TBI review and Polytrauma eval

[drago]

Hi All,

Me again... another few questions that hopefully someone can shed some insight on.

Over the last few months, as I've gotten deeper into the VA medical side, they have talked about a polytrauma referral, basically saying it could be helpful in me getting to a better place. I was involved in an incident and sustained a significant concussion. I agreed to the referral, and had an MRI that did not show any abnormalities other than something with sinuses. I'm now scheduled for a neuropsych exam. I'm not sure what all that entails, and I can't seem to find much "meat" of what polytrauma is about, other than kind of marketing info that it's "good".

So the questions:

1. Does anyone have any experience with poly-trauma, what it is, is it helpful etc? It is worth following up on and if not, are there any consequences to cancelling it out?
2. Has anyone had any experience with poly-trauma evals affecting ratings? This may just be in my head (and probably is), but it's starting to feel like things with VA medical are just data collection for VA rating side, to look to show why a veteran is over-rated (rating is too high). I'm just not feeling good about how it seems the rating side of VA can access my medical records whenever they want.

Thoughts from the group?

*BTW... I am very thankful for everyone putting up with me, and continuing to hang in there with me.

[pacmanx1]

2 hours ago, drago said:

• Does anyone have any experience with poly-trauma, what it is, is it helpful etc? It is worth following up on and if not, are there any consequences to cancelling it out?
• Has anyone had any experience with poly-trauma evals affecting ratings? This may just be in my head (and probably is), but it's starting to feel like things with VA medical are just data collection for VA rating side, to look to show why a veteran is over-rated (rating is too high). I'm just not feeling good about how it seems the rating side of VA can access my medical records whenever they want.

Please review the following, it is possible  for treatment and for compensation that more test are needed.

What is Polytrauma? - Polytrauma/TBI System of Care (va.gov)

[El Train]

On 10/2/2021 at 7:02 AM, drago said:

I'm now scheduled for a neuropsych exam. I'm not sure what all that entails, and I can't seem to find much "meat" of what polytrauma is about, other than kind of marketing info that it's "good".

 

I'm guessing you are rated for TBI?  If so, I'm sure you already did neuropsych testing.  If not, look up MOCA testing.  I did the MOCA test like four times with different C&P examiners.  They were trying to separate PTSD with TBI symptoms.  In the end I was rated 100% ptsd with tbi symptoms, P&T with smc-s.

I'm not sure what can be done about fixing TBI.  The damage is done.  In my case, I've lived with it for 30+ years.

[drago]

Thanks for your replies.

EI Train: I am rated for PTSD 70%, and then was also rated at TBI, but PTSD and TBI were bundled together to be 70%. However, the original TBI exam wasn't real thorough.

16 hours ago, El Train said:

I'm not sure what can be done about fixing TBI.  The damage is done.  In my case, I've lived with it for 30+ years.

My incident was 30+ years ago too, and I never realized I had PTSD until the C&P a year ago. I can see the influence it had now that I'm seeing a counselor, but never realized how it had affected me (and still is). I did look up the MOCA, and actually found some images of at least the first page. I stopped looking though because I didn't want to develop some kind of practice effect. LOL

 

pacmanx1: I checked out your link, and I didn't realize there were other descriptions/links to the left that also discuss polytrauma. Thanks for that

[drago]

Hi All,

Just had TBI review. I'll not go into great detail in the unlikely occurrence the actual examiner would happen to read this post LOL... but stranger things have happened...

Anyway, I'd call the review very light, basically with reviewer asking me (after she realized I was already service connected TWICE) what about my TBI has changed since the initial. I said now diagnosed with hypersomnia. She asked why I thought that was connected to TBI. I said because civilian dr said so. She asked why he said that, i said I'm assuming a medical reason but don't really know. Then was given the MOCA and passed with flying colors except for the very end when asked to repeat the words from the middle of the test.

So new question... how much weight does the MOCA carry in the process?

[El Train]

1 hour ago, drago said:

So new question... how much weight does the MOCA carry in the process?

Hard to say.  They will rate TBI based on how bad you did in any one category.  In my case I was rated at 70% for TBI alone.  I'm not a moderate to severe TBI but that's was based on the one category I did terrible on (memory section I believe).  But who knows honestly.  My guess, you stay at 70% PTSD/TBI.  You're not gonna get any bonus for hypersomnia because it falls under your PTSD/mental rating.  Just a guess on my part.

I got 100% based on PTSD alone.  That was the higher rating of the two combined ratings for PTSD/TBI.  I went from 50% ptsd to 100%.

 

[drago]

It will be interesting to see how it turns out. In my case, it's not that any one thing is severe, it is just many mild symptoms, that combined make life a bit difficult. Ultimately, as I've said before, and i think like many going through the process, I just want to be "heard". Yesterday's appointment would have been 20 minutes if I would have let it. Even by trying to explain some of my symptoms, I felt I was very much annoying the evaluator. I think the evaluator's preference would have been for me to simply say the issue is hypersomnia, do the MOCA, and be done.

Also, I had taken with me "my notes", which were a list of my VA ratings, civilian diagnoses, and then examples of each category on the DBQ. So for memory, attention, concentration I noted how I was unable to tell my wife where a funeral was held for a friend the week before. I couldn't remember which road it was on. So I listed that, and similar things. At the end, as the evaluator was pretty much forcing the appointment to end, I handed the notes and asked if they would help. The answer wasa grudging "sure", then a quick review and then looking at the computer, then the notes, then the computer a statement of "oh... these align with the actual form" with a dead stare at me. I said yes, I reviewed the previous eval and the form that is available online, and made my notes to match because I thought we would probably go section by section in this appointment. I know it is dangerous to ascribe motive to looks and statements, but I think that format at the very least caught the evaluator off guard, and perhaps had a hint of "unethical" in the look and questions. Could be my own paranoia though.