revised PTSD regulations would result in huge amounts of granted claims and awarded benefits?Instead, VA granted service-connected for PTSD but then “low-balled” the assigned rating as zero or 10-percent disabling.) In the TBI case, VA can even more easily fold the TBI-caused medicalconditions under existing ratings.On the positive side, I can see where the proposed regulations will be beneficial because VA willultimately have to improve the breadth and depth of medical care provided to veterans with TBI-relatedconditions. However, because VA compensates a veteran for a medical condition’s disabling symptomsand not for the number of service-connected conditions, these proposed regulations may not change theamount of many veteran’s monthly compensation.Katrina Eagle, Esq.Veterans Law Attorneyhttp://www.eagleveteranslaw.com/
The responses of Chrisanne Gordon, M.D.
Jim;Thanks for allowing my participation to discuss this important topic. The following will be from the perspective of a health care provider.Does the inclusion of the 5 new conditions go far enough? (For example, when the addition of ischemicheart disease was added as a presumptive condition, the new rule specifically excluded other vascular disease. That doesn't make sense to anyone who understands the etiology of arterial vascular disease.Are there similar holes in this one?) As a rehabilitation physician, I do not believe that the new rulegoes far enough, though I applaud the efforts. I remain hopeful that these new conditions will,rightfully be addressed with military personnel who have suffered mild TBI as well, especially sincethe diagnosis is made, according to the rule, in the immediate post injury period. In the war theatre, Iwould imagine that it would be more difficult to make this diagnosis of mild TBI since the adrenalin of the life/death situation often “kicks in” and the injured warrior appears to be functioning according tohis/her duties. However, the injured warrior may have little or NO recollection of what they are doingin the moments/minutes/hours following a traumatic brain injury.Add with the stigma associated with TBI or PTS, it becomes even less likely for the diagnosis to bemade in the immediate post injury period in this very specific population. Similar to athletes whoPLAY through the “Concussion” our warriors will most likely continue with the process at hand, andnot realize their injuries until days, months, or even a year or more later. It is the warrior personality;on the battlefield and the playing field.Is the definition of moderate - loss of consciousness for more than 30 minutes - reasonable? If I'mknocked unconscious for 30 seconds in a war, I'm seriously injured as far as I'm concerned. Weunderstand now that no loss of consciousness is necessary for a traumatic brain injury to have occurred,therefore, those who have symptoms related to TBI: memory loss, slowed reaction times, headaches, processing difficulties, should definitely be included in the group of Veterans who will be at high risk for any of the 5 related conditions. As a rehab physician with a special interest in TBI, especiallyfollowing my own TBI, I feel it is imperative to include all levels of brain injury in the group with“suspected” secondary illnesses.