Unless there are special rules that apply, the VA will deny service connection for Traumatic Brain Injury (TBI) unless the Veteran can prove a:
Current diagnosis,
In-service event, disease or injury, and
Medical nexus between the first 2 elements.
Reason for TBI C&P Exam
It is the veteran’s burden to prove he deserves the VA benefits. In certain circumstances, the VA must help the veteran meet his burden. A compensation & pension (C&P) exam is one example of how the VA helps veterans develop evidence. In a C&P exam, the VA asks a qualified professional to answer medical questions related to your claim.
When Should I Expect a TBI C&P Exam?
If you file a claim for a Traumatic Brain Injury based on sudden head trauma during service, then you should expect the VA to schedule a C&P examination.
A C&P exam can help VA answer the following medical questions:
Does the veteran have a confirmed diagnosis of a Traumatic Brain Injury?
Is it at least as likely as not that the TBI was caused or aggravated during active duty service?
How severe are the residuals of the Traumatic Brain Injury?
Who Can Conduct a TBI C&P Exam:
Neurologist,
Neurosurgeon,
Physiatrists, or
Psychiatrist.
Diagnosis of A Traumatic Brain Injury
A Traumatic brain injury occurs when a sudden trauma causes damage to the brain. According to the Department of Defense, more than 313,816 service members have sustained a Traumatic Brain Injury in training or combat. Common causes of this kind of head trauma include blast-related concussion events resulting from training or combat. A Traumatic Brain Injury is known as a signature injury of the Iraq and Afghanistan wars due to the frequency of IED attacks. However, a simple fall down a 10-foot ladder could also damage the brain.
Always Document Your Injuries
If you cannot prove that your that your Traumatic Brain Injury is related to service, then the VA may assume that it happened after discharge. For this reason, it is critical that service members document any and all head injuries. Your case is much easier to win if head trauma is clearly documented in your service medical records. In the absence of official records, statements from witnesses would be helpful. If you file a claim for Traumatic Brain Injury without a confirmed diagnosis, then VA may refer you for a C&P exam.
Medical Nexus for TBI
After a TBI C&P exam confirms a diagnosis, the next question is: what caused it? Is it at least a 50/50 chance that the TBI was caused by in-service head trauma? If your doctor’s answer is “Yes” and he provides a reasonable explanation, then you have your medical nexus. If the doctor answers “No”, then you should consider a second opinion from a private doctor.
What Are Residuals Of A Traumatic Brain Injury?
Veterans with a Traumatic Brain Injury may experience problems long after the initial head trauma. These problems are known as residuals. During a TBI C&P exam, the doctor will determine which TBI residuals are present.
Traumatic Brain Injuryresiduals are broken down into the following 10 categories:
Memory, attention, concentration, and executive functions–
Judgment
Social interaction
Orientation
Motor functions
Visual-spatial orientation
Subjective symptoms
Neurobehavioral effects
Ability to communicate
Consciousness
TBI Rating, TBI C&P Exam
After the TBI C&P exam, the doctor will send a written report to the VA. The report will include how severe your residuals are. If the VA approves your claim, it will likely use this report to assign a percentage rating. VA rates TBI residuals on a scale of 0, 1, 2, 3, or total.
0 = 0% (normal functioning)
1 = 10% (mild)
2 = 40% (moderate)
3 = 70% (severe)
Total = 100%
Every C&P exam involves the doctor asking questions of the veteran. The doctor relies on the veteran to explain his symptoms, some of which may not be present or observable on the day of the exam. Because memory deficits are common TBI residuals, a veteran should attend C&P exams with a spouse, family member, or friend who knows them well. They can fill in the blanks if the veteran is unable to either remember or communicate certain residuals during the exam.
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Working with the VA as a disabled veteran can be frustrating. Our expert Veterans Disability Advocates are here to help you through your VA Disability benefits process. Call us today at 800-800-3332 or click here to get in touch with a disability expert NOW.
How To Increase Your VA Disability Rating From 70% To 100%
If you currently have a 70% VA disability rating, you may already understand how VA ratings work.
A 100% VA disability rating is the maximum allowed by law and with some diligent work and, the help of a disability advocate the road to a 100% rating is accomplishable.
Single Disability Rated at 70%
If your 70% VA disability rating is for a single disability and you’re looking to raise it to 100%, your first step is to find the ratings criteria for that single disability you are rated for.
The Schedule of Ratings contains the ratings criteria for all disabilities in various categories. Each category contains groups of medical problems, each group contains a list of disabilities, and each disability has its own diagnostic code.
Every diagnostic code specifies the symptoms required for various ratings. For example, the 9411 code applies to post-traumatic stress disorder (PTSD). VA rates PTSD –along with many other mental health conditions – under the General Rating Formula for Mental Disorders. Depending on the symptoms, a veteran may receive either 0%, 10%, 30%, 50%, 70% or 100%.
Develop Medical Evidence to Increase Your VA Disability Rating
You must develop the evidence to match the criteria for a 100% rating. The rating criteria lays out what it takes to get a higher rating.
For example, let’s say you have a 70% rating for PTSD. According to the Schedule, the only PTSD rating higher than 70% is 100%. A 100% rating for PTSD is warranted when the veteran is totally impaired both occupationally and socially.
One or more of the following symptoms would yield a 100% VA disability rating:
Gross impairment in thought processes or communication
Persistent delusions or hallucinations; grossly inappropriate behavior
Persistent danger of hurting self or others
Intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene)
Disorientation to time or place
Memory loss for names of close relatives’ own occupation, or own name.
The Best Evidence To Increase Your Rating From 70% To 100%
To increase your VA disability Rating from 70% to 100% it is vital that you provide medical records to the VA that show your symptoms.
Not all doctors will provide records to show your symptoms. Fortunately, the VA provides rating tools such as Disability Benefits Questionnaires (DBQs) on their website. Doctors can check boxes off that apply to your symptoms and submit this form to the VA.
The DBQ forms apply to every kind of disability. For example, the VA provides a DBQ for PTSD that simplifies rating decisions. If the symptoms noted in a DBQ satisfy the criteria for a higher rating, then VA will likely grant that rating.
70% Combined Rating with Multiple Disabilities
If you have a 70% overall rating for a combination of conditions, then getting to 100% is much tougher. This is mostly because of the VA Combined Ratings table.
VA Combined Ratings Table
The VA Combined Ratings table provides that, after individual conditions are separately rated, the disabilities are then all combined using a specific formula. See 38 C.F.R. § 4.25(b). VA first considers the most disabling condition – that is, the one with the highest rating – then less disabling conditions in order of severity. This method captures the residual efficiency of a veteran with more than one service-connected condition. The purpose is to prevent an overall rating higher than 100%.
When the combined value ends in a number from 5 through 9, VA rounds up to the next highest multiple of 10. If the combined value ends in 1 through 4, VA rounds down to the lower multiple of 10. Or, if the combined value ends in 0, then rounding is unnecessary.
To get higher ratings for each disability, follow these steps:
Read the specific rating criteria,
Ask your doctor whether you meet the criteria for higher ratings, and
Develop medical evidence to support your request for higher ratings.
Although, it is not as simple as getting an additional 30% rating. This is because VA does not add your ratings; it combines them.
For example, a veteran with only PTSD at 50% and asthma at 30% has a combined value of 65%. A 65% value rounds up to a 70% combined rating. To get to 100% overall, this veteran must either (1) win a 100% rating for PTSD or asthma, or (2) win at least a 90% rating for an additional disability (or group of disabilities) rated at 90%.
Contact A Disability Advocate
If you have more questions about how to increase your VA disability rating from 70% to 100%, please reach out to us at (800) 800-3332 or contact us here. We will provide a 100% free VA case review and are always happy to answer any questions you may have.
Sleep is required to function. Sleep Apnea is a condition where someone briefly and repeatedly stops and starts breathing. This can severely disrupt someone’s sleeping patterns affecting their mental, emotional, and physical health.
Service Connection
For the VA to assign a 100% rating for Sleep Apnea, the VA must first determine that the condition is related to service.
Generally, VA will grant service connection if the following are met:
Proof of a current diagnosis,
Proof of an in-service event, disease, or injury, and
Proof of a medical nexus between the first 2
elements.
VA Schedule of Rating
After the VA grants service connection, it must determine the correct rating. To do so, VA consults the Schedule of Ratings. The ratings should reflect how much that specific disability impairs your ability to work.
To get a 100% rating for sleep apnea, it must be so severe that it prevents gainful employment.
Requirements Specific to Sleep Apnea
The Schedule of Ratings breaks down disabilities into different categories. Each category contains groups of medical problems. For example, Sleep Apnea is found in the Respiratory System category. Each group contains a list of disabilities, each with its own diagnostic code. In turn, each diagnostic code specifies the symptoms required for various ratings. For example, the 6847 code applies to Sleep Apnea. See 38 C.F.R. § 4.97.
A 100% VA rating for Sleep Apnea requires:
Chronic respiratory failure with carbon dioxide
retention or cor pulmonale, or
The condition requires a tracheostomy.
Chronic Respiratory Failure
Chronic respiratory failure usually happens when the airways that carry air to your lungs become narrow and damaged. In other words, less oxygen gets in and less carbon dioxide goes out. A tracheostomy is a surgically made hole in the front of your neck where a breathing tube is connected to your windpipe to help you breathe. Naturally, a veteran with these extreme symptoms deserves a 100% VA rating for Sleep Apnea.
Medical Evidence
Only medical evidence can satisfy these requirements. It is not enough for the veteran to say “I cannot work because of my sleep apnea.” Fortunately, the VA provides rating tools such as Disability Benefits Questionnaires (“DBQs”) on their website. Specifically, VA provides a Sleep Apnea DBQ that focuses on the symptoms described in the Schedule. Veterans seeking a higher rating for sleep apnea should have their doctors complete the DBQ. The VA will likely grant the rating if the DBQ includes the criteria for a 100% rating for Sleep Apnea.
Disability Benefits Questionnaire
A doctor who treats the disability in question should fill out a Disability Benefits Questionnaire. For example, an orthopedic specialist who is treating a foot condition should not complete a DBQ for PTSD.
Watch out for Pyramiding
When seeking a 100% rating for Sleep Apnea, one must consider every rule and exception related to VA ratings. Under the VA rating system, a veteran should be compensated for each service-connected disability. However, there is one big exception. VA cannot pay a veteran more than once for the same disability or same manifestation. For example, Asthma and Sleep Apnea have nearly identical manifestations. They both involve airway impairment, share symptoms such as daytime fatigue and are under the same category in the Schedule of Ratings. A veteran who is service connected for both will only receive a rating for one of them. In that circumstance, the VA must assign the higher of the 2 possible ratings.
How We Can Help
Many variables come into play when trying to get 100% VA disability for Sleep Apnea. The first step is to not give up. Our team of experts are here to support you the entire way through. Whether you are struggling to secure your VA disability or need help with your denied SSD claims, we’re only a phone call away. To learn more about how our team can help you call us today at (800) 800-3332 or contact us here now for a FREE consultation.
Social Security has two types of benefits for disabled people. The first is for people who have worked for a certain number of years. These are disability insurance benefits or SSDI benefits. The second is a needs-based benefit. It is for people who meet certain financial requirements. These are Supplemental Security Income or SSI benefits.
Social Security Disability Interview Questions
First, your medical conditions must keep you from working. Second, you must be unable to work for at least twelve months. To file, you must provide certain information.
What Happens During the Social Security Disability Interview?
The claims representative asks you a series of questions. Your interview can take place in person or over the telephone. It generally lasts for about an hour.
Call Disability Help Group, We Can Complete Your Interview.
Specifically, a claims representative will ask you:
Your current name and any past names you have used
Your social security number
About your education
Names and dates of birth of your children under the age of 18 and your spouse
Dates of marriages and divorces
Bank information for Direct Deposit
An alternate contact person in case they can’t reach you
Worker’s compensation information, if applicable
In addition, you must provide your work history. Only the last 15 years are important.
This work history should include:
Last worked Date
The name of your previous employers
Your job title
The dates that you approximately worked for each employer
Your medical information should include:
All of your medical conditions
Your doctor’s information
Emergency Room or Hospitalizations
A list of your medications
Naturally, disability applications require a lot of information. It is best to get this information before your interview. Social Security may send you a form to fill out before your interview. This form helps you put the information together. In any case, it is always best to write this information out clearly.
Applying For SSI? You May Be Asked Additional Questions
These questions could include:
Where you live and who lives with you
Your household expenses
All sources of income for you and your spouse
The amount of your resources
Be Prepared With Documentation
You will also have to provide Social Security with some documents. These are in addition to the information you have given.
The documents include:
Birth certificate
A government-issued picture ID
A medical release Form SSA-827 (Authorization to Disclose Information to the Social Security Administration)
Why You Should Be Prepared
The Social Security disability interview process is crucial to your application. Therefore, providing complete information gives you a better chance of winning your case. Also, you can avoid problems or delays in your application. Missing information can often lead to being denied.
Getting Help with Your Claim
The process for applying for SSDI or SSI can be overwhelming. Hiring an experienced SSDI disability advocate can improve your chances of a successful claim.
An SSDI advocate can:
Help you prepare for your interview
Understand the Social Security disability process
Keep in contact with Social Security to make sure your claim is moving forward
Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
Cervical Neck Fusion and Social Security Disability
Cervical Neck Fusion and Social Security Disability. You may qualify for Social Security disability benefits if you’ve had a cervical neck fusion. However, you must show that you still can’t work. Many different problems can cause neck pain and other symptoms. Typically, degenerative disc disease, whiplash, herniated discs, and arthritis can cause ongoing symptoms. Neck impairments can cause many different symptoms.
These symptoms may include:
Pain
Limited movement of the neck or shoulders
Headaches
Shooting pain down the back or arms
Numbness and/or tingling
Getting Disability For Cervical Neck Fusion
You may qualify for Social Security disability benefits for your cervical neck fusion or impairments. However, you must show that your symptoms are severe. They must cause problems doing normal activities. Additionally, they must keep you from working for at least 12 months.
Social Security provides a listing of impairments, known as the “Blue Book.” The Blue Book provides specific conditions that you must meet to qualify for disability benefits. Social Security doesn’t have a specific listing for a cervical neck fusion. However, they do provide a listing for spinal disorders under 1.04.
To meet Social Security’s listing for your neck problems, you must show that the nerve root or spinal cord has been affected.
Additionally, you must show:
Evidence of nerve root compression, limited movement of your spine, and muscle weakness with loss of feeling or reflexes, or
Spinal arachnoiditis is a painful disorder caused by inflammation that causes you to have to change positions every two hours
Getting Disability If You Don’t Meet The Listing
Many people will not meet the listing for their cervical neck impairments. Fortunately, you can still get disability benefits. Specifically, you need to show that your neck problems limit your functioning and prevent you from working. Social Security assesses your residual functional capacity (RFC.)
Particularly, Social Security considers:
How long you can sit, stand, or walk at one time or in an 8-hour workday
How much weight you can lift or carry
Using your arms and hands for activities such as reaching, pushing, pulling, gripping, or grasping objects
If pain, fatigue, other symptoms, or side effects from medications cause limitations with concentration, persistence, or pace
Cervical Neck Fusion And Social Security Disability
Here’s an example of cervical neck fusion and SSD:
Anne injured her neck in a car accident. She required a cervical spinal fusion surgery. Despite surgery, she continued to have severe pain and difficulty moving her neck. She also still had problems using her hands due to numbness and tingling. Social Security determined that she could not lift or carry more than ten pounds but could sit for six hours. Additionally, Social Security found that she had serious problems using her hands throughout the day. Therefore, she was unable to do even simple seated jobs. As a result, Anne was approved for disability benefits.
Social Security Grid Rules
Social Security uses a chart called the Medical-Vocational Guidelines to evaluate your disability claim. These guidelines are known as the “grid rules”. The grid rules make it easier for older people to win their case. Social Security understands that it may be harder for older people to do new or different work. They will look at the grid rules if your impairments do not meet the conditions under the Social Security medical listings.
Cervical Neck Fusion And The Grid Rules
Here is an example of the grid rules for Cervical Neck Fusion:
Brad, a 57-year-old man previously worked as a janitor. He filed for disability because he developed degenerative disc disease in his neck. He had cervical spine surgery. Unfortunately, he continued to have pain in his neck. His doctor told him he couldn’t lift more than 10 pounds. Social Security found he couldn’t perform the duties required to be a janitor. Under the grid rules, Social Security approved Brad’s claim.
Medical Evidence Needed For Cervical Neck Fusion And Neck Impairments
You must provide medical evidence to document any problems related to your neck problems. Generally, medical evidence includes your doctor’s treatment notes, test results, and imaging. Most importantly, you should have MRI evidence of your cervical spine.
Also, your doctor should document:
Any pain with movement of your bones or joints
Problems moving your neck
Problems using your hands
Difficulty traveling to places without assistance
Difficulty performing activities of daily living such as shopping, cooking, cleaning, using public transportation, bathing, or getting dressed
RFC Forms
An RFC form can clearly explain how your conditions impact your functioning. Having your doctor complete an RFC form can be very helpful. After all, they should know more about your health than anyone else. An RFC form should be very detailed. It should indicate all your medical symptoms and conditions. It should also include all of your treatment and any side effects from medications. An experienced disability advocate can provide these forms to you.
Disability Help Group Can Help You
Make sure you start your claim the right way and apply for all the benefits you deserve. If you have already applied for SSI or SSDI, call immediately to make sure your case is still pending and was filed correctly. You may be entitled to significant compensation. Contact us now for a free consultation.