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Veterans Can Qualify for Increased Disability due to TBI

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Veterans Can Qualify for Increased Disability due to TBI

 

Veterans Can Qualify for Increased Disability due to TBI

 

By Debbie Gregory

Over the last several years, traumatic brain injury (TBI) has been thrust into the forefront of the consciousness of the medical community and the general public. This is in large part due to recent combat operations and subsequent recognition of this potentially “silent injury.”

Traumatic brain injury is characterized by both physical and psychological impairments, and oftentimes, veterans suffer from residual effects of TBI. In those cases, the VA may not recognize those residual symptoms as being caused by traumatic brain injury, and this creates a limitation on the benefits a veteran can receive.

There has been a big increase in the number of veterans and servicemembers being diagnosed with TBI. Issues caused by TBI include cognitive deficits, speech, language, sensory, perceptual, vision, hearing, smell, taste, and emotional, social and physical changes.

TBI symptoms may include:

  • Blurry vision
  • Depression or irritability
  • Difficulty concentrating
  • Difficulty with memory
  • Difficulty speaking or slurring words
  • Difficulty walking or loss of coordination
  • Dizziness or vertigo
  • Headaches
  • Light and sound sensitivity
  • Lightheadedness
  • Nausea
  • Ringing in the ears
  • Sleep disturbances
  • Tingling or numbness of the arms and legs

Individuals with a history of TBI often receive a rating and compensation for “disability”. In order for a veteran to receive the highest overall rating due to TBI, he or she should file a claim for every symptom caused by TBI and classify it as secondary to TBI, not just the overall diagnosis of TBI.

For veterans who have already filed a claim for general TBI, they should file each unrated symptom as a new claim and state that each TBI symptom is “secondary to TBI.”  

Veterans who believe that the VA has underrated their conditions should get a second opinion from an accredited attorney or a veteran’s service officer.  If this is done less than one year after the rating decision is issued, the veteran may be able to appeal the decision to maximize the backpay.

Vets with TBI at Increased Risk for Dementia

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Vets with TBI at Increased Risk for Dementia

Vets with TBI at Increased Risk for Dementia

By Debbie Gregory.

After reviewing the medical records of more than 350,000 servicemembers who served during Operation Enduring Freedom and Operation Iraqi Freedom, researchers have found a link between those who experienced at least one mild traumatic brain injury (TBI) and the development of dementia.

The study, led by Deborah E. Barnes, PhD, MPH, posed the question “Is mild traumatic brain injury without loss of consciousness associated with an increased risk of dementia diagnosis in veterans?”

The findings revealed that mild TBI, even without loss of consciousness, was associated with more than a 2-fold increase in the risk of a dementia diagnosis.

Some 15-20 percent of veterans who served in Afghanistan and Iraq had at least one mild TBI, usually through one (or in some cases multiple) exposure to post-explosion shock waves.

The study included 178,779 patients diagnosed with a TBI through the Veterans Health Administration health care system, and 178,779 patients in a propensity-matched comparison group.

While it is not clear why the damage caused by a TBI would make someone more prone to a dementia diagnosis, there is a theory that inflammation and the loss of white matter after the injury could create a more inviting environment for the amyloid beta plaques and neurofibrillary tangles associated with dementia.

“The chronic effects of traumatic brain injury (TBI), particularly dementia and related neurodegenerative disorders in military veterans, have become an intense research focus,” wrote Dr. Kimbra Kenney of the U.S. Uniformed Services University and Dr. Ramon Diaz-Arrastia of the University of Pennsylvania’s Traumatic Brain Injury Clinical Research Center in a JAMA editorial article. “This study provides the best information to date that military veterans are at risk for dementia as a consequence of injuries sustained during their service to the United States,”  

New VA Online Wizard Aims to Upgrade Your Discharge

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By Debbie Gregory.

The Department of Veterans Affairs (VA) has launched a new online wizard that will assist veterans who are seeking to upgrade their military discharges.

By going to the VA’s Vets.gov benefits website, participants go through a series of questions that guides them, step by step, through the upgrade process based on their individual situation.

This is an especially good tool for veterans who are trying to correct or upgrade “bad paper” discharges. Veterans with bad paper discharges have long complained that they were drummed out of the service with no consideration of their invisible wounds.

All branches of the military consider a strong case for a discharge upgrade if applicants can show their discharge was connected to any of these categories:

Mental health conditions, including Post Traumatic Stress Disorder (PTSD)

Traumatic brain injury (TBI)

Sexual assault or harassment during military service

Sexual orientation (including under the Don’t Ask, Don’t Tell policy)

By answering a series of questions, users get customized step-by-step instructions on how to apply for a discharge upgrade or correction. If their application goes through and the discharge is upgraded, these veterans will become eligible for the VA benefits they earned during their period of service.

If a previous upgrade application was denied, users can apply again, especially if the application is significantly different from the original. For example, the applicant may have additional evidence that wasn’t available during the original application was processed, or the Department of Defense (DoD) may have issued new rules regarding discharges. (DoD rules changed for discharges related to PTSD, TBI, and mental health in 2014, military sexual harassment and assault in 2017, and sexual orientation in 2011.)

The wizard will also assist those who require an updated DD214 or DD215 to reflect an upgrade.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

How California Plans to Help Veterans with Traumatic Brain Injury

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By Debbie Gregory.

Hundreds of thousands of military personnel have been diagnosed with some level of traumatic brain injury (TBI) in the past decade, many as a result of combat injury. TBI can have long-term and  often times severe effects on service members’ lives, affecting their ability to work, interact with others, manage basic living tasks, and even interact with their own families.

The California Legislature hopes that Senate Bill 197 will help restore the lives of the state’s military veterans suffering with TBI.

SB 197 would waive the California sales tax on building materials and supplies purchased for the construction of specified military and veteran medical facilities.

“SB 197 is about stretching charitable dollars farthest and adding additional medical care infrastructure at the lowest possible cost,” said Republican Senator Patricia Bates, one of the bill’s authors.

After the Senate’s recent unanimous approval, the last hurdle for the bill is for the Assembly Appropriations Committee to release it from the suspense file.

The Intrepid Fallen Heroes Fund, in collaboration with one of California’s top brain injury experts and a nationwide team of doctors and researchers has been working breakthrough treatments for TBI while building dedicated facilities on military bases to implement these revolutionary methods.

The Intrepid Fallen Heroes Fund has paid for, built and donated to the Army the burn and prostheses facility at Brooke Army Medical Center in San Antonio, the Center for the Intrepid.

In 2008, the Intrepid Fallen Heroes Fund partnered with Dr. David Hovda, director of the UCLA Brain Injury Research Center and 24 additional institutions doing brain research to take a new approach to TBI treatment.

The fund also paid for, built and donated a TBI and post-traumatic stress research center on the Walter Reed National Military Medical Center campus in Bethesda, Md., outside Washington.

In total, nine rehabilitation centers, called Intrepid Spirit Centers, will be built by the Intrepid Fallen Heroes Fund on military bases. In May, IFHF and the Navy broke ground at Marine Corps Camp Pendleton on the seventh center.

SB 197 would waive the California sales tax on purchases made to build the Pendleton center. For state government, that cost is small, a little over $200,000 – less than what the state might spend on a veteran who, because of TBI-related drug abuse, did not have an honorable discharge, and so was denied VA benefits and on Medi-Cal and public assistance. But for a nonprofit in a race to save more service members, that small amount is huge.

When the Assembly Appropriations Committee moves SB 197 out of the suspense file and to the Assembly floor, the entire State Legislature will be able to demonstrate California’s gratitude to those who have given and sacrificed so much.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Wearable Technology May Determine Severity of TBIs

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By Debbie Gregory.

Modern body armor better protects warfighters against shrapnel from explosive blasts. However, they still face a hidden threat — the resulting blast pressure and shock wave which could cause traumatic brain injury (TBI).

Navy researchers are developing a wearable system that could help determine the severity of a brain injury, often called an invisible wound, following an explosion.

The Blast Load Assessment Sense and Test (BLAST) is a five-year, $30 million program that will use sensors in helmets to measure the shockwave thrust of an explosion.

BLAST uses coin-sized sensors which are tough enough to survive an explosion, can be worn on helmets and body armor, and are able to record blast pressure. This pressure can be downloaded with a specialized scanner, and design possibilities include a handheld, barcode-style scanner or a stationary one modeled after airport metal detectors. An algorithm will convert the data to determine if the affected warfighter needs an additional exam.

“When you’re injured mildly, you don’t want to get another injury on top of that because they don’t add up linearly,” said Dr. Timothy Bentley, program manager for the Office of Naval Research’s Warfighter Performance Department. “One plus one doesn’t equal two, but one plus one may equal three, even, because you’re weakened.”

Data from BLAST could signal when an affected warfighter needs to be pulled out for treatment or can return to the fight.

“BLAST sensors can provide valuable blast pressure data that can be used to assess the possibility of TBI,” said Dr. Amit Bagchi, a scientist at the Naval Research Laboratory, which is developing the physical sensors. “The more data we have, the better we can predict the presence of TBI.”

“We’ve learned a great deal about how brains get injured now, much more than we knew previously,” Bentley said.

BLAST could be tested in a year, although its rollout, if approved, is still several years away.

The program is sponsored by the Washington-based Office of Naval Research and involves its Naval Research Laboratory, the University of North Carolina, NASA and New Mexico-based research firm Applied Research Associates Inc.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Pardons Sought for Troops Discharged for Mental Health-related Offenses

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By Debbie Gregory.

Military veteran advocates are urging President Barack Obama and President-elect Donald Trump to join forces and pardon tens of thousands of post-9/11 service members whose “bad paper” or “general” discharges were based on infractions related to mental health issues.

John Rowan, the national president of the Vietnam Veterans of America says such a pardon can only be achieved if President Obama and President-elect Trump work together to identify and restore benefits to these some 300,000 veterans.

“Over the last 15 years of continuous warfare, our government has failed to respond appropriately to multiple, comprehensive reports of veterans being inappropriately discharged from the military,” the letter states. “We implore you to at least save the current generation of America’s warriors an unfairly marginal life as outcasts in the nation they have so faithfully served.”

Bad paper discharges are often given to those who suffered from post-traumatic stress, traumatic brain injury, military sexual trauma or other mental health issues.

Others have been kicked out for alcohol abuse, drug use and suicide attempts.

Between fiscal years 2000–2013, these types of bad paper discharges totaled 125,204. However, what is spoken about even less are those who have “general” discharges, which means veterans also lose benefits and have difficulty finding jobs in the civilian world. Veterans discharged under general conditions number as many as 172,125 since 2000.

Advocates insist that these veterans should have received treatment for those under-diagnosed problems. Veterans with less-than-honorable discharges are ineligible for a host of government benefits, including free health care.

While veterans can appeal those discharges, the process is complicated, time-consuming and expensive.

Instead, Rowan is asking for an upgrade in discharge status for all veterans who qualify and “to immediately grant access to PTS and TBI screening at the VA for all veterans.”

Setting up the system to identify and screen eligible veterans will not happen overnight, which is why the president-elect’s cooperation is vital.

Between fiscal years 2000–2013, these types of bad paper discharges totaled 125,204. However, what is spoken about even less are those who have “general” discharges, which means veterans also lose benefits and have difficulty finding jobs in the civilian world. Veterans discharged under general conditions number as many as 172,125 since 2000.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Top Ten Tips for Vets to Achieve Successful Civilian Careers

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By Debbie Gregory.

Transitioning from the military is an exciting time in your life, but it can also be a little intimidating. In order to help you achieve success, here are some tips to help you navigate your way into your new civilian career:

  1. Deal with issues

You need to demonstrate that you are a team player and are engaged with the company’s needs. Learn the company’s issues and priorities, and how you can contribute to dealing with both.

  1. Don’t judge a book by it’s cover

Unlike the military, there are no uniforms with rank that reveal someone’s position within the organization. Until you’ve been with an organization for a while and have figured out who is who, treat everyone as if they are the boss.

  1. Don’t rely on military terms

While addressing those at work as “sir” and “ma’am” will set you apart in a good way, it’s important to remember that you need to civilian-ize your speech in order to be understood.

  1. Loosen up a bit

Military customs and courtesies don’t often translate well in the civilian world. Gauge your behavior to your company’s social culture. If it is a bit laid back, your behavior should fit in with that. Rely on your coworkers to educate you.

  1. “Praise in public and punish in private” is still important

In the military, you learned that the best leaders heap praise on their teams in public and choose to go behind closed doors to make corrections. Stay with that, even though sometimes you may see the opposite.

  1. Don’t overshare PTSD or TBI

While your civilian counterparts at your new job may be curious and ask questions about your experiences in the military, a measured response will serve you better than too much detail. This is especially true of the invisible wounds, such as PTSD and TBI. Private information should be shared on a need-to-know basis, or in with those with whom you truly feel comfortable with. Which brings us to the next tip:

  1. Be prepared for off-the-wall questions

There is a large disconnect between veterans and civilians. Most civilians would never intentionally ask rude questions, but should a question come off as rude or ignorant, try to roll with it.

  1. Learn the company’s corporate culture

Corporate culture is comprised of the values, beliefs and attitudes that characterize the company and guide its practices. To some extent, a company’s internal culture may be articulated in its mission statement or vision statement. Learn it. Know it.

  1. Find out how to advance

Build a diversity of relationships and rely on those individuals for honest feedback, advice, insight, and information. Include peers inside and outside the company, higher-ups in your chain of command and in other divisions, someone in your company’s human resources department

  1. Join your company’s veteran affinity group

Take advantage of the camaraderie, assistance and support of your co-workers who have traveled a path similar to yours. If there isn’t one, start one. Your employer will only benefit from the support provided to their veteran employees.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

BrainScope’s Diagnostic Device for TBI/Concussion Cleared by FDA

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By Debbie Gregory.

BrainScope, a Maryland-based biotech firm is working on an easier way to diagnose concussions. The medical neuro-technology company  has developed a medical device to aid in the assessment of traumatic brain injury (TBI) and its milder forms (concussion) at the initial point of care.

The handheld, wearable Ahead 300 device uses electrodes to measure electronic activity inside your brain and transmit readings to a reconfigured Android smartphone. The company recently received clearance from the federal Food & Drug Administration to market the device.

The Ahead 300 features BrainScope’s proprietary, patent-protected electroencephalography (EEG) capabilities utilizing sophisticated algorithms and machine learning to analyze head-injured patient data.  Leveraging state-of-the-art handheld smartphone technology and a proprietary disposable electrode headset, the Ahead 300 provides a rapid, objective assessment of the likelihood of the presence of TBI in patients who present with mild symptoms at the point of care. In addition to EEG capabilities, the Ahead 300 includes additional assessments providing clinicians with a digitized, streamlined report, delivering a comprehensive and objective panel of results to facilitate their differential diagnosis.

“FDA clearance of the Ahead 300 is a bellwether moment in our company’s history. The Ahead 300 provides the specific capabilities needed today for the clinician to undertake a comprehensive assessment addressing the full spectrum of traumatic brain injury, from structural injuries visible on a CT scan, through mild TBI, also known as concussion,” stated Michael Singer, Chief Executive Officer of BrainScope.

BrainScope’s devices are focused on TBI in military, sports, and emergency/urgent care environments both in the U.S. and internationally.

The Department of Defense invested $27 million into the project in search of better ways of assessing traumatic brain injury among service members.

The technology was developed by the late Dr. E. Roy John and Leslie Prichep, a husband and wife duo of neuroscientists from New York University.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Quadruple Amputee Marine Veteran Receives Double Arm Transplant

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By Debbie Gregory.

During his first tour of duty, Retired Marine Sgt. John Peck suffered a traumatic brain injury. But in a subsequent tour in 2010, Peck’s life completely changed.

During that second tour, Peck stepped on an improvised explosive device in Afghanistan, which triggered a blast that caused him to lose his arms and legs.

After losing his limbs, Peck was equipped with prosthetic arms and a wheelchair. However, in 2014, he was approved to undergo a double arm transplant, in which he would receive real arms from another young man — a man who died.

In August, the 31-year-old veteran underwent a bilateral arm transplant. The 13-hour surgery was performed by a team headed by Simon G. Talbot, Brigham and Women’s Hospital’s director of upper extremity transplantation.

His donor’s arms were surgically connected to Peck’s body near his elbows, which doctors say will allow him to eventually feel, grasp and hold in a way that prosthetics couldn’t.

“My dream job since I was 12 was to be a chef, and because of my donor’s gift, I actually have a fighting chance to do this,” Peck said. “As a result of this surgery, I’ll be able to pursue my dreams.”

Although Peck had significant out-of-pocket expenses, a spokeswoman for Brigham and Women’s said the hospital covered the cost of the surgery, and the physicians volunteered their time.

Of his donor, Peck said, “I will love him every day and will respect his life and this gift until the day I die.” To his donor’s family, Peck said, “Your loved one’s death will not be for nothing. Every day that I look down at our new arms, I will drive on . . . and I will never give up. I will remember his selflessness and his gift until the day I die.”

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Should Separation Policy Address Service-related Trauma?

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By Debbie Gregory.

Last month, Sens. Barbara Boxer (D-Calif.), Chuck Grassley (R-Iowa), Kirsten Gillibrand (D-N.Y.), Susan Collins (R-Maine), Amy Klobuchar (D-Minn.), Tammy Baldwin (D-Wis.), Ed Markey (D-Mass.), Al Franken (D-Minn.) and Gary Peters (D-Mich.) sent a letter to Secretary of Defense Ashton Carter urging the Department of Defense (DOD) to update the military’s separation policy to address behavior that results from trauma, such as sexual assault or post-traumatic stress disorder (PTSD.)

“Clear guidance will ensure that all service members who are impacted by combat or military sexual assault-related trauma receive fair consideration of their medical conditions prior to their separation from the military and will ensure that fair, consistent and transparent standards are applied across the services,” the senators wrote.

The Department of the Navy has already updated its administrative separation policy to ensure a diagnosed mental health condition takes precedence over misconduct when a sailor or Marine is being involuntarily separated. But the other branches of the military have not yet made similar changes to their policies.

The senators made reference to a May 2015 inspector general report that found sexual assault survivors who engage in trauma-related misconduct are at an increased risk of being involuntarily discharged under less than honorable conditions than the general military population.

Additionally, combat veterans with PTSD or Traumatic Brain Injury (TBI) may exhibit irregular behavior, have difficulty performing at work, or battle substance abuse. These disciplinary infractions can often be mischaracterized as misconduct rather than symptoms of a mental health condition.

“Their chain of command may not understand that these disciplinary infractions can be symptoms of mental health conditions,” they wrote.

Involuntary discharges have a number of negative consequences including increased rates of suicide, homelessness, and employment discrimination.

While changes have been made in recent years, they said, more needs to be done.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.


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