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Traumatic Brain Injury (TBI) Claims
Roger Hale, Veterans Law Attorney


As most veterans that have suffered from a TBI know, the rating system used by the VA is anything

but easy.  Most of these same veterans and their families also know that the VA finally admitted to

performing “improper” screenings on at least 25,000 veterans.  This admission did result in

major changes to the TBI screening and rating process, but it is still far from perfect.
               What a lot of TBI victims or their families do not realize is that there are multiple other “disabilities/impairments” that come into play when dealing with a TBI and the VA rating system. The

VA often just messes up when evaluating these medical problems due to the underlying TBI.

These problems might be mental, physical or neurological.
               The VA uses a Manual called the M21-1 Compensation and Pension Manual. This “manual” is basically the “Bible” for the VA in working claims.  It has 11 “Parts” but we are really only concerned

about “Part III” which is further broken down into numerous Sub-parts, Chapters, Sections and

Sub-Sections.  I bet a lot of heads are spinning already and we have only just started!  Anyway, we

are going to look at “M21-1, Part III, Subpart iv, Chapter 4, Section G- Neurological Conditions and

Convulsive Disorders”.  This “part” of the M21-1 discusses TBI’s.
               What happens in a lot of TBI claims before the VA, the veteran (or his family member) has filed

a claim for a “TBI” or maybe even just said “head injury” or “brain injury”. However, there are other

problems that often go along with a TBI that MIGHT be entitled to a disability rating which is IN

ADDITION to the rating for the TBI itself. Things such as migraines, generalized anxiety disorders,

memory problems, self-care, pain, vision or hearing problems and many, many others are

associated with a TBI, and could result in additional compensation for the veteran.
               The VA, in making their evaluations of the other diagnosis associated with a TBI will always

rely upon the “C&P” medical exam/opinion that they have requested.  The Doctors writing the

opinions will sometimes take the easy way out when preparing their report and ends up

causes problems for the veteran.
               For example: The C&P exam finds that the veteran has a TBI and adjustment disorder with

anxiety & depression. However, the Doctor finds that he/she is not able to tell the difference

(differentiate) in what portion of each symptom was due to each diagnosis. So, seeing this finding,

the VA Rater might issue out a Rating Decision that says the TBI is entitled to 10% and the

Adjustment Disorder with anxiety & depression is 50%, BUT since the Doctor can’t tell which

symptoms are related to which diagnosis, the veteran is only entitled to the higher rating of 50%,

NOT to 10% AND 50%.   This would short change the veteran 10% in benefits.
               The veteran will be confused for sure with this type of finding. Especially since IF the “Rating

Decision” sheet is included with the “Notification of Award” sheet that is sent to the veteran, and the

Notification of Award letter says the veteran is entitled to 30% for “TBI and adjustment disorder with

anxiety & depression”, yet the Rating Decision findings say he is entitle to 10% for the TBI and

makes a separate finding of 30% for the Adjustment Disorder with anxiety & depression.
               So, again, in the above example, the veteran is awarded 50% total instead of 60%.
               TBI claims are very complex and the VA follows very complex regulations and policies when

evaluating these injuries. I would always strongly recommending that the veteran or family member

assisting the veteran contact an experienced and accredited representative after receiving an award

for a TBI.  In fact, contacting someone before filing your claims COULD make a huge difference

in the outcome. While it is possible to “win” a TBI claim on your own, it is one of the very few

claims that I believe require at least the input of an experienced and accredited representative.

It normally should cost the veteran nothing to at least get some pointers before filing the claim.


Have you had problems filing your TBI claim?
Speak with veterans law attorney Roger Hale today!


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Your VA refers to any illness or injury as a  condition.

You must have a specific medical diagnosis to claim a condition. For example,

you can't generalize by saying "My bones hurt." You'll need a

medical diagnosis such as "osteoarthritis, left knee" or similar.


The very best listings of all VA rateable conditions will be found in

The Schedule For Rating Disabilities.


Below you'll find a listing of DBQ's of rated conditions.

As you research and develop your claim, you should find your condition in

The Schedule For Rating Disabilities as well as its specific DBQ.

Once you've done that you'll know exactly what VA is looking for so that they

can service connect and rate your disabling condition.


Veterans Law Attorney
Veterans Medical Malpractice Attorney


Things You'll Need













Mail your forms, documents
and evidence here...


Department of Veterans Affairs
Claims Intake Center
PO BOX 4444
JANESVILLE, WI 53547- 4444


Toll Free Fax: 844-531-7818
We recommend that you mail a copy and then

fax a copy!  Yes, it's twice thework but maybe

VA will only lose oneand the other will

be processed. Remember: Use Certified Mail!

Forms

VA Form 21-526EZ
For...

Disability Service Connection
Secondary Service Connection

IncreasedDisability Compensation

Temporary Total Disability Rating
 Individual Unemployability
Compensation under 38 U.S.C. 1151
 Special Monthly Compensation
Specially Adapted Housing

Special Home Adaptation

Automobile Allowance/Adaptive Equipment
Benefits Based on a Veteran's
Seriously Disabled Child


VA Form 21-0958 - NOD
​Notice of Disagreement


VA Form 21-534 EZ
Application for DIC, Death Pension


Change of Address​


TDIU Annual - VA Form 4140


Declaration of Status of Dependents
VA form 21-686c


How To

How To Apply For SSDI


How To Apply For

TDIU Unemployability


How To Use

Disability Benefits Questionnaires

(DBQ's)


How To Apply For A Disability Rating


How To Apply For An Increase

to an existing rating


How To Retrieve Your

Military Personnel Records


Research Your Claim

The M21-1MR
The CFR
TDIU
SMC

The Schedule For Rating Disabilities



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Veterans Disability Attorney