What Are Traumatic Brain Injuries?
Traumatic brain injuries (TBI) typically result from a violent blow or jolt to the head or body. There are several different types of TBI, ranging from mild to severe, with impairments that can be temporary or permanent. The symptoms of TBI present differently in every person depending on the severity of the injury and the individual, but there are some common symptoms. For mild TBI, the most prevalent symptoms are:
- Nausea or vomiting
- Fatigue or drowsiness
- Problems with speech
- Dizziness or loss of balance
- Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell
- Loss of consciousness for a few seconds to a few minutes
- Memory or concentration problems
- Difficulty sleeping
For moderate to severe TBI, the most prevalent symptoms are:
- Loss of consciousness from several minutes to hours
- Persistent headache or headache that worsens
- Repeated vomiting or nausea
- Convulsions or seizures
- Inability to awaken from sleep
- Loss of coordination
- Profound confusion
- Agitation, combativeness or other unusual behavior
- Slurred speech
- Coma and other disorders of consciousness
Among service members, particularly those who served during the Gulf War era, TBI is a common occurrence because of exposure to roadside bombs (IEDs), fire bombs, and other explosives. There are a number of cognitive, emotional/behavioral, and physical impairments that can occur as residuals of TBI. Proximate conditions, such as dementia, depression, and Parkinson’s disease, which are due to or result from the TBI, can also develop. The development of these residual impairments and proximate conditions can mean that even someone who recovers from TBI will still be affected by his or her injury for the rest of his or her life. Thankfully, the VA has a schedular disability rating system for both TBI residuals and proximate conditions to TBI, allowing veterans to receive the compensation they deserve as a result of their service connected injuries.
Getting Service Connected for TBI Residuals and Proximate Conditions
By far the most important evidence a veteran will need to provide to support his or her claim for service connection for TBI will be medical records. These records will ideally include information about (1) in-service treatment for a TBI and (2) private medical records showing treatment for the TBI symptoms or a condition caused by the TBI within several years of the TBI causing event. Additional records that could be helpful in providing proof of injury are service personnel records that show evidence of the veteran’s involvement in an incident capable of causing TBI or a record of change in behavior or performance following a TBI incident.
How the VA Rates TBI Residuals and Proximate Conditions
Under 38 CFR § 4.124a, the VA evaluates TBI residuals (Diagnostic Code 8045) which are not defined by another diagnostic code (such as those for mental or physical conditions) based on the Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified. This rating scale assigns ratings based on the veteran’s severity of impairment in the following ten categories:
- Memory, attention, concentration, executive functions
- Social interaction
- Motor activity (with intact motor and sensory system)
- Visual spatial orientation
- Subjective symptoms
- Neurobehavioral effects
Under each of these categories, the VA rates the severity of impairment caused by the TBI residual on a scale of 0 to 3. Each rating corresponds to a disability percentage rating:
- 0 = 0% (normal functioning)
- 1 = 10% (mild)
- 2 = 40% (moderate)
- 3 = 70% (severe)
- Total = 100%
Any evaluation assigned under this rating schedule will be considered the evaluation for a single condition for the purposes of combining with other disability evaluations. If any of the categories evaluated result in a total rating, the VA will grant a 100 percent schedular disability rating for the condition of TBI residuals. If none of the categories receive a total rating, then the rating for TBI residuals will be assigned based on the highest residual rating overall among the ten categories. For example, if the category of Orientation is assigned a 3 rating, but every other category has a 2 or 1 rating, the overall schedular disability rating assigned for TBI residuals would still be 70 percent because of that 3 rating.
Disabilities that are proximately due to, or aggravated by, TBI will be evaluated under 38 CFR § 3.310. This includes conditions of:
- Parkinsonism, including Parkinson’s disease, following moderate or severe TBI;
- Unprovoked seizures following moderate or severe TBI;
- Dementias of the following types: presenile dementia of the Alzheimer type, frontotemporal dementia, and dementia with Lewy bodies, if manifest within 15 years following moderate or severe TBI;
- Depression if manifest within 3 years of moderate or severe TBI, or within 12 months of mild TBI; or
- Diseases of hormone deficiency that result from hypothalamo-pituitary changes if manifest within 12 months of moderate or severe TBI.
Get Help With Your TBI Claim
If you are a veteran looking for assistance to apply for service connection for TBI residuals or proximate conditions, or need help appealing a denial by the VA, please contact us today. Our experienced veterans law attorneys are ready to help you get the compensation you deserve.