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VA adds five diseases to be covered with traumatic brain injury

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WASHINGTON (Dec. 16, 2013) – Some Veterans with traumatic brain injury (TBI) who are diagnosed with any of five other ailments will have an easier path to receive additional disability pay under new regulations developed by the Department of Veterans Affairs.

The Centers for Disease Control and Prevention (CDC) defines the cause of TBI as “a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.” The severity of a TBI may range from “mild” (a brief change in mental status or consciousness) to “severe” (an extended period of unconsciousness or amnesia after the injury.) (Note - Not all blows or jolts to the head result in a TBI.)

The new regulation, which takes effect January 15, 2014, will impact some Veterans living with TBI who also have Parkinson’s disease, certain types of dementia, depression, unprovoked seizures or certain diseases of the hypothalamus and pituitary glands.

“We decide Veterans’ disability claims based on the best science available,” said Secretary of Veterans Affairs Eric K. Shinseki. “As scientific knowledge advances, VA will expand its programs to ensure Veterans receive the care and benefits they’ve earned and deserve.”

This regulation is a direct result of a report by the National Academy of Sciences, Institute of Medicine (IOM) regarding the association between TBI and the five diagnosable illnesses. The IOM report, Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury, found “sufficient evidence” to link moderate or severe levels of TBI with the five ailments.

The new regulations, printed in the Federal Register, say that if certain Veterans with service-connected TBI also have one of the five illnesses, then the second illness will also be considered as service connected for the calculation of VA disability compensation.

The severity of a TBI may range from “mild,” i.e., a brief change in mental status or consciousness, to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury.

TBI can cause a wide range of functional short- or long-term changes affecting thinking (memory and reasoning), sensation (touch, taste, and smell), language (communication, expression, and understanding), or emotions (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).

TBI can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age.

Repeated mild TBIs occurring over an extended period of time can result in cumulative neurological and cognitive deficits, while those occurring within a short period of time can be catastrophic or fatal. The latter is the concern of military personnel in combat, as these events can occur on an hourly or daily basis.

According to a press release about the addition of these ailments, “eligibility for expanded benefits will depend upon the severity of the TBI and the time between the injury causing the TBI and the onset of the second illness.” However, the VA states that Veterans will still be able to file a claim to establish direct service-connection for these additional ailments “even if they do not meet the time and severity standards in the new regulation.”

Earlier this month, On December 11, the journal JAMA Psychology, also reported on a study showing direct lkinks between PTSD and TBI. The study, which took place between 2008 and 2012, showed a doubling or nearly doubling of "PTSD rates for participants with less severe predeployment PTSD symptoms." Currenlty, the VA classifies PTSD separate from TBI.

Veterans who have questions or who wish to file new disability claims may use the eBenefits website, available at www.eBenefits.va.gov/ebenefits.

Servicemembers who are within 180 days of discharge may also file a pre-discharge claim for TBI online through the VA-DoD eBenefits portal at www.eBenefits.va.gov/ebenefits.

The published final rule will be available Dec. 17 at www.regulations.gov.

Information about VA and DoD programs for brain injury and related research is available at www.dvbic.org.

Information about VA's programs for Gulf War Veterans is available at www.publichealth.va.gov/exposures/gulfwar/hazardous_exposures.asp.

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