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.
A Veterans Disability Advocate Can Help You!
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.
What is the Criteria for 70% TBI Disability Rating?
What is the Criteria for 70% TBI Disability Rating? After VA grants service connection for Traumatic Brain Injury (TBI disability), VA must determine the correct rating percentage. As a result, the rating percentage determines how much money VA must pay to the veteran. Rather than assign percentages subjectively, VA uses criteria in the Schedule of Ratings.
VA Schedule of Rating Criteria for 70% TBI Disability Rating
The VA Schedule of Ratings breaks down disabilities into different categories. Firstly, each category contains groups of medical problems. Secondly, each group contains a list of disabilities, and each disability has its own diagnostic code. Thirdly, every diagnostic code specifies the symptoms required for various ratings. For example, the 8045 diagnostic code covers residuals of Traumatic Brain Injury (TBI).
How is a TBI disability rated?
The VA divides the rating criteria for TBI disability into 10 categories.
Veterans are rated based on the level of severity and impairment in each of these areas:
1. Memory, attention, concentration, and executive functions, including goal setting, planning, self-monitoring, and flexibility in changing actions when they are not productive.
2. Judgment: a veteran’s ability to make reasonable decisions.
3. Social interaction: how often a veteran acts appropriately in social situations.
4. Orientation: a veteran’s awareness of who, where, and when he is.
5. Motor activities: a veteran’s ability to perform previously learned motor activities (such as riding a bike).
6. Visual-spatial orientation: A veteran gets lost, even in familiar surroundings, or cannot point at or name their own body parts.
7. Subjective symptoms: symptoms that cannot be measured with objective tests, such as panic attacks and thoughts of suicide.
8. Neurobehavioral effects: examples include lack of motivation, verbal aggression, physical aggression, and lack of empathy.
9. Ability to communicate: Can the veteran communicate either by spoken or written language or communicate basic needs?
10. Consciousness: Is the veteran in a coma or a vegetative state?
Traumatic Brain Injury (TBI) residual scale
VA rates TBI residuals on a scale of 0, 1, 2, 3, or total. Each increment corresponds to a disability rating:
0 = 0% (normal functioning)
1 = 10% (mild)
2 = 40% (moderate)
3 = 70% (severe)
Total = 100%
The VA will award a 100% TBI disability rating if any residuals of TBI are rated “total”. Conversely, the VA will assign a percentage based on the highest-rated residual if no residual is rated “total”. For example, let’s say a veteran has TBI residuals in 3 out of the 10 categories. Therefore, he has a 1 for Judgment, a 3 for the ability to communicate, and a 2 for orientation. In this example, VA will award 70% because 3 is the highest residual rating.
70% TBI Disability Rating Varies
Across the 10 residual categories, the criteria for a 70% rating varies. For example, a Neurobehavioral residual must interfere with or preclude workplace interaction, social interaction, or both on most days. By contrast, VA assigns a 3 if Motor activities are moderately decreased due to apraxia. When in doubt, one should consult diagnostic code 8045 and the associated tables.
The following examples would yield a 70% disability rating for TBI:
A 50 year-old veteran who is often disoriented in time and place.
A 35 year-old veteran whose social interaction is inappropriate most of the time.
A 70 year-old veteran who is unable to communicate either by spoken or written language about half of the time.
Special Monthly Compensation
A veteran may receive special monthly compensation, in addition to a 70% rating, for Traumatic Brain Injury (TBI). As a result, the question is simple: Does your 70% rated TBI disability render you so helpless that you require the regular aid and attendance of another person?
Disability Help Group Case Study
Disability Help Group represented a veteran of the Army who had TBI at 10%. After increasing his rating to 70% for Traumatic Brain Injury, we continued fighting for him to receive special monthly compensation. We were able to prove that he could not care for himself, because the local VA hospital appointed his mother as his VA caregiver. Among other duties, she assisted with medication management, personal hygiene, reminding him of and taking him to appointments, and paying his bill. Therefore, we proved the veteran had a permanent need for regular aid and attendance due to his TBI.
As a result, VA granted Special Monthly Compensation at the (r)(2) rate, increasing monthly payment from $264.02 to $8,343.91.
Do you believe you meet the criteria for a 70% rating for TBI disability? Be sure you start your claim the right way and apply for all the benefits you deserve. Call our team of experts today at (800) 800-3332 or contact us here for your FREE consultation!
Adam Neidenberg is co-founder of Disability Help Group. He has been litigating claims since graduating law school in 1996. Once he became an experienced trial attorney, he began focusing on representing disabled individuals. Mr. Neidenberg has represents thousands of disability claimants and provides training to Disability Help Group advocates by teaching them how to assess legal issues, present evidence in cases, and cross examining experts.
Adam Neidenberg is an Expert Disability Advocate
Adam Neidenberg has achieved much in life and feels a sense of pride in his ability to help disabled people receive the disability benefits they deserver. Some of Mr. Neidenberg’s educational and professional accomplishments include:
Firstly, University of Florida, Undergraduate Degree, 1993.
Secondly, Hofstra University, Juris Doctor, 1996.
Thirdly, Florida Bar Association
Fourthly, 11th Circuit Federal District Court
Moreover, United States Court of Veterans Appeals for Veterans Claims.
Finally, Department of Veterans Affairs Accredited Attorney.
Getting the Help You Deserve
Mr. Neidenberg provides specialized services in disability law. Disability Help Group’s experienced advocates can help you with your Social Security disability or Veteran’s disability claims. We can help you understand which are the most advantageous disability rules for your claim. Mr. Neidenberg and Disability Help Group help you build the strongest case possible.
The Application Process
Mr. Neidenberg and his dedicated team help you file your disability claim. We focus on making sure your disability application is accurate and complete. Complete applications give you a better chance of winning your case at the earlier stages of the disability process.
Understanding the Disability Process
Mr. Neidenberg and his team make sure you are in good hands during the Social Security disability process.
Firstly, provide an educated staff to answer your questions
Secondly, check on the status of your case regularly
Thirdly, ensure Social Security processes your case correctly
Fourthly, make sure documentation is submitted timely
Adam Neidenberg is an Experienced Hearing Advocate
Adam Neidenberg and Disability Help Group prepares you for you for your disability hearing. Your advocate fully reviews your file. We obtain any missing medical evidence you need and will discuss with you the questions the judge will ask you. In addition the the administrative judge, there may be a vocational and/or medical expert that may be involved in your hearing.
Adam Neidenberg and Disability Help Group know what it takes to win your case.
Case Study 1: Adam Neidenberg Disability Help Group
Donald had a car accident and hit his head losing consciousness. Following his accident, Donald started having frequent headaches. He also had problems with his balance, memory, and concentration. As a result, he became irritable easily. After applying for disability, Social Security denied Donald’s case twice. Donald hired Adam Neidenberg as his disability advocate. When we reviewed the file, it was clear that his doctor did not provide the necessary descriptions of Donald’s symptoms. Therefore, it was necessary to resolve the issues with the medical evidence. Once the issues were resolved, Donald had a hearing in front of an administrative law judge who found that Donald missed work frequently and determined that Donald met the Social Security disability rules and his case was approved.
Case Study 2: Adam Neidenberg Disability Help Group
Anne injured her neck in a car accident. She required cervical spinal fusion surgery, however, surgery did not help improve her symptoms. Likewise, she developed numbness and tingling in her arms., causing her problems using her hands. Disability Help Group made sure that Social Security received all of Anne’s records. Anne’s advocate suggested certain tests that could help her case, also provided additional forms for Anne’s doctor to complete. Ultimately, Social Security found that Anne was unable to work and approved her case.
Working with a Disability Expert
The Social Security Disability process and rules can seem very confusing. For example, there several states in the process, an initial application, reconsideration, hearing, appeals council, and federal appeals. In addition, within each stage in the process there are has various forms that need to be completed and distinct rules that need to be followed. It is important that you hire an expert that understands how to apply the rules to your case that will benefit you. For example, Social Security has rule that makes it easier for people over the age of 50 to win their case.
Case Study 3: Adam Neidenberg Disability Help Group
Janet, a 51 year old woman, applied for disability based on coronary artery disease, depression and anxiety. She previously worked as a medical assistant. She was unable to continue working because she suffered from frequent chest pain and swelling in her legs. Due to her depression and anxiety symptoms, she had trouble concentrating and remembering things. After being denied for disability by Social Security, Janet hired Disability Help Group. Thereafter reviewing her file, we found that Janet did not provide Social Security with her psychiatrist’s information. Her advocate requested her psychiatrist’s records and with the addition of these records, the judge found that Janet could not stand for long periods of time. She also could not perform complex tasks. Therefore, she could not return to work as a medical assistant. Since Janet was over the age of 50, the judge was able to approve her case.
Call Now for a Free Case Review, 800-700-0652
Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
How to Qualify for VA Compensation While Receiving SSI. Veterans can receive both VA compensation and SSI. Both VA compensation and SSI require that you have disabling conditions. However, the requirements to qualify differ.
How to Qualify for VA Compensation While Receiving SSI: VA compensation
VA disability compensation offers monthly payments to Veterans who got sick or injured while serving. You must show that your disabling condition was “incurred or aggravated by your military service.” The VA does not require total disability. The VA awards benefits based in proportion to your percentage of disability. Compensation rates range from 10%-100%, in 10% increments.
VA pension
The VA also offers benefits for veterans who have non-service disabilities. VA pension benefits require that you were not dishonorably discharged and you meet certain financial limits. You must also meet certain service requirements. Additionally, you show one of the following:
You are at least 65 years old
Have a permanent and total disability
Are a patient in a nursing home for long-term care because of a disability or
Are receiving Social Security disability insurance or SSI. The OT and ICS cyber security is what is needed to protect data.
How to Qualify for VA Compensation While Receiving SSI: SSI benefits
Unlike VA compensation, SSI does not offer partial disability. You must prove that your medical conditions keep you from working in any job. You must also show that you can’t work for at least 12 months. SSI also has specific financial requirements. Specifically, these requirements include:
You must have less than $2,000 in assets (or $3,000 for a couple)
Have a very limited income
Are a US citizen (there are very few exceptions to this)
VA compensation and SSI benefits
Since SSI is a needs-based program, other income affects the amount you receive from SSI. Therefore, VA compensation will reduce your SSI payments. Social Security considers VA compensation as “unearned income.” Social Security deducts unearned income on a dollar for dollar basis with a $20 exclusion. The SSI federal payment amount for 2021 is $794 per month.
How to apply for VA compensation
You can apply for veterans benefits online. You may also apply by using VA Form 21-526, Veterans Application for Compensation and/or Pension. Once you apply, the VA uses military doctors and other health personnel to evaluate your disability claim. The VA may ask you to attend a C&P exam to help rate your claim. The VA assigns a disability rate to each of your conditions. These rates determine your Total Combined VA disability rating. The VA then uses this rate to figure out the amount of your benefits. We Can Help You Qualify for VA Compensation While Receiving SSI.
How to apply for SSI
You must contact your local Social Security office to file. Unlike the VA, Social Security doesn’t rate your conditions separately. Social Security looks at how the combination of your conditions impacts your functioning. First, they consider if any of your conditions meet certain conditions under their listing of impairments, known as the “Blue Book”. Most conditions will not meet these strict requirements. Next, Social Security considers your residual functional capacity or RFC. Your RFC includes both physical and mental limitations. If Social Security determines that your conditions keep you from working, they will approve your disability claim. Like the VA, Social Security may ask you to attend a medical exam to help evaluate your claim.
Disabled veterans and your age
Social Security has special disability rules the older you are. They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.” The grid rules make it easier for older people to win their case. Social Security considers your age, education and work background. The older you are, the easier it can be to win your case.
Can a veteran work and receive both VA and SSI?
If you are working, you may not qualify for SSI. Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA. If you earn over the SGA limit, you will not qualify for Social Security disability. For 2021, SGA is earnings $1,310 per month or more (before taxes). However, if you earn more than $794 per month, you will not qualify to receive SSI payments. Unlike Social Security, veterans can work while receiving VA disability benefits unless you receive Total Disability Based on Individual Unemployability (TDIU). We can help you Qualify for VA Compensation While Receiving SSI.
VA and SSI medical benefits
Veterans receiving VA disability automatically receive TRICARE benefits. TRICARE covers health costs found “medically necessary” for your condition. SSI recipients receive Medicaid benefits. If you receive both TRICARE and Medicaid, TRICARE becomes your primary insurance.
Getting help with your VA compensation and SSI claims
Get help with your case now. Firstly, your advocate helps you with your application and can make sure you provide all necessary information. Secondly, your advocate walks you through the process and can answer all of your questions. Thirdly, your advocate knows what it takes to get your case approved.
Call Now for a Free Case Review, 800-700-0652
Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
