  

[Berta]

They sure do Broncovet.

I  am surprised they did not consider him sooner for Housebound, based on this:

"The VA said that on 07/29/1998 my husband was awarded 100% Service Connected, permanently and totally for dementia due to head trauma with mood disorder and PTSD code 9304."

The 100% plus an eventual 60% would gain the SMC-but  can you scan and attach here the 1998 decision, as to their rationale- (cover C fle # ,name, prior to scanning it)

 

[Berta]

“As in effect prior to October 23, 2008, DC 8045 provided that purely subjective complaints such as a headache were to be rated at a maximum of 10 percent under DC 9304. Ratings in excess of 10 percent for brain disease due to trauma under DC 9304 were not assignable in the absence of a diagnosis of multi-infarct dementia associated with brain trauma. As there is no evidence of multi-infarct dementia associated with brain trauma, the Board finds that a rating in excess of 10 percent is not warranted for headaches under DC 8045, as in effect prior to October 23,2008."

https://www.va.gov/vetapp18/files7/18120215.txt

 

"am going to pull out an old 1998 decision on my husband- he had multi infarct dementia, and I had to file CUE not only on the ratings but also on the lack of SMC consideration. However it was not from a TBI- but from a misdiagnosed stroke, with the multi infarct brain trauma undiagnosed, and untreated, and finally 1151 , 100% P & T. But there might be nothing there to help you in my claim-

- The case above is a LONG read but incorporates the way the TBI regulations changed in 2008.

 

[Berta]

I did a search here and realized  I gave you the TBI regulations changes sometime ago.

The prior TBI regs -prior to the change date (October 23, 2008) would control any prior decisions on the TBI-

If you can scan the older decision:

"The 100% plus an eventual 60% would gain the SMC-but  can you scan and attach here the 1998 decision, as to their rationale- (cover C fle # ,name, prior to scanning it)"

they always sent a full rating sheet in those days , please scan and attach here the rating sheet as well.

My 1998 rating sheet, as I mentioned, I Cued because they had my husband's  brain trauma, stroke residuals at 80% and had ignored his SSDI award solely for Stroke.

By time of this award ( DIC under 1151) he also had a SSDI award solely for PTSD as I had filed for Reconsideration because SSA guidelines  say they will consider all disabilties listed but they only had considered the Stroke.

( he was 30% SC PTSD in his lifetime, with a VA claim pending under both higher PTSD rating as well as a 1151 claim,but SSDI used all of his VA medical records to determine the 100% SSDI  for PTSD-and a few other pieces of evidence I sent to them) and they gave him a Very Favorable EED for the PTSD SSA Award- I mention both awards here- thought I better explain how that happened.A SSDI lawyer would not support the Recon Request.I called him a few months later to tell him he lost 4500 bucks. The SSDI retro was about 18,000. We had a long talk and he said he would never look at PTSD the same way again and thanked me for giving him so much info on what PTSD is all about.I often wonder how many vets applied for SSDI for PTSD and got denied erroneously.SSA even tried to talk us out of filing the Recon request. But when you are right- you are Right! maybe this info will help someone out there. VA awarded 100% P & T for PTSD abut 2 1/2 years after he died, when I assumed his claims. )

This was the same rating 1998 sheet I used for CUE-the VA corrected the ratings for stroke in 2012 to 100% P & T.

The director of my VARO 3 years ago- regarding anther issue I had tried to tell me he was Total when he died (with the stroke contributing) but NOT Permanent.She offered no evdence of any sudden CURE to the stroke which VA, I proved (FTCA) had caused.

She tried by phone twice to convince me of this ridiculous statement.That's OK- I complained recently to a higher VA entity than her.

Death makes any 100% Total award Permanent.

I also cued under lack of SMC consideration because the rating sheet clearly showed the 80% ( over 60) under 1151 and by then the 100% P & T for SC PTSD.

My socalled vet rep told me not to NOD it because 1151s are different than regular claims.

He was wrong.SMC CUE awarded 2012.

There might be a CUE here on the older decision but without seeing that decision, and the rating sheet, we really cannot opine on that.

 

 

 

 

 

 

 

 

Edited November 17, 2018 by Berta

[Berta]

This  TBI and migraines decision contains current migraine ratings...the highest is 50%:

that wont get the 100% plus 60 but perhaps a PTSD award separate from the TBI might.

It might be easier to get the Housebound award. They both pay the same SMC amount.

https://www.va.gov/vetapp18/files8/18130996.txt

 

 

[Vet Dog and wife]

Edited December 14, 2018 by Vet Dog and wife
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