Many veterans who experienced traumatic brain injury (TBI) develop post-traumatic stress disorder (PTSD). If you are a veteran who suffered a TBI during your service and now have mental health concerns, it’s worth considering whether the two may be related and what compensation you deserve.
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In this article about TBI and PTSD
Are you among the 9% to 28% of veterans who experienced a traumatic brain injury (TBI) during your military service? If so, you are at a higher risk of developing post-traumatic stress disorder (PTSD). And if you already have PTSD, a TBI could be the underlying cause.
Veterans who served in Iraq and Afghanistan are especially likely to experience PTSD due to a TBI. An estimated 17% of veterans from those wars have PTSD. Experts also estimate that more will develop the trauma disorder over time. Veterans from these wars are more likely to develop PTSD because many of them suffered TBIs as a result of tactics employed by the enemy, especially the use of improvised explosive devices (IEDs).
This post explains the relationship between TBIs and PTSD and how the VA handles ratings for the conditions.
Understanding TBI
A traumatic brain injury results from a blow or bump to the head, a severe jolt of your body, or something penetrating your skull. The most common causes of TBIs include falls, gunshot wounds, vehicle crashes, and assaults. They rate from mild to severe — anything from a concussion to a brain injury resulting in death. TBIs can cause ongoing mental and physical health issues. And the more TBIs someone experiences, the worse the effect likely is.
The symptoms of TBI include:
- Seizures
- Nerve damage
- Blood clots
- Stroke
- Coma
- Difficulty learning, remembering, or making decisions
- Double vision
- Ear ringing
- Tingling or pain
- Difficulty talking, reading, writing, or explaining things
- Aggression or problems with self-control
- Depression
- Anxiety
- Mood swings and irritability
People recover from the traumatic brain injury, but it may leave behind other mental and physical health concerns.
How are TBI and PTSD related?
Post-traumatic stress disorder is the most severe type of trauma disorder. It happens after a person is exposed to an extreme stressor and can’t process the emotions associated with it. PTSD is a common response for soldiers trying to work through things they witnessed or experienced during combat. But traumatic experiences aren’t the only cause of PTSD.
Scientists determined that head injuries also can cause PTSD. One study found that even a mild TBI caused PTSD in 44% of the veterans tested. Researchers originally believed the connection was because TBIs often happen during traumatic events encoded into the brain. While it’s true that TBIs often occur during a traumatic incident, researchers now understand that substantial head injuries damage the brain, including the parts that process cognition, including emotion and understanding.
PTSD and TBI share the following symptoms:
- Sleep disturbances
- Irritability
- Physical restlessness
- Difficulty concentrating
- Memory disturbances
- Impulse control issues
- Anxiety
- Depression
“TBIs are often experienced as comorbid with mental health disorders. Usually, the severity of the mental health condition will be affected at some level by the brain injury itself,” said Zack Evans, a VA disability lawyer.
Comorbidity is when two or more disorders exist simultaneously.
In addition to sharing symptoms, the symptoms from PTSD or a TBI may start months after the injury, seeming to come out of nowhere.
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How does the VA rate veterans with both TBI and PTSD?
The VA rates TBI and PTSD separately. The VA rates the residuals of traumatic brain injury using diagnostic code 8045 in the Schedule for Rating Disabilities.
The three areas of dysfunction resulting from TBI are cognitive, emotional/behavioral, and physical. Here is how the VA rates the conditions in each of these areas of TBI-related dysfunction:
- Cognitive residuals are defined as decreased memory, concentration, attention, and executive functions of the brain. The VA’s process of determining the level of cognitive impairment is complex. It involves evaluating 10 facets of TBI-related cognitive impairment. The VA determines the level of impairment for each facet.
- Emotional/behavioral residuals are mental disorders that the VA rates using the General Rating Formula for Mental Disorders in the Schedule for Rating Disabilities. TBIs have a presumptive service connection with depression, if it manifests within three years. That means the connection is assumed.
- Physical concerns, including neurological ones, resulting from TBI are evaluated under the specific area of physical dysfunction.
“A TBI isn’t really an individual distinct disability in and of itself,” Evans said. “Rather, it’s a cluster of disabilities or symptoms that flow from a single event, the event being the brain injury.”
Therefore, PTSD can be secondarily connected to a TBI. A secondary service connection means the disability is medically related to a service-connected condition.
Because TBI and PTSD share many of the same symptoms, it’s essential to remember the VA’s rule about pyramiding. A symptom can only receive one rating. Therefore, for example, the VA could not consider headaches in your claims for both TBI and PTSD, even though they are a symptom of both. Also, the VA is required to make rating decisions that are most favorable to the veteran. That means, if a group of symptoms can be rated under different diagnostic codes, the VA must rate them in whatever way results in the highest rating for the vet.
“The VA is supposed to award the higher benefit, but often sweeps emotional and mental health symptoms into TBI ratings and uses it as a no man’s land because TBI disabilities are so difficult to quantify and evaluate,” Evans said.
Because rating PTSD and TBI together is so complicated, it may be a good idea to work with a VA disability lawyer who knows the rules and has your best interest in mind.
Evans said that when there’s evidence of TBI and mental health concerns, he always develops those claims together because so many of the symptoms overlap. Still, the VA often denies service connection.
“The truth is that the VA will sweep as many emotional and mental health symptoms into non-service connected health problems as possible,” he said.
How Woods and Woods can help
When making claims for PTSD and TBI, the VA is supposed to give veterans the highest rating, whether for PTSD, TBI, or a general mental health condition. But trying to determine the details of the claim can be confusing. And the VA sometimes erroneously denies benefits. Woods & Woods works with doctors and mental health professionals to evaluate veterans’ claims and use those statements as evidence with the VA. Woods and Woods can help you get the compensation you deserve. Contact us today.
Talk to Us About Your Claim:
(812) 426-7200
FREQUENTLY ASKED QUESTIONS
It may. The traumatic injury and the event that resulted in a TBI may result in PTSD. There is a clear link between the two conditions.
Most people recover from a TBI in that the brain heals, but PTSD isn’t curable. Instead, people with PTSD learn to manage their symptoms more healthily.
You want to consider your symptoms and which health concern they most fit. You may be able to receive a rating for TBI and a secondary rating for PTSD.
