Traumatic Brain Injury (TBI) has become more and more common in the wars
in Iraq and Afghanistan. TBI is caused by trauma to head, most commonly
associated with the use of roadside improvised explosive devices (IEDs)
and resulting blast forces. Automobile accidents, repeated hits to the
head playing sports, and falls involving head trauma may also be causes.
The physical, cognitive, emotional, and behavioral effects of TBI are often
accompanied by an acquired psychiatric disorders like post-traumatic stress
disorder (PTSD), anxiety, and depression. However, these symptoms are
often overlooked, considered by the VA as part of a veteran’s TBI
symptoms - not two or three different disabilities caused by in-service
TBI. This means veterans service-connected for TBI may not receive adequate
compensation for every disability related to their military service.
The VA recently amended its secondary service connection regulations to
recognize that TBI may cause additional, separately compensable, secondary
disabilities. The VA now recognizes that Parkinson’s disease, unprovoked
seizures, certain forms of dementia, depression, and diseases of hormone
deficiency will be considered proximately due to TBI in the absence of
clear evidence to the contrary. However, whether the VA will consider
TBI to be the proximate cause of one of these depends on the severity
of a veteran’s service-connected TBI. The VA characterizes TBI as
mild, moderate, or severe. When determining the degree of a veteran’s
TBI, the VA looks at his or her symptoms at the time of TBI and shortly
thereafter. Factors affecting the characterization of TBI as mild, moderate,
or severe are structural imaging of the brain, loss of consciousness,
alteration of consciousness and/or mental state, post-traumatic amnesia,
and the Glasgow Coma Scale.
The length of time between when the TBI occurred and when disabilities
arose can affect whether the VA considers these additional disabilities
secondary to service-connected TBI. For example, service connected TBI
will be considered to be the proximate cause of a diagnosis of depression
if it manifests within 3 years of a moderate or severe TBI or within 12
months of a mild TBI.
The determination of the severity level of TBI is based on symptoms at
the time of the in-service injury or shortly thereafter, rather than at
the current level of functioning. This is an important distinction as
the level of severity of the TBI may allow a veteran to be awarded secondary
service connection for the above disabilities. Oftentimes, there is no
record of a veteran’s in-service TBI; a veteran’s service
medical records may only note a head injury. When a veteran’s TBI
is evaluated for service connection or for secondary claims, it is important
for him or her to describe to the VA examiner the event that caused the
injury, any loss of consciousness and the duration of loss of consciousness,
any alteration of the veteran’s mental state after the injury including
confusion, and any amnesia or loss of memory of the event or difficulty
recalling events following.
Secondary service connection for other disabilities caused by TBI requires
an opinion from a qualified medical professional. Other helpful evidence
includes statements from the veteran and his family, an opinion from a
vocational expert on the effects on the veteran’s TBI and his work,
and any medical records that contain diagnoses of mental and physical
disorders that may be caused by TBI.
If you think you may have additional disabilities caused by your service-connected
TBI or if you have been denied and need help with your appeal, please
call 1-888-883-2483 to speak with a member of our team or contact us online.
Your consultation is free.