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.
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!
Since 1991, American forces have served in the Southwest Theater of Operations. To dispose of nearly all forms of waste, the military dug large burn pits. Every forward operating base (FOB) in the region used burn pits. See map below.
This region stretches from Somalia up to Uzbekistan, and all the countries in between.
The burned waste products include, but are not limited to:
Plastics,
Metal cans
Rubber
Chemicals,
Petroleum products,
Munitions
Wood waste, and
Medical and human waste.
Jet fuel (JP-8) is used as the accelerant. However, the burn pits do not properly burn the volume of waste generated. As a result, smoke blows over bases and into living areas.
The most infamous burn pit is at Joint Base Balad, Iraq. In 2008, the military found several deadly toxins in the air at Balad. They detected some of the same toxins found in Agent Orange and the groundwater at Camp LeJeune.
Unfortunately, this is not an isolated incident. Over a quarter of a million veterans have reported an illness they link to the burn pits.
I’ve never filed a VA claim before. How do I start a Burn Pit claim?
If you never filed a VA claim before, then you’ll need to file an Original claim. Per VA rules, you can only file an original claim using a VA Form 21-526EZ. The form asks for your Social Security number, dates of active duty service, branch of service, and other biographical information. Most importantly, you must briefly explain why your disability is related to your burn pit exposure.
In addition, you should also submit evidence to meet the 3 basic elements of any VA claim:
In-service event, disease or injury,
Current diagnosis of a disability, and
Medical nexus between the first 2 elements.
Is my condition related to Burn Pit exposure?
According to VA, toxins in burn pit smoke may affect the following body systems:
Skin,
Eyes,
Respiratory,
Cardiovascular,
Gastrointestinal, and
Internal organs.
However, this general information is not enough to prove a link to burn pits.
In most cases, this will be a medical question for your doctor. But remember: most civilian doctors are unfamiliar with burn pit exposure. You, the veteran, will need to provide context. This context will help your doctor figure out a link between your condition and the burn pit.
The following factors are critical:
Proximity, amount of time, and frequency of exposure
Military specialty
Pre-existing respiratory conditions
Wind direction and other weather factors
Types of waste burned.
If you were only exposed to burned human waste, then it is easy to research those toxins. There is a lot of science on this topic. However, a pit that also burned munitions, Styrofoam and chemicals requires more analysis. Likewise, a soldier who personally visited the burn pits has more exposure than one who did not.
New presumptive conditions
As of August 5, 2021, veterans don’t need to prove a link to burn pit exposure for these 3 conditions:
Asthma,
Rhinitis, and
Sinusitis.
For veterans with a qualifying period of service, VA no longer requires specific proof of exposure to burn pits. If you served in the Gulf War, Iraq, Syria, or Afghanistan, then you qualify. All you need to prove is a current diagnosis.
VA denied my burn pit claim. What now?
Hire an accredited VA representative.
There are so many rules and exceptions that apply to burn pit claims. Without a representative, you may not know if VA was wrong to deny your claim. Too many VA decision-makers deny claims if there is any doubt at all. However, this is not the correct standard.
Further, when VA denies a claim, it MUST explain why. VA must explain to the veteran which elements he successfully proved. With that knowledge, a veteran should focus on getting evidence for the unproven element(s). For example, if VA says you were never exposed to burn pits, then you need to develop evidence to the contrary.
An experienced representative can make all the difference in your case.
Are you entitled to VA compensation for burn pit exposure? The experts at Disability Help Group are standing by. Contact us for a FREE CONSULTATION.
A burn pit is an area devoted to open-air burning of trash and you can receive VA Compensation for burn pit exposure. During U.S. operations in countries such as Kuwait, Iraq and Afghanistan, the military commonly used burn pits for waste disposal. It was a very efficient way to get rid of large amounts of waste. The largest pit was about 20 acres long .
These burn pits disposed of various materials, such as:
Human waste
Body parts
Medical waste
Unexploded ordinance
Chemicals
Plastics and Styrofoam
Paints
Rubber.
Smoke from these pits contained toxins that may lead to serious health conditions. This is especially true for those who had prolonged exposure. This includes service members who personally dumped waste into a burn pit. In addition, those with pre-existing respiratory conditions were especially sensitive to the smoke.
Basic Eligibility
VA compensation is a monthly payment to veterans for disabilities related to service. However, VA will not start the process for you. You must first file a claim.
To win VA compensation, a veteran must satisfy the 3 basic elements of a VA claim:
In-service event, disease or injury,
Current diagnosis of a disability, and
Medical nexus between the first 2 elements.
The first step is to prove you were exposed to burn pits during your active duty service. If you served in the Southwest Asia Theater of Operations, then your DD Form 214 should confirm this. Absent official service records, obtain statements from buddies who witnessed your exposure to burn pits.
Second, the veteran must have a current disability. The time between exposure and diagnosis will vary based on several factors. For example, the toxins from burned human waste may affect the body differently than those from burned Styrofoam.
Even so, a short-term adverse reaction to the smoke is not enough. Shortly after burn pit exposure, many veterans develop medical conditions. However, many do not develop disabilities until years after discharge.
Third, VA requires proof that the condition you suffer from today was caused or aggravated during service. This usually takes the form of a medical nexus letter. Only a medical professional should write a disability nexus letter. In limited circumstances, non-doctors such as physician’s assistants and nurse practitioners can write them. However, VA will find a disability nexus letter more persuasive if written by a doctor in the relevant specialty.
Does Every Burn Pit Claim Need a Medical Nexus Letter?
Not every burn pit claim needs a nexus letter because in some cases, the link to service is undeniable. For example, if your service records note a disability you still suffer from today, then VA would probably grant a claim for that disability without a nexus letter. As of August 2021, VA will concede that burn pit exposure causes certain health conditions. These are known as burn pit presumptive conditions.
New presumptive conditions, you can receive VA Compensation for burn pit exposure.
On August 5, 2021, VA issued a new rule to remove the medical nexus requirement for 3 conditions:
Asthma,
Rhinitis, and
Sinusitis.
This rule removes the medical nexus requirement for certain veterans. But that’s not all. It also makes it easier to prove burn pit exposure. For veterans with a qualifying period of service, VA no longer requires specific proof of burn pit exposure to burn pits. If you served in the Gulf War, Iraq, Syria, or Afghanistan, then you qualify. In those cases, all you need to prove is a current diagnosis.
Why does VA keep denying my burn pit claim?
VA has been slow to recognize the science linking serious conditions to burn pit exposure. Because the decision-makers don’t see a link, they tend to deny the claims.
The Secretary of Veterans Affairs recently talked about this . He conceded that many vets have come home with ailments that their doctors believe are a result of burn pit exposure. VA has recognized burn pits cause asthma, rhinitis and sinusitis. However, VA has yet to accept the scientific link to many more serious conditions.
Secretary McDonough cited a critical example. A female veteran was trying to stay healthy in Fallujah, Iraq. She went running daily around a burn pit. When she informed her doctor, he said she should get tested early for breast cancer. It turned out she had stage 4 breast cancer at the age of 38. The science indicated she was way too young to have such an advanced stage cancer.
When VA denies a claim, the veteran can file an appeal. However, appeals can take years to win. With such an advanced cancer, this veteran may not survive before VA decides the appeal. This is grossly unfair to veterans who served our country with honor.
Are you entitled to VA compensation for burn pit exposure? The experts at Disability Help Group are standing by. Contact us for a FREE CONSULTATION.
Disability Help Group, Call Now for a Free Case Review, 800-700-0652.
You can receive VA Compensation for burn pit exposure.
Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
Because memory deficits are common VA TBI residuals, a veteran should always have an advocate. Disability Help Group specializes in TBI cases and is here to answer your questions now.
