PTSD and TBI rated together?

ReinaCat

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My husband just got his ratings. They combined the PTSD and TBI. 50% Basically every TBI residual is stated to be caused by PTSD and not able to rated separately. TBI is already diagnosed. They are just rated it with PTSD and gave it a single rating. Anyone have any luck here getting them separated? Thanks
 

USDevilDawgMC

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My husband just got his ratings. They combined the PTSD and TBI. 50% Basically every TBI residual is stated to be caused by PTSD and not able to rated separately. TBI is already diagnosed. They are just rated it with PTSD and gave it a single rating. Anyone have any luck here getting them separated? Thanks
Glad he got his ratings. Curious...when was your husband found unfit? Trying to bounce his timeline off of mine.
 

slayhert

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Glad he got his ratings. Curious...when was your husband found unfit? Trying to bounce his timeline off of mine.
I think you said your timeline was close to mine. My package went to the PEB 30NOV2015, and on 11MAR2016 my ebenefits showed a closed claim in historical, and my original claim went to "Pending Decision Approval"
 

USDevilDawgMC

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I think you said your timeline was close to mine. My package went to the PEB 30NOV2015, and on 11MAR2016 my ebenefits showed a closed claim in historical, and my original claim went to "Pending Decision Approval"
Pretty close, my ratings were sent back to the PEB on 29 Feb. I'm a little over two weeks right now and am ANXIOUS.
 

CWOUSMC

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USDevilDawgMC I am over 4 weeks now. My package was sent back 13 Feb and I haven't received anything back either.
 

CWOUSMC

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ReinaCat, VA does combine and separate diagnosis regularly and they are supposed to do it to the benefit of the member.
It may be that by combining them under one rating yields a higher percentage. remember that VA math is different when adding separate ratings. 2+2= less than 4. It's very possible that the TBI on it's own is say 10% and the PTSD is 50% but when they rate them together it's 70%
with that said, if it is 50% with them combined, I would want them separated. Reason being is the minimum for PTSD by itself is %50 for a member being separated. So if combining them together didn't yield higher I would want the TBI broken out on it's own in hopes of rating higher than 0% for that one item.
Hope that made sense!
 

ReinaCat

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ReinaCat, VA does combine and separate diagnosis regularly and they are supposed to do it to the benefit of the member.
It may be that by combining them under one rating yields a higher percentage. remember that VA math is different when adding separate ratings. 2+2= less than 4. It's very possible that the TBI on it's own is say 10% and the PTSD is 50% but when they rate them together it's 70%
with that said, if it is 50% with them combined, I would want them separated. Reason being is the minimum for PTSD by itself is %50 for a member being separated. So if combining them together didn't yield higher I would want the TBI broken out on it's own in hopes of rating higher than 0% for that one item.
Hope that made sense!
Yes they gave him 50% total for PTSD and TBI combined which is the minimum for PTSD, so basically nothing for TBI. Vertigo was also included in that 50% combined PTSD/ TBI also, and migraines were 0%. We were a bit shocked. His docs were also shocked and are all willing to show supporting medical evidence. We meet the lawyer next week to discuss.

As far as timeline. Package was sent off mid Oct. Unfit came back mid Jan. Rating mid March.
 

chaplaincharlie

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@ReinaCat

The symptoms caused by PTSD and TBI are very similar. Parsing them apart is often impossible. Know whether the event itself caused the symptoms (TBI) or the psychological response to the event caused the symptoms (PTSD) is often impossible to distinguish.

Do you mind sharing more about the vertigo and migraines?


Best wishes
Mike
 

ReinaCat

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@ReinaCat

The symptoms caused by PTSD and TBI are very similar. Parsing them apart is often impossible. Know whether the event itself caused the symptoms (TBI) or the psychological response to the event caused the symptoms (PTSD) is often impossible to distinguish.

Do you mind sharing more about the vertigo and migraines?


Best wishes
Mike
Yes, PTSD and TBI are very hard to separate. We have been working with his doctors for a year to do just that. We have a better understanding of it mow as his PTSD mainly effects him emotionally/psychologically and the TBI effects him more physically. (Cognitive, Tinnitis, vertigo, headaches). Vertigo was not rated at all separately and headaches was given a 0% but they both are listed with the combined PTSD/ TBI rating 50% unfitting non combat DOD and 100% VA. Vertigo and migraines should be at 30% each we feel, but fighting that is not so much of an issue as the fact that the PTSD and TBI were combined and he was given the lowest possible rating for PTSD alone. FPEB is in 10 days and we are nervous. VARR will be requested for sure. As well as combat related for the PTSD (OJAG).
 

danieldresen

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Look at the justification and APPEAL... For years I was given 30% for anxiety and 10% tbi with 0% for chronic migraines. I am now rated 70% for PTSD combat related... gee... maybe the article 15s after my second deployment had something to do with it... still only 10% tbi because even though I have SIGNIFICANT deficits... I still rate better cognitively than most civilians... this is coming from a civilian outside the VA who did my final C&P exam. I caught the VA in enough shit with my file on how they low balled me... given another month... I might get P&T at 100% with crohns... losing a ton of weight without intent. I went from 268 on April 2nd to 231 as of yesterday. Try to look at the C&P eval and if ANYTHING is inconsistent to the record... submit a rebuttal. If your regional office is Oakland, I have a few POCs so you can get things rolling. At 50% he will still retire but... if you keep fighting for what you feel is accurate, you can get a higher rating. They never rated my leakage and fistulas prior to crohns and now rated that at 10%... because I have to consistently change dressings. That one goes from 0, 10, 60, 100... at 60 I need to have incontinence and need depends... thankfully not there yet. At 100... which I may just plead to get there for better quality of life... jpouch or colostomy bag. Its funny... PTSD is rated higher but like the psychologist said... much of my affect and attitude is due to chronic pain from crohns. I can cope otherwise with my nuttiness.
 

Warrior644

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Look at the justification and APPEAL... For years I was given 30% for anxiety and 10% tbi with 0% for chronic migraines. I am now rated 70% for PTSD combat related... gee... maybe the article 15s after my second deployment had something to do with it... still only 10% tbi because even though I have SIGNIFICANT deficits... I still rate better cognitively than most civilians... this is coming from a civilian outside the VA who did my final C&P exam. I caught the VA in enough shit with my file on how they low balled me... given another month... I might get P&T at 100% with crohns... losing a ton of weight without intent. I went from 268 on April 2nd to 231 as of yesterday. Try to look at the C&P eval and if ANYTHING is inconsistent to the record... submit a rebuttal. If your regional office is Oakland, I have a few POCs so you can get things rolling. At 50% he will still retire but... if you keep fighting for what you feel is accurate, you can get a higher rating. They never rated my leakage and fistulas prior to crohns and now rated that at 10%... because I have to consistently change dressings. That one goes from 0, 10, 60, 100... at 60 I need to have incontinence and need depends... thankfully not there yet. At 100... which I may just plead to get there for better quality of life... jpouch or colostomy bag. Its funny... PTSD is rated higher but like the psychologist said... much of my affect and attitude is due to chronic pain from crohns. I can cope otherwise with my nuttiness.
Indeed, never default acceptance to any injustices; fight to the very end! Good deal and take care! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

ReinaCat

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Indeed, never default acceptance to any injustices; fight to the very end! Good deal and take care! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
Warrior,
We have our ducks in a row and have another conference call in the mooring with the FPEB lawyer. The issue is my husband really does not want to go before the formal board at all. He has severe anxiety. Hopefully I can convince him we can do this. I think it is worth a try. All documents are ready for the VARR. He is okay with that and it will be sent off soon. Now if I can just convince him to get on that plane in a week and a half and go to they FPEB. I don't even care if he gets 10% for TBI at least it is separate. He does have positive MRI imagery for TBI and his neurologist agrees his TBI has caused issues separate form PTSD. The 50% for PTSD is just too low. We have plenty of evidence for 70% PTSD so we will give it a go with the VARR. The TBI and PTSD combined has just been so frustrating. They are very similar, but there are some differences. Any advice on the FPEB to lessen his fears? Thanks so much.
 
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danieldresen

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Dress appropriately, answer all questions as addressed, bring all evidence... BREATHE... that one is key. If he gets too anxious, have him drink some yerba mate tea. It helps with anxiety. I would suggest other stuff but yerba mate wont make him drowsy. Chamomile tends to make one sleepy. Just stick by him and keep fighting the good fight. This happens all too often and seeing it happen consistently eats me up. I can't stand seeing injustice in the world.
 

Warrior644

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Warrior,
We have our ducks in a row and have another conference call in the mooring with the FPEB lawyer. The issue is my husband really does not want to go before the formal board at all. He has severe anxiety. Hopefully I can convince him we can do this. I think it is worth a try. All documents are ready for the VARR. He is okay with that and it will be sent off soon. Now if I can just convince him to get on that plane in a week and a half and go to they FPEB. I don't even care if he gets 10% for TBI at least it is separate. He does have positive MRI imagery for TBI and his neurologist agrees his TBI has caused issues separate form PTSD. The 50% for PTSD is just too low. We have plenty of evidence for 70% PTSD so we will give it a go with the VARR. The TBI and PTSD combined has just been so frustrating. They are very similar, but there are some differences. Any advice on the FPEB to lessen his fears? Thanks so much.
In my opinion, attendance at the FPEB hearing shall serve you both well. It shall give the members of the FPEB an opportunity to visually evaluate your husband's medical conditions (e.g., PTSD and TBI) first-handed; as viewed from attendance at several FPEB hearings when I was in the DoD IDES process.

Bottom line is that your husband seems to have well-documented MH & neurological medical evidence and once presented to the FPEB, I would tend to believe that you all should prevail with a favorable outcome. Indeed, it's challenging for MH & neurology physicians to separate PTSD versus TBI symptomology, but it definitely can be done for sure. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

ReinaCat

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We have decided not to go to the formal board. My husband is just cannot handle it. We have a friend who just went for this exact reason to separate PTSD and TBI and it didn't work and his case was very well prepared. I really wanted to go and fight but my husband is a mess over this whole process. We are going to just go ahead with a VARR. We have a bunch of documentation that puts him at 70%. I am a bit bummed because I feel he had a strong case for separation, but we are just going to let it go and ask for an increase. Thanks so much.
 
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tony292

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If you have a lot of 70% VARR evidence, you have a strong case. A VARR can be very quick and relatively painless if documented and done correctly. Your husband should be at an advantage as he is past 20 years and will qualify for CDRP. Once he is out he can focus 100% on his mental health. It is a catch 22 while on active duty, but once he retires and has all of his time to devote to getting better, it is much easier.
 

Warrior644

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We have decided not to go to the formal board. My husband is just cannot handle it. We have a friend who just went for this exact reason to separate PTSD and TBI and it didn't work and his case was very well prepared. I really wanted to go and fight but my husband is a mess over this whole process. We are going to just go ahead with a VARR. We have a bunch of documentation that puts him at 70%. I am a bit bummed because I feel he had a strong case for separation, but we are just going to let it go and ask for an increase. Thanks so much.
Indeed, albeit, at the end of the day..."it is what it is" unfortunately! :(

Hopefully, the VARR request shall yield favorable results upon its completion by the DoVA D-RAS. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

ReinaCat

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Thank you guys. We are still working with the docs and lawyers getting the VARR for PTSD/TBI increase. Everyone says it all looks good and we have plenty of evidence. Also moving along with OJAG on the PTSD/TBI being rated as not combat related.

One last question. It really surprised myself and others that he came back 100% VA and not 100% P&T. His rating add up to 100% in va math even without the PTSD/TBI just all his ortho/ joint issues, etc are 100% by themselves. Is there anyway to ask for the P&T reconsideration now or do we have to wait until he is actually retired? Thanks so much.
 
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