What Do I Need To Do?

[Billyboy]

I have been fighting with the VA to grant me service connection for head injury. The VA insists there was no head injury. The VA says, April of 06 “There is still no medical evidence of a chronic disability related to military service” I have a statement of fact stating I did slip and fall while in service, although this person was not there he remembers me telling him of the event. (I never claimed anything else) I have my physiologist request a head scan because I told him I hit my head severely. The VA used this CT head scan as evidence to connect me with MDD, 50%. WHAT AM I TO DO??????? Now I know why Vets would just go and live under a bridge!

[Objee]

Billy,

A diagnosis of MDD can be from a mild head injury:

"Neurol Clin. 1992 Nov ;10:815-47 1435659 [Cited: 2]

The postconcussion syndrome and the sequelae of mild head injury.

[My paper] R W Evans

The postconcussion syndrome refers to a large number of symptoms and signs that may occur alone or in combination following usually mild head injury. The most common complaints are headaches, dizziness, fatigue, irritability, anxiety, insomnia, loss of consciousness and memory, and noise sensitivity. Mild head injury is a major public health concern because the annual incidence is about 150 per 100,000 population, accounting for 75% or more of all head injuries. The postconcussion syndrome has been recognized for at least the last few hundred years and has been the subject of intense controversy for more than 100 years. The Hollywood head injury myth has been an important contributor to persisting skepticism and might be countered by educational efforts and counter-examples from boxing. The organicity of the postconcussion syndrome has now become well documented. Abnormalities following mild head injury have been reported in neuropathologic, neurophysiologic, neuroimaging, and neuropsychologic studies. There are multiple sequelae of mild head injury, including headaches of multiple types, cranial nerve symptoms and signs, psychologic and somatic complaints, and cognitive impairment. . . . ."

Is it possible that your 50% MDD came from the CT scan looking for head injury???

Ralph

[Vike17]

Billyboy,

What the VA is saying is that they concede you may have had a some type of head injury while in the service, but that incident didn't result in any chronic disabling residuals thereafter. Also, as far as VA is concerned you also have a current condition noted by the CT scan, but the problem with this whole thing is you do not have the nexus or the "connection" between the two. In order to obtain service-connection for post cucussion residuals, you'll need an IMO connecting your current symptoms with the head injury you sustained while in service.

Down below is the rating criteria for such a condition;

"8045 Brain disease due to trauma:

Purely neurological disabilities, such as hemiplegia, epileptiform seizures, facial nerve paralysis, etc., following trauma to the brain, will be rated under the diagnostic codes specifically dealing with such disabilities, with citation of a hyphenated diagnostic code (e.g., 8045–8207).

Purely subjective complaints such as headache, dizziness, insomnia, etc., recognized as symptomatic of brain trauma, will be rated 10 percent and no more under diagnostic code 9304. This 10 percent rating will not be combined with any other rating for a disability due to brain trauma. Ratings in excess of 10 percent for brain disease due to trauma under diagnostic code 9304 are not assignable in the absence of a diagnosis of multi-infarct dementia associated with brain trauma"

Keep in mind that if you only have subjective complaints, meaning only by your own words or accounts of symptoms such as headache or dizziness, the VA can only assign a 10% evalution, which would be reverted to DC 9304. If this happens, then you would have two evalutions under the criteria for mental disorders and then your disability would be "lumped' together with your current MDD of 50%.

If you have objective findings of epileptiform seizures or facial nerve paralysis ect.. then they would be rated under that particular DC for that etiology and would carry its own rating so to speak.

So, what I'm saying is the only way you would benefit from this is if you were able to be rated at 20% or higher due to objective findings of a neurological disability.

I hope this helps!

Vike 17

Edited March 29, 2007 by Vike17 (see edit history)

[Billyboy]

Vike, the VA has not conceded I had a head injury. They have danced all around the issue. There first reply said there was no evidence even with the Statement of Fact, Then they said Bill was not there, I told them he was not there, then they said Bill said nothing about any sign of head trauma, I told the Bill was a cook. This seems to me the VA doesn’t want to admit the slip and fall along with the head trauma????

Ralph Please let me know where you are getting your info. I’ll do some research on this.

Thanks, bill

[Vike17]

Billyboy,

When the VA uses the term “There is still no medical evidence of a chronic disability related to military service,” generally, they use this in the context of somehow conceding that a ijury took place while in the service, but there is no evidence of any rsiduals of that injury thereafter. Normally, when the VA says that a particular injury didn't happen and isn't noted in one's SMR's, they state something to the affect of "We grant service-connection for a disability that you currently have if this disability began in military service or was caused by some event or experience in service...ect..." By the looks of it, the VA acknowledged the statement from your buddy, but there is still no evidence of residuals of that event that can be linked to the recent findings from the CT scan.

Furthermore, I would like to know the rational as to how the VA service-connected MDD off of a CT scan??? Normally, the VA is to use the various clinical tests from a shrink and his or her opinion to establish a diagnosis. Did the VA examiner or a private doctor opine that the CT scan somehow showed evidence of MDD??????? If this is truely the case, the VA was extremely liberal with the regulations and so forth to grant service-connection for a mental disorder on that basis!! Also, was the MDD service-connected as directly related to your service? It had to have been, they couldn't award service-connection on a secondary basis to some head trauma, according to you the head trauma isn't service-connected!!

I'm not trying to be critical or anything, but something doesn't sound right here. There's probably more to this than what is being posted. If you could give a more detailed explanation of all of this, maybe I can help you further?

Vike 17

[Billyboy]

They did not connect my MDD from the CT scan. In my sessions with the Fresno VA shrink I told him I had slip and fell during the service. He sent me to have the CT scan. The scan showed evidence of an old trauma at the base of the skull. (an infract) I sent this evidence to the VA and stated that a severe blow to the head will, according to the AMA, at some time cause PTSD. The VA in turn sent me to an out site shrink for an IMO. What he determined was, “His depression disorder is at least as likely as not caused by or result of his military duty”

The VA connect me 50% MDD and the VA stated it’s evidence was:

1 VA examination scheduled June 1, 2005 ( IMO from shrink )

2 Treatment records, VAMC, Fresno, from September 7, 2004 through October 13 2005

I have read these records and they do not support my claim near as much as the IMO did!

3 CT of the head, VAMC, Fresno, dated September 21, 2004

The VA used this CT as evidence which I would think was related to the slip and fall?

No private doctor opined the CT showed evidence of MDD.

Yes, as stated above the MDD is service-connected and directly related to service?

“according to you the head trauma isn't service-connected!!” NO I believe the head trauma IS service connected

As far as the records from Fresno VA, I do not believe the VA would have sent me for an IMO without me pushing the fact I slip and fell and the CT scan that pushed the VA towards the IMO!

[huskerfanfl]

Billyboy,

The question is this: What disability has been caused by the head injury? Are you having headaches, dizziness, an inability to keep your balance, anything? It is like this, I was a tanker in the army, and hit my head inside the tank many, many times. I did get headaches when this happened, and even have a few small scars. There is, however, no disabilty that is caused by my hitting the head, so I should not get disabilty compensation just becasue I hit my head.

[Vike17]

Billyboy,

Like I said the VA was really liberal in granting service-connection for MDD based on the shrinks assessment from the CT scan. I assume though that the shrink also tied the needed psychological testing in withthe CTscan and his opinion so the diagnosis would have some credibility.

And like I said before, you're missing the nexus between the CT scan and the in-service head trauma to be rated seperately for post concussion residuals. My guess is, however, that if you get an IMO from a neorologist making a nexus statement of some sort for post concussion residuals too, they will not amount to anything more than a 10% evaluation under DC 8045, which as I said before, would be reverted to DC 9304 and in the end be 'lumped' together with the MDD and your overall percentage would remain unchanged.

Vike 17

[militarynurse]

If I'm reading this right, your MDD is SC'd as a secondary condition of the residuals from the head injury. How could it be otherwise? If you had no residuals from the head injury, why would you be depressed? Typical VA illogic to deny...instead of granting you SC for the obvious. Almost seems like a CUE. Eventually, you should win your claim if you persist...I'd ask for a hearing.

I'm more or less in the opposite situation of you. I can't get SC'd for MDD. I'm SC'd 10% for post concussion syndrome from head injury, have EEG indicating "bifrontal intermittent rhythmic slowing" and CT scan indicating "mild frontal atrophy",(radiologist's impression: no abnormality. Huh???), yet the VA can't seem to see the connection. I also have MDD-severe and was given two neuropsych tests to determine what impairment was due to the MDD and what was due to the TBI. The neuropsych conclusion: depression-retest when depression is resolved! So, no farther ahead then when I started.