I opened 2 Claims with the VA, they went and combined my claims. I argued that each claim are regulated by its own Code of Federal Regulations and all have separate DBQ's. By combining these, they are preventing Injuries from being properly evaluated. The trick VA is using is not to deny the claim but to simply closed the Claim and attach/combine evaluated symptoms into a Single Claim although they are evaluated differently.
Based on the information you've provided, you may have grounds to appeal the VA's decision to combine your claims. Here are some potential arguments: Violation of Specific Regulations: Argue that combining the claims prevents the VA from applying the correct regulations and rating criteria for each specific condition. Cite specific regulations and DBQs that apply to each condition and how they differ. Impact on Disability Rating: Demonstrate how combining the claims could potentially lead to a lower overall disability rating. Explain how each condition should be evaluated separately to accurately assess the combined impact on your overall health and functioning. Procedural Errors: If you believe the VA made procedural errors in combining the claims, such as failing to consider relevant evidence or applying incorrect regulations, you can raise this issue in your appeal. Hope this helps!
Thanks for the comment. No, at the moment we don't have a specific video on ear conditions to include conditions such as meniere's disease and vertigo. However, we are in the process of producing an ENT video, so stay tuned! We anticipate that to be published within the next 3-5 weeks.
Should I be concerned when I went to comp and pension for this they only wanted to know about the incident that I believe led to it and that was all there was for the exam.
Hello. Thanks for your comment. This is hard to answer without more information. TBIs often occur in combat settings, so they are rarely documented properly. With this in mind, it's quite important to communicate the specific combat event that caused your TBI. If you lost consciousness, you will definitely want to communicate that. You will also want to communicate how long people told you that you were unconscious (if known). You will also want to communicate any other common symptoms such as headaches, irritability, depression, vision changes, audiological changes such as ringing in the ears, etc.. Best of luck!
I had this same experience at my comp and pen exam. The examiner only seemed interested in the precipitating event and none of the subsequent symptoms. I had to interject with a brief summary of the neurobehaviorial effects, but the examiner seemed uninterested and dismissive even though it was the whole point for starting my claim. I had received functional brain scans and psychiatric assessments to back up the claim, but he didn't seem familiar with any of the evidence I submitted. I included a lay statement after the appt to add my side of the story because I wasn't confident that the examiner was taking me seriously at all.
@@chuckgripp7209 Got denied the first go around, said there was “no evidence”. Unbelievable, since it was a FDC with medical records, images, MD letters, etc. I literally had brain scans and psychiatrist diagnosis of brain injury. Submitted a supplemental with another letter from my doc hand-holding the VA through the medical images and diagnosis this time. I’m guessing it was the evaluator who screwed me, he was completely derelict during the exam. Fingers crossed this time.
Hello I have a TBI rating of 10, which was given years ago. I recently read about you can be reevaluated under a new code “Where VA rated the veteran’s TBI residuals under the old version the veteran may request review under the new code.” How can I go about doing that? Thank you for sharing this!
Hello and thank you for the question. All that is needed to request review is to submit a 526EZ with a claim for an increase. In the notes I would comment on this reevaluation program. You can submit this claim to the evidence intake center (www.benefits.va.gov/compensation/mailingaddresses.asp); alternatively, you can submit a claim on Ebenefits. Be aware, if you have a service connection mental health condition that condition will also be reevaluated. For example, if you have a 10% awarded for TBI and 70% awarded for PTSD, you might not want to stir the pot as the 70% is a great evaluation for mental health and all TBI claims necessarily bring scrutiny to your mental health claim as TBI examiners must also assess mental health conditions because of the overlap. All the best!
My Dad is 100 p&t for MD alone with a verity of other problems for over 20 years. With a&a and K, he has a Nurse, a OT, a PT, and a PCA. He's has been diagnosed with TBI. The TBI is new, but not service connected. His in service medical records prove that he went to sick call for the TBI related problems that he is complaining about. Some of those injuries are service connect and some are not service connected. But, of the ones that are not, he has them as medical complaints during his active service. His head injury happened during his active period. A VSO said that it's too late for TBI to be added or even separated from his MD because it has been so long. So can he not reach SMC R2T even if he qualifies for it via the VA's own regulation? Or was the VSO correct?
It's concerning to hear that the VSO may have given incorrect advice regarding your father's potential eligibility for additional VA benefits, particularly given his existing 100% P&T rating and the newly diagnosed TBI. While it may seem counterintuitive to add a new condition to an already 100% P&T rated veteran, it's possible to achieve a higher level of benefits, specifically SMC R2T, if the new condition, in this case, the TBI, significantly impacts the veteran's ability to function independently. If the TBI can be directly linked to a specific incident or exposure during military service, it can be considered service-connected. Or, it may be presumed to be service-connected if they occur within a specific timeframe after military service, especially if the veteran served in a theater of war. The severity of the TBI and its impact on the veteran's overall health and functioning will be crucial in determining eligibility for additional benefits. The TBI may exacerbate existing conditions or lead to new disabilities, which could increase the combined disability rating. It might be wise to seek a second opinion from a different VSO or VA representative. Explain your father's situation in detail, including the evidence of his TBI and its impact on his daily life. If necessary, file a new claim specifically for the TBI. Provide all relevant medical records, including those from active duty, to support the claim. Keep in mind that any time you file an new claim, it does bring scrutiny to the case. And with the VA, there is always a risk for this to have a negative impact, so you will need to weigh the pros and cons carefully.
Is your Dad getting Special Monthly Compensation? If not you can appeal the TBI and Request Special Monthly Compensation. So you know, Special Monthly Compensation (SMC) is over $8000.00 a month besides is 100% Rating. Lets say $3740.00 for 100% plus $8000.00 Plus for Special Monthly Compensation. That is over $11,700 per month. Don't let the VA Short-Change your Dad. SMC Covers additional expenses related to the care of your Dad, which include, fitting a Car to accommodate disabilities, Rooms, Meals, Special equipment, Travel Arrangements, Service Attendant etc.
How about accumulation of low level blasts like firing multiple heavy mortars like 4.2in and 120mm munitions? Also anti tank munitions like AT4 and M47 Dragon anti tank? The concussive forces from those can cause TBI and long term residuals.This is my issue and I just had a C&P exam for it recently. Waiting for a rating now.
You definitely have a case. What you will want to do is compile as much literature as possible supporting your claim. Send the actual literature to the VA (not a page with website links). Also, you need to document that you have an actual condition/TBI attributable to these concussive forces. That's what the medical opinion/exam is for you just went to. Here's some links that might be helpful: www.health.mil/Military-Health-Topics/Warfighter-Brain-Health/Brain-Health-Topics/Low-Level-Blast-Exposure www.health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/Low-Level-Blast-Exposure All the best. We hope it works out. Don't be discouraged if you get an initial denial. Keep fighting. The facts are definitely on your side if you had a military job involving routine blast exposure.
@@VADisabilityGroup awesome....thank you for your time and comment. Really put me at ease. All I want is to receive what I earned. My mental health is the worst part of it. diagnosed MDD anxiety and panic disorder. 7 hospitalizations 1 5150 hold and a suicide attempt. I was even forced into a medical retirement from the state of CA after 18 years because of these symptoms. With videos like yours I finally zeroed my issues down to a possible TBI. Please keep making them. they help us tremendously.
This made us smile. Glad to hear you got the 100% P&T. It's not uncommon for them to grant mental health with a compensable rating and award a noncompensable TBI. That is because the examiner typically expressly states in their report that they cannot delineate your TBI and mental health symptoms. When this happens the VA will service connect both but only award a compensable rating to either TBI or mental health. The overwhelming majority of the time mental health pays better, so that's what get's awarded. Hope that makes sense and thanks for sharing. Be well!
VA examiners typically use a combination of methods to assess TBI. They will review medical records, looking for previous diagnosis of TBI or accidents or injuries that could have led to a TBI. The physical exam assesses neurological functions like balance, coordination, reflexes, and sensory perception. They may administer standardized tests to help with this assessment. And they may do a mental health evaluation. This will all vary depending on the individual and the severity of the TBI.
So I have 70% PTSD and I have a C&P for a TBI coming up, if they can’t differentiate the symptoms, I should expect to an increase in the PTSD rating and should I just expect no increase or no separate rating for the TBI?
In theory, the VA is supposed to consider the higher evaluation. However, in practice, the examiner tends to say they can't differentiate the mental health vs. TBI symptoms and the VA adjudicator keeps the PTSD evaluation at the same rate. We aren't saying that'll happen in your case, but it's the typical outcome. Good luck!
@@VADisabilityGroupthis is what happened to me. My original claim my tbi was connected to my PTSD. I’m currently going through the exams for the second time with the help of a civilian lawyer and everything has been so much easier with their help!
Do not get caught in the Argument they can't differentiate between symptoms. A closer look you will realize the TBI and PTSD have their own Code of Federal Regulation (CFR) that governs how these symptoms are evaluated for Compensation. Look at the DBQs for each symptom. You can always request a hard copy unredacted of your C&P Exams. Review them and look at the check boxes and entries that the C&P Examiner entered. If you notice that your C&P DBQ Form was miscategorized, file an appeal for an increase. It is your right. Don't let them short-change your rating.
How about accumulation of low level blasts like firing multiple heavy mortars like 4.2in and 120mm munitions? Also anti tank munitions like AT4 and M47 Dragon anti tank? The concussive forces from those can cause TBI and long term residuals.This is my issue and I just had a C&P exam for it recently. Waiting for a rating now.
Good video, thank you.
I opened 2 Claims with the VA, they went and combined my claims. I argued that each claim are regulated by its own Code of Federal Regulations and all have separate DBQ's. By combining these, they are preventing Injuries from being properly evaluated. The trick VA is using is not to deny the claim but to simply closed the Claim and attach/combine evaluated symptoms into a Single Claim although they are evaluated differently.
Based on the information you've provided, you may have grounds to appeal the VA's decision to combine your claims. Here are some potential arguments:
Violation of Specific Regulations:
Argue that combining the claims prevents the VA from applying the correct regulations and rating criteria for each specific condition.
Cite specific regulations and DBQs that apply to each condition and how they differ.
Impact on Disability Rating:
Demonstrate how combining the claims could potentially lead to a lower overall disability rating.
Explain how each condition should be evaluated separately to accurately assess the combined impact on your overall health and functioning.
Procedural Errors:
If you believe the VA made procedural errors in combining the claims, such as failing to consider relevant evidence or applying incorrect regulations, you can raise this issue in your appeal.
Hope this helps!
Thanks info helped me... do you have anything on dbq ear conditions (including vestibular and infectious conditions)?
Thx
Thanks for the comment. No, at the moment we don't have a specific video on ear conditions to include conditions such as meniere's disease and vertigo. However, we are in the process of producing an ENT video, so stay tuned! We anticipate that to be published within the next 3-5 weeks.
Should I be concerned when I went to comp and pension for this they only wanted to know about the incident that I believe led to it and that was all there was for the exam.
Hello. Thanks for your comment. This is hard to answer without more information. TBIs often occur in combat settings, so they are rarely documented properly. With this in mind, it's quite important to communicate the specific combat event that caused your TBI. If you lost consciousness, you will definitely want to communicate that. You will also want to communicate how long people told you that you were unconscious (if known). You will also want to communicate any other common symptoms such as headaches, irritability, depression, vision changes, audiological changes such as ringing in the ears, etc..
Best of luck!
I had this same experience at my comp and pen exam. The examiner only seemed interested in the precipitating event and none of the subsequent symptoms. I had to interject with a brief summary of the neurobehaviorial effects, but the examiner seemed uninterested and dismissive even though it was the whole point for starting my claim. I had received functional brain scans and psychiatric assessments to back up the claim, but he didn't seem familiar with any of the evidence I submitted. I included a lay statement after the appt to add my side of the story because I wasn't confident that the examiner was taking me seriously at all.
@@danf5120did you get a “proper rating” for this?
@@chuckgripp7209 Got denied the first go around, said there was “no evidence”. Unbelievable, since it was a FDC with medical records, images, MD letters, etc. I literally had brain scans and psychiatrist diagnosis of brain injury. Submitted a supplemental with another letter from my doc hand-holding the VA through the medical images and diagnosis this time. I’m guessing it was the evaluator who screwed me, he was completely derelict during the exam. Fingers crossed this time.
@danf5120 what was the outcome?
Hello I have a TBI rating of 10, which was given years ago. I recently read about you can be reevaluated under a new code “Where VA rated the veteran’s TBI residuals under the old version the veteran may request review under the new code.” How can I go about doing that? Thank you for sharing this!
Hello and thank you for the question. All that is needed to request review is to submit a 526EZ with a claim for an increase. In the notes I would comment on this reevaluation program. You can submit this claim to the evidence intake center (www.benefits.va.gov/compensation/mailingaddresses.asp); alternatively, you can submit a claim on Ebenefits.
Be aware, if you have a service connection mental health condition that condition will also be reevaluated. For example, if you have a 10% awarded for TBI and 70% awarded for PTSD, you might not want to stir the pot as the 70% is a great evaluation for mental health and all TBI claims necessarily bring scrutiny to your mental health claim as TBI examiners must also assess mental health conditions because of the overlap.
All the best!
The VA in whole is incapable of making an honest appraisal of any condition, especially a TBI
My Dad is 100 p&t for MD alone with a verity of other problems for over 20 years. With a&a and K, he has a Nurse, a OT, a PT, and a PCA. He's has been diagnosed with TBI. The TBI is new, but not service connected. His in service medical records prove that he went to sick call for the TBI related problems that he is complaining about. Some of those injuries are service connect and some are not service connected. But, of the ones that are not, he has them as medical complaints during his active service. His head injury happened during his active period. A VSO said that it's too late for TBI to be added or even separated from his MD because it has been so long. So can he not reach SMC R2T even if he qualifies for it via the VA's own regulation? Or was the VSO correct?
It's concerning to hear that the VSO may have given incorrect advice regarding your father's potential eligibility for additional VA benefits, particularly given his existing 100% P&T rating and the newly diagnosed TBI.
While it may seem counterintuitive to add a new condition to an already 100% P&T rated veteran, it's possible to achieve a higher level of benefits, specifically SMC R2T, if the new condition, in this case, the TBI, significantly impacts the veteran's ability to function independently.
If the TBI can be directly linked to a specific incident or exposure during military service, it can be considered service-connected. Or, it may be presumed to be service-connected if they occur within a specific timeframe after military service, especially if the veteran served in a theater of war.
The severity of the TBI and its impact on the veteran's overall health and functioning will be crucial in determining eligibility for additional benefits.
The TBI may exacerbate existing conditions or lead to new disabilities, which could increase the combined disability rating.
It might be wise to seek a second opinion from a different VSO or VA representative.
Explain your father's situation in detail, including the evidence of his TBI and its impact on his daily life.
If necessary, file a new claim specifically for the TBI.
Provide all relevant medical records, including those from active duty, to support the claim.
Keep in mind that any time you file an new claim, it does bring scrutiny to the case. And with the VA, there is always a risk for this to have a negative impact, so you will need to weigh the pros and cons carefully.
Is your Dad getting Special Monthly Compensation? If not you can appeal the TBI and Request Special Monthly Compensation. So you know, Special Monthly Compensation (SMC) is over $8000.00 a month besides is 100% Rating. Lets say $3740.00 for 100% plus $8000.00 Plus for Special Monthly Compensation. That is over $11,700 per month. Don't let the VA Short-Change your Dad. SMC Covers additional expenses related to the care of your Dad, which include, fitting a Car to accommodate disabilities, Rooms, Meals, Special equipment, Travel Arrangements, Service Attendant etc.
How about accumulation of low level blasts like firing multiple heavy mortars like 4.2in and 120mm munitions? Also anti tank munitions like AT4 and M47 Dragon anti tank? The concussive forces from those can cause TBI and long term residuals.This is my issue and I just had a C&P exam for it recently. Waiting for a rating now.
You definitely have a case. What you will want to do is compile as much literature as possible supporting your claim. Send the actual literature to the VA (not a page with website links). Also, you need to document that you have an actual condition/TBI attributable to these concussive forces. That's what the medical opinion/exam is for you just went to.
Here's some links that might be helpful:
www.health.mil/Military-Health-Topics/Warfighter-Brain-Health/Brain-Health-Topics/Low-Level-Blast-Exposure
www.health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/Low-Level-Blast-Exposure
All the best. We hope it works out. Don't be discouraged if you get an initial denial. Keep fighting. The facts are definitely on your side if you had a military job involving routine blast exposure.
@@VADisabilityGroup awesome....thank you for your time and comment. Really put me at ease. All I want is to receive what I earned. My mental health is the worst part of it. diagnosed MDD anxiety and panic disorder. 7 hospitalizations 1 5150 hold and a suicide attempt. I was even forced into a medical retirement from the state of CA after 18 years because of these symptoms. With videos like yours I finally zeroed my issues down to a possible TBI. Please keep making them. they help us tremendously.
Didn't get rated for TBI but was rated for MDD 100% P&T so it's a win for me...
This made us smile. Glad to hear you got the 100% P&T.
It's not uncommon for them to grant mental health with a compensable rating and award a noncompensable TBI. That is because the examiner typically expressly states in their report that they cannot delineate your TBI and mental health symptoms. When this happens the VA will service connect both but only award a compensable rating to either TBI or mental health. The overwhelming majority of the time mental health pays better, so that's what get's awarded.
Hope that makes sense and thanks for sharing. Be well!
@@VADisabilityGroup yes it does thank you for your time and videos👍
How are they testing these different faucets, Memory and such?
VA examiners typically use a combination of methods to assess TBI. They will review medical records, looking for previous diagnosis of TBI or accidents or injuries that could have led to a TBI. The physical exam assesses neurological functions like balance, coordination, reflexes, and sensory perception. They may administer standardized tests to help with this assessment. And they may do a mental health evaluation. This will all vary depending on the individual and the severity of the TBI.
@VADisabilityGroup So they don't necessarily need to do a neurophycogical exam if they have evidence of a injury correct?
So I have 70% PTSD and I have a C&P for a TBI coming up, if they can’t differentiate the symptoms, I should expect to an increase in the PTSD rating and should I just expect no increase or no separate rating for the TBI?
In theory, the VA is supposed to consider the higher evaluation. However, in practice, the examiner tends to say they can't differentiate the mental health vs. TBI symptoms and the VA adjudicator keeps the PTSD evaluation at the same rate. We aren't saying that'll happen in your case, but it's the typical outcome.
Good luck!
@@VADisabilityGroupthis is what happened to me. My original claim my tbi was connected to my PTSD. I’m currently going through the exams for the second time with the help of a civilian lawyer and everything has been so much easier with their help!
Do not get caught in the Argument they can't differentiate between symptoms. A closer look you will realize the TBI and PTSD have their own Code of Federal Regulation (CFR) that governs how these symptoms are evaluated for Compensation. Look at the DBQs for each symptom. You can always request a hard copy unredacted of your C&P Exams. Review them and look at the check boxes and entries that the C&P Examiner entered. If you notice that your C&P DBQ Form was miscategorized, file an appeal for an increase. It is your right. Don't let them short-change your rating.
*#AllOfAbove
Sadly, there’s an element of truth to your comment. Thanks for the comment!
How about accumulation of low level blasts like firing multiple heavy mortars like 4.2in and 120mm munitions? Also anti tank munitions like AT4 and M47 Dragon anti tank? The concussive forces from those can cause TBI and long term residuals.This is my issue and I just had a C&P exam for it recently. Waiting for a rating now.