If you served in Iraq or Afghanistan, you could be part of the rising number of veterans that have experienced a Traumatic Brain Injury (TBI). The US military has seen drastic increases in TBIs in the last several years. Increases attributed largely to tactics employed by the enemy’s guerrilla insurgency with improvised explosive devices (IEDs) during Operation Enduring Freedom and Operation Iraqi Freedom.
While IEDs are causing the main increase in TBIs, it is only in recent years that a link between TBIs and PTSD (Post-Traumatic Stress Disorder) has been found. Soldiers with TBI are at an increased risk for psychiatric disorders like depression and PTSD which can complicate their life for years to come.
- What is TBI and PTSD?
- Residuals of TBI can Make PTSD Worse
- Make Sure You Know How the VA Disability Benefits Work for TBI
- Traumatic Brain Injury Disability and Social Security
- Is TBI Permanent? Is PTSD Permanent?
- How to Measure the Severity of the TBI and PTSD
- Can I get TBI Disability and Still Work?
- Long Term Solutions to TBI and PTSD Disability
- Questions about TBI and PTSD
Veteran TBI claims are very time sensitive, whereas PTSD effects may last a lot longer. 80% of people that have a mild TBI recover within 3 to 6 months of the injury. If you know service members that have experienced a TBI, make sure they document every detail they can as soon as possible. Keep any letters your brother or daughter may have sent home while they are in active duty because those documents can also be used in their disability claim.
The VA rates TBI (diagnostic code is 8045 for residuals of traumatic brain injury) based on the following categories:
- cognitive impairment
- emotional and behavioral dysfunction
- physical and neurological dysfunction
Along with the TBI rating, you want to also seek a PTSD rating because so many of the symptoms are linked. Telling a complete story of what happened and it’s long-lasting effects on your daily life are the key to a winning VA Disability Compensation case.
What is TBI and PTSD?
TBI stands for Traumatic Brain Injury. PTSD stands for Post-Traumatic Stress Disorder. They are different types of injuries. TBI is physical. Something happened to a person’s head that injured their brain. PTSD is mental. Something happened (or didn’t happen) that caused great mental trauma to the person.
Cognitive impairment includes things like memory, concentration, attention, and executive functions. It is one of the more difficult categories to provide evidence for and prove the severity of, because cognitive impairment is unlike, say, a knee injury where one can examine an x-ray for proof and assess the damage.
Some Examples of TBI:
- Car wreck
- Falling from a moving vehicle
- Falling from a great height
- Concussive blasts
- Bullets, shrapnel, or other high-velocity projectiles
It is hard to list examples of what can cause PTSD because it is a disability based on the impact of events on a person mentally rather than an object to their body. What causes PTSD in one person might be no big deal to another, and vice versa. We have helped veterans with their disability claims for PTSD resulting from events like:
- Being the sole survivor from a division
- Watching best friends get killed
- Overwhelming feelings of guilt
- Loss of a loved one back home while away on active duty
- Discovering the enemy combatants were children
- Captured as a Prisoner of War
- Victims of Military Sexual Trauma
It’s a grim list of things that were treated with “tough it out” attitudes while on the field, but they can make coming home nearly impossible.
Residuals of TBI can Make PTSD Worse
Emotional and behavioral dysfunction usually accompanies mental health disorders. Unfortunately, the VA seeks to classify many mental health symptoms as non-service connected. Because of this, lawyers look to develop mental health impairment alongside a traumatic brain injury. Medical doctors, psychiatrists, psychologists (preferably neuropsychologists) are the experts that are qualified to administer TBI compensation and pension exams on behalf of the VA.
The symptoms of TBI can be can be observed. They include motor and sensory dysfunction, headaches, pain, seizures, gait, coordination, balance issues, incontinence, and reflex problems. The VA assigns a point system based on all of these different categories. Each category of impairment is calculated to generate a raw score. A rating is then assigned based on the most severely rated category.
10% to 15% of patients may go on to develop chronic post-concussive symptoms. These symptoms can be grouped into three categories: somatic (headache, tinnitus, insomnia, etc.), cognitive (memory, attention and concentration difficulties and emotional/behavioral (irritability, depression, anxiety, behavioral dyscontrol). Patients who have experienced mTBI are also at increased risk for psychiatric disorders compared to the general population, including depression and PTSD.
National Center for PTSD: https://www.ptsd.va.gov/professional/treat/cooccurring/tbi_ptsd_vets.asp
Make Sure You Know How the VA Disability Benefits Work for TBI
The VA has an important rule that you must take into account when you’re looking at TBI ratings, and that’s the rule against pyramiding. Essentially, it just means that you can’t get two separate compensable ratings for one disability or manifestation. A really good example of the rule is headaches. Because of the overlap between mental health ratings, TBIs, and headache ratings, it is best to develop TBI alongside that of mental health and headaches if you are pursuing a traumatic brain injury claim.
Traumatic Brain Injury Disability and Social Security
Depending on the nature of your TBI Disability, you may qualify for Social Security in addition to your VA disability benefits. This would be handled on a completely separate application to a different agency, but you can use the documentation from your VA claim for your Social Security Disability claim and vice versa. Talk to your Woods and Woods Disability Lawyer team about other applications you are working on. We do more VA Disability law than anything else, but many of our clients have received SSDI also.
Is TBI Permanent? Is PTSD Permanent?
In most cases, TBI is not permanent. The difficulty comes in diagnosis. Knowing what symptoms are caused by PTSD, TBI, or other spinal or neurological injuries depends on the doctors writing the report for the VA. TBI is unlikely to get a permanent disability rating since it is often a disability that can improve over time. PTSD is also rarely given a permanent rating because the symptoms can change and the condition can improve over time. This should not discourage you from calling a lawyer and starting your disability claim, though.
Disability claims that win are the cases where you work through the entire lifestyle and condition of the veteran. If your spouse takes a drastic turn and begins to show symptoms of PTSD years after active duty, you can still claim VA disability for those symptoms. While the effects of TBI wear off over time, the effects of PTSD can increase based on the event. If a disability prevents a veteran from playing with her grandchildren, depression may set in that she never experienced before.
Adult children of veterans might grow old enough to recognize PTSD in their parents. Calling to ask us questions is always free, and we have worked with a lot of children of vets for their parent’s cases.
How to Measure the Severity of the TBI and PTSD
The VA is all about putting a rating on the severity of your service-connected disability. They might use the “TBI Blue Book” which is the listing of impairments for the Social Security Administration. Those guidelines rate symptoms that last more than 3 months after the injury. Physical limitations such as balance and the ability to stand up from a seated position are considered. They also count understanding information, interacting with others, and how well you concentrate and manage yourself.
These same kinds of criteria are the measures they use to rate PTSD. If you are discharged early due to a traumatic event, you are rated at 50% rating. After 6 months, they can revisit your rating to increase or decrease your disability rating. The VA rates PTSD as an anxiety disorder but is still learning a lot more about how Veterans experience it. Journaling your veteran’s behavior, moods, and coping practices can all help the VA diagnose your veteran and will help your lawyer make your case for VA Disability.
Tthe medical journal JAMA Psychiatry, found that among hospital patients, 21.2% of those with mild traumatic brain injuries experienced PTSD or depression up to six months after injury, compared with 12.1% of those with non-head injuries.
CNN https://www.cnn.com/2019/01/30/health/mild-traumatic-brain-injury-ptsd-depression-study/index.html
Can I get TBI Disability and Still Work?
TBI and PTSD can have a lot of different effects on your ability to work. Since TBI is viewed as a disability that will slowly improve, you might be able to get back into the workforce after a period of TBI disability. If PTSD sets in as a result of the TBI or the event that caused the brain injury, work will be more difficult. If there is permanent brain damage or if the event is coupled with other injuries like the loss of a limb or vision, you should try to apply for TDIU.
Veteran head injuries are often not isolated and may also include hearing loss, skin injury, or spinal issues. All of these should add to your combined rating calculations. Even a car wreck during active duty can account for the TBI, so include everything in your call to Woods and Woods. There are even separate events where a traumatic event happened apart from the TBI, but because of the symptoms of the TBI, the PTSD was made worse.
Use our VA Disability Calculator to estimate your combined VA rating and monthly entitlement here.
Veterans who have seen combat may have longer-term effects from explosions than previously thought. Johns-Hopkins medical center discovered findings in 2015 that “reveal a unique pattern of injuries in parts of the brain involved in decision making, memory, reasoning and other executive functions. ”
Johns-Hopkins Medical Center https://www.hopkinsmedicine.org/news/media/releases/combat_veterans_brains_reveal_hidden_damage_from_ied_blasts
Long Term Solutions to TBI and PTSD Disability
TBI and possible PTSD are injuries and disabilities that need the whole family’s support. While disability claims for TBI need to be done as close to the injury as possible, that shouldn’t discourage you from looking into a VA disability claim if it’s been a long time. A spouse or family member can work with our team to complete all of the necessary paperwork and get the veteran’s claim submitted. We also help with VA appeals in case you have been denied in the past and things are getting worse. We will look over your claim to see what we can do about getting benefits your PTSD symptoms and TBI.
If you are a family member of a vet that is already getting VA disability but you are concerned that the rating needs to be increased or that a PTSD rating needs to be added to what he or she already has, you can also call us. Like I said above, it can take years for some symptoms of PTSD to show up, so you might not have a PTSD rating now, but you should get one.
We will look into your case and see how far back your vet had these symptoms and struggles to establish the earliest effective date possible. Increasing a VA rating is better than applying for one in the first place, so if you suspect any of these disabilities, you want to get started on your claims as soon as you can.
Questions about TBI and PTSD
It isn’t necessarily the blow to the head that causes PTSD. There is, however, and increased risk of PTSD in people that have experienced a TBI, especially in the circumstances surrounding the TBI event.
Yes, for the majority of people, recovery from a TBI is 3-6 months.
Some people are able to handle their PTSD through exercise, counseling, and a well-developed support structure. It can come and go; decreasing for years, but then returning as a veteran’s life changes.
Yes, because it can affect a person’s entire brain, it can have a lasting effect on personality disorders, depression, anxiety, and more.
Give your full case to the Woods and Woods team for a complete review. We’ll go over it with our on-staff psychiatrists and doctors that are specialized in VA disability claims. Every case is different.
Sure, but you won’t be able to get TDIU. You can work with any level of a VA disability rating, but you can’t get TDIU as long as you work a job.
Call our office and talk to our legal team for free to get your questions answered and your claim started, or fill out the form below.