What is a Traumatic Brain Injury (TBI)?
In the context of veterans disability law, the term “traumatic brain injury,” or TBI for short, refers to any significant head trauma that an individual sustains while in service in the United States military. A traumatic brain injury can be caused by roadside bombs (IEDS), mortars, mines, bullets, grenades, vehicle crashes, and falls, among other causes.
Traumatic brain injuries, called the “signature injury” of the Iraq and Afghanistan wars due to the staggering number of combat veterans that have returned home with traumatic brain injuries as the result of roadside bombs (IEDs) and other explosives, can have disabling and life-altering symptoms. While traumatic brain injuries can limit a person’s ability to walk, maintain proper balance, or even speak, they also can negatively affect a person’s ability to think, control their emotions, or maintain concentration. Additionally, traumatic brain injuries can impact a person’s hearing and vision.
This is particularly concerning given that of the 2.4 million service members who have served in Iraq and Afghanistan between 2000 and 2012, 266,810 soldiers have already been diagnosed by the Defense and Veterans Brain Injury Center with traumatic brain injuries. Moreover, over 900,000 veterans have filed veterans disability claims for TBI and the number is expected to surpass one million in the near future.
How Does the VA Rate Traumatic Brain Injuries?
To rate traumatic brain injuries sustained by veterans disability claimants, the Department of Veterans Affairs relies on diagnostic code 8045, Residuals of traumatic brain injury (TBI) (§4.124a Schedule of ratings—neurological conditions and convulsive disorders). Here, the VA makes clear that there are three main areas of dysfunction that may result from TBI: cognitive, emotional/behavioral, and physical. For cognitive and emotional/behavioral impairments without a distinct diagnosis and separate diagnostic code, the VA will evaluate the severity of these impairments under the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.”
As the VA describes it, this table contains
“10 important facets of TBI related to cognitive impairment and subjective symptoms. It provides criteria for levels of impairment for each facet, as appropriate, ranging from 0 to 3, and a 5th level, the highest level of impairment, labeled “total.” However, not every facet has every level of severity. The Consciousness facet, for example, does not provide for an impairment level other than “total,” since any level of impaired consciousness would be totally disabling.”
If any facet receives a “total” evaluation, the VA will assign a 100-percent evaluation. However, if no facet is evaluated as “total,” the VA will assign an overall percentage based on the level of the highest facet in the following manner: 0 = 0 percent; 1 = 10 percent; 2 = 40 percent; and 3 = 70 percent. For instance, if a veteran’s highest level of evaluation for any facet is 2, the veteran will be assigned a 40-percent evaluation for TBI.
In contrast, physical residuals of TBI should be evaluated under an appropriate diagnostic code. The VA provides the following list (not exhaustive): pain, of the extremities and face; visual impairment; hearing loss and tinnitus; loss of sense of smell and taste; seizures; gait, coordination, and balance problems; speech and other communication difficulties, including aphasia and related disorders, and dysarthria; neurogenic bladder; neurogenic bowel; cranial nerve dysfunctions; autonomic nerve dysfunctions; and endocrine dysfunctions.
New Rules for TBI Presumptive Conditions
According to a VA statement released in December 2013, five more diseases will now be presumed to be service-connected. They are as follows (note all conditions must be diagnosed following moderate or severe TBI; more details are below):
• Parkinson’s disease
• seizures for which no cause has been established
• certain dementias (if diagnosed within 15 years)
• depression (diagnosed within 3 years of moderate or severe TBI or within 1 year of mild TBI)
• hormone deficiency diseases (if diagnosed within 12 months of a diagnosis of moderate to severe TBI)
Other TBI Symptoms from the BIAMI.org
• Memory Loss
• Emotional (more or less)
• Mood Changes
• Balance Problems
• Fatigue or Drowsiness
• Sleep (more or less)
• Trouble Sleeping
• Sensitivity to Light
• Numbness / Tingling
• Sensitivity to Noise
• Dazed or Stunned
• Forget Recent Conversations
• Difficulty Concentrating
• Difficulty Making Decisions
• Respond to Questions Slowly
• Ringing in the Ears
• Mentally Foggy
• Feeling Slowed Down
If you or a loved one served in the military and are now suffering from TBI, please do not hesitate to contact our office for a free consultation. Call us at 800-742-5035 or use the contact form on this site.