If you do not understand how VA rates or weighs TBI residuals this article will help.
Are Your VA TBI Residuals Related to Service?
Before VA will assign a rating for TBI, it must first determine whether it is related to service. The question is whether VA should award service connection for TBI. Generally, VA will deny service connection for TBI unless the following elements 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.
Do you have a current TBI diagnosis
If you file a claim for TBI without a confirmed diagnosis, then you should expect VA to deny the claim. It is not enough for the veteran to say they have VA TBI residuals. Before VA will rate TBI, it must confirm that it has been medically diagnosed. For VA purposes, only one of the following specialties can diagnose TBI:
- Physiatrists, or
Traumatic brain injury (TBI) occurs when a sudden trauma causes damage to the brain. If you had sudden head trauma during service, you may have VA TBI residuals in the following areas:
- Cognitive (such as decreased memory, concentration, or attention),
- Emotional/behavioral (such as anxiety, crying spells, short temper), or
- Physical (such as seizures or balance problems)
If you have any of these symptoms, then you should probably get checked for a TBI. To prove the current diagnosis element, one of the approved specialties must provide the diagnosis.
In-service event, disease or injury
According to the Department of Defense, more than 313,816 service members have sustained a TBI in training or combat. Common causes of this kind of head trauma include blast-related concussion events resulting from training or combat. In fact, TBI 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.
If you cannot prove that your VA TBI residuals are related to service, then 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.
Medical nexus is required to prove VA TBI residuals
Proving the first 2 elements of the claim is not enough. To win a TBI claim, you still need medical evidence linking your current diagnosis to the in-service event. In most cases, a statement from your doctor can provide a medical nexus.
Fortunately, a medical nexus does not have to express 100% certainty. Instead, here is the question: 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.
Rating VA TBI Residuals
After VA concedes service connection for TBI, it turns to the rating percentage. The rating percentage determines how much money VA must pay to the veteran. The ratings for TBI residuals are covered in the VA Schedule of Ratings.
VA divides the rating criteria for VA TBI residuals into 10 categories. Veterans are then rated based on the level of severity and impairment in each of these areas:
- Memory, attention, concentration and executive functions: Executive functions include goal setting, planning, self-monitoring, and flexibility in changing actions when they are not productive.
- Judgment: Is the veteran able to make reasonable decisions?
- Social interaction: How often does the veteran act appropriately in social situations?
- Orientation: Is the veteran aware of who, where, and when he is?
- Motor functions: Is the veteran able to perform previously learned motor activities (such as riding a bike)?
- Visual spatial orientation: Does the veteran get lost even in familiar surroundings? Is he able to point at or name own body parts?
- Subjective symptoms: Symptoms that cannot be measured with objective tests, such as panic attacks and thoughts of suicide.
- Neurobehavioral effects: Examples include lack of motivation, verbal aggression, physical aggression, and lack of empathy.
- Ability to communicate: Can the veteran communicate either by spoken or written language? Can he communicate basic needs?
- Consciousness: Is the veteran in a coma or a vegetative state?
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%
If any residuals of TBI are rated “total”, then VA will award a 100% rating. If no residual is rated “total”, then VA must rate based on the highest rated residual. For example, let’s say a veteran has TBI residuals in 3 out of the 10 categories. He has a 1 for Judgment, a 3 for Ability to Communicate, and a 2 for Orientation. In this example, VA will award 70% because 3 is the highest residual rating.
Get Help Now
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.
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