Veteran Traumatic Brain Injury Claim Denial | Filing An Appeal
Veterans who suffered traumatic brain injuries while serving active duty can file VA disability claims to appeal a denial of benefits.
Summary
- Veterans often sustain traumatic brain injuries (TBIs) from explosions, vehicle crashes, and falls during service.
- Veterans seeking disability benefits for TBIs must prove the injury occurred during service, affects civilian life, and meet other eligibility criteria. A VA disability lawyer can assist with appeals if the VA denies an initial traumatic brain injury claim.
- TBIs range from mild concussions to severe injuries causing long-term physical and cognitive impairment.
- Service-related traumatic brain injuries can increase the risk of chronic traumatic encephalopathy (CTE) and brain cancer.
- Successful TBI claims require comprehensive documentation to establish a service connection and the injury’s impact.
- The VA assigns disability ratings for TBIs, impacting compensation levels.
Noble men and women join the United States military knowing that injuries or even death may result from their service. When they return from active duty, they should receive adequate medical care for any service-related injuries. For instance, many servicemembers sustain traumatic brain injuries while in uniform.
Severe head trauma can affect your ability to sleep, balance, move, and think. A VA disability lawyer’s role is to assist you throughout the confusing and frustrating appeals process if you are a veteran who received a denial for your traumatic brain injury claim.
Generally, you need to be denied at least once before an attorney can assist you with an appeal. However, once a veterans disability benefits denial lawyer is involved they can help quickly determine how to prove entitlement.
VetLaw’s accredited team of skilled attorneys can assist you in filing traumatic brain injury claims, measuring your losses, and pursuing appeals after a benefits denial. You can call (855) 573-1503 or submit a contact form to schedule a free consultation.
What Are Common Causes of Service-Related Head Injuries?
A traumatic brain injury, often referred to by the acronym TBI, can result from any direct blow to the head or neck which causes the skull to whip back and forth. Severe head trauma involves physical damage to the brain and can range from concussions that fully heal to permanently impaired cognitive function.
Active duty servicemembers may experience explosions, vehicle crashes, blows to the head in combat, bullet wounds, falls from great heights, or training accidents involving heavy machinery. These are all common sources of traumatic brain injuries. However, the most common cause of service-related head injuries is an injury from an IED explosion.
A VA-accredited veteran disability claims lawyer can help you provide accurate and up-to-date documentation of a service-connected injury for severe head trauma claims if the VA denied your initial application for benefits due to a lack of in-service evidence.
Severe Head Trauma Sustained During Military Service
A concussion from any source while on active duty may be considered a traumatic brain injury, even if the residuals of the TBI are mild. While the term “mild” suggests that the TBI isn’t severe, it can become severe over time.
Veterans who have suffered from a concussion could develop chronic traumatic encephalopathy (CTE) later in life. Researchers are still learning about CTE. However, in most cases, most who develop CTE later in life have more than one concussion.
It is difficult to diagnose CTE while the person is still alive. Doctors can only look at symptoms and determine that “maybe” a person has CTE. The only way to know for sure is to do an autopsy.
TBIs Can Be Fatal or Disabling Regardless of the Severity of the Initial Injury
With mild traumatic brain injuries, or concussions, there is also a risk of Second Impact Syndrome. If an individual sustains two concussions in close succession before the first injury has had time to heal, the additional trauma can have the kind of catastrophic or fatal consequences typically associated with more serious TBIs.
Servicemembers could also suffer from moderate, severe, or penetrating brain injuries, in addition to mild brain injuries. Moderate and severe brain injuries come with their own health complications.
Unfortunately, it only takes a single violent impact to cause impairments that last months, years, or the rest of the veteran’s life. A new study has even found evidence that a severe brain injury increases the risk of brain cancer in veterans.
Pursuing a Claim for a Traumatic Brain Injury
The Veterans Disability Compensation Program offers benefits to former servicemembers who suffered injuries while on active duty. If a veteran’s condition is severe enough to impact their civilian life, the VA may recognize service connection and provide disability compensation.
However, there are standards that applicants must meet to qualify for these benefits. For example, it is essential to establish that a condition is a direct result of an incident that took place during active duty service.
Brain injuries that occur while in combat, in training accidents, or even while serving in an office setting could form the basis of a successful claim for disability benefits. An applicant must also prove that their condition negatively affects their civilian life.
For instance, if a brain injury affects a veteran’s ability to speak, it could count as a disabling condition. Other qualifying symptoms include:
Finally, a former servicemember must have been discharged under honorable conditions in order to qualify for VA disability benefits. Providing a copy of a DD214 form should be sufficient evidence for this portion of a traumatic brain injury claim.
How Is Service Connection Established for Head Injuries?
Doctors must look at several factors, including when the injury happened, what the servicemember was doing at the time of the injury, and whether there was a loss of consciousness. As with all disability claims, the veteran must provide certain evidence to qualify for a service-connected brain injury.
This can include medical records from the time of the injury, a personal statement from the veteran, medical test results, treatment for TBI, a medical nexus letter, and witness statements.
If the veteran can also prove that the initial TBI caused a secondary condition, they could qualify for additional compensation. Secondary conditions may include Parkinson’s Disease, dementia, disease of hormone deficiency, seizures, headaches, tinnitus, or depression.
How Do I Prove to the VA That My TBI Qualifies for Compensation?
Proving TBI to the VA will depend on what caused your brain injury. If the injury was caused by an explosion or car accident while deployed it should be simple to document the service connection.
Unfortunately, records from combat deployments are often missing or incomplete. Obtaining witness statements, buddy letters, or other supporting evidence is helpful in overcoming a veteran traumatic brain injury claim denial.
Did You Receive A Denial for Your Veteran Traumatic Brain Injury Claim?
It has always been difficult to obtain a disability rating from the VA, but in recent years, it has become more difficult. Brain injuries are not always easy to prove, either, especially non-penetrating brain injuries.
If your VA disability for a head injury claim was denied, a VA disability attorney could help you with the appeals process. The VA will not approve your claim unless you have the required medical information showing that your head injury or secondary injuries related to a head injury happened during your time in the service.
In some cases, it is harder to win a veterans disability claim if you use “outside” doctors. Still, even those who use VA doctors have difficulty getting a head injury approved for disability.
How Does the VA Rate a Head Injury?
Currently, any veteran who receives health care from the VA receives mandatory traumatic brain injury screening if the veteran served in combat. The screening consists of four questions. Additionally, if a VA provider determines that a vet has suffered a traumatic brain injury, the provider will discuss the results of the screening with them.
Then, they will recommend follow-up care with the VA’s specialty providers or outside specialty providers. The VA evaluates a TBI at 0, 10, 40, 70, or 100 percent. In some cases, the VA will admit that the rating should be higher than 100 percent because the brain injury is so severe.
In those cases, the veteran could be eligible for additional VA disability compensation in the form of special monthly compensation (SMC) based on their need for aid and attendance.
How Much Does VA Pay for TBI?
The compensation someone will receive from the VA for a TBI depends on the rating that was assigned. The compensation amounts change on an annual basis and historically increase each time there’s a change.
In addition to schedular payments, veterans with severe TBI residuals may also qualify for special monthly compensation based on the need for aid and attendance. If your brain injury causes you to need the assistance of another person to perform certain activities of daily living, you could receive an additional SMC rating.
The VA adds the amount indicated in the table to your regular disability compensation. To receive special monthly compensation based on the need for Aid and Attendance, you must show that one or more of the following is true:
- You cannot dress or undress yourself
- You do not have the ability to attend to your hygiene needs yourself
- You cannot feed yourself
- You need help using the restroom
- Leaving you alone exposes you to dangerous activities, such as using a stove
Let a VetLaw Attorney Help You Appeal A Veteran Traumatic Brain Injury Claim Denial
Serving in the military involves many health risks, not least of which is the potential to suffer traumatic brain injuries. Severe head trauma can result in concussions, a permanent impairment of cognitive functions, and irreparable brain damage.
Oftentimes the residuals of a TBI may not be recognizable until years after active duty service ends. If you sustained a brain injury while serving on active duty which affects your civilian life, you may qualify for VA disability benefits.
VetLaw’s team can help you pursue an appeal if you are a veteran who received a denial for a traumatic brain injury claim. For help with understanding the elements of a claim, filing updated paperwork, and challenging the VA’s decision, contact VetLaw today.
You can get in touch with our team at (855) 573-1503 or submit a contact form to schedule a free consultation. We can assist you with your veteran traumatic brain injury claim denial.
Frequently Asked Questions
How do providers diagnose a traumatic brain injury?
After an individual sustains a blow to the head, healthcare providers will want to rule out a traumatic brain injury. To do so, they rely on a neurological exam and medical imaging.
The neurological test looks for abnormalities in speech, balance, behavior, reflexes, and cognitive functioning that often accompany a TBI. They may also use CT scans and MRIs to detect or confirm a TBI. These scans can also help determine the location and severity of the injury.
How common are traumatic brain injuries for military service members?
The Defense and Veterans Brain Injury Center found that over a nearly 20-year period, approximately 414,000 service members sustained traumatic brain injuries. On average, that translates into 20,700 traumatic brain injuries each year among military personnel. Unfortunately, many face veteran traumatic brain injury claim denials from the VA.
Why should I apply for additional VA disability benefits if my spouse is taking care of me after a traumatic brain injury?
Veterans who survive traumatic brain injuries often require support as they rebuild their speech, mobility, memory, and other skills, all while coping with the emotional toll of their injury.
The VA offers Aid and Attendance benefits for family members who act as caretakers for their loved ones with service-related injuries, including severe traumatic brain injuries. Aid and Attendance benefits are monthly payments that can help supplement the cost of caring for disabled veterans who rely on others for daily care.
If your family member needs to help you get dressed, bathe, manage your medications, and more, you may qualify. Aid and Assistance benefits can cover expenses like in-home medical equipment, cleaning services, and the caretaker’s lost income.
What is the difference between a penetrating and a non-penetrating Traumatic Brain Injury?
With a non-penetrating traumatic brain injury, or closed brain injury, the skull remains intact. When the brain shifts violently or internally collides with the skull, it causes damage. With a penetrating traumatic brain injury, the skull fails to protect the brain from direct contact with an external object or damage from the fractured skull itself.
For example, if you are in a rear-end car accident and the impact causes your brain to slam against the front of your skull, you may sustain a non-penetrating TBI. In the same scenario, if your head hits the steering wheel and fractures your skull, you could suffer a penetrating TBI as the broken pieces of bone put pressure on the brain.
