A traumatic brain injury (TBI) suffered during combat can cause a host of changes to mood, behavior, and cognitive function that make it difficult for a Veteran to complete daily activities. However, one often overlooked effect of a brain injury is the increased risk of post-traumatic stress disorder (PTSD).
PTSD and TBI Are Often Interconnected
PTSD is more than just combat stress. It is a serious mental health disorder that can occur after a person experiences a traumatic event and is characterized by symptoms such as flashbacks, nightmares, and severe anxiety.
A traumatic brain injury occurs when there is swelling, bruising, or bleeding in the brain after a sudden jolt or blow. TBIs are classified as mild, moderate, or severe based on the length of time a person was unconscious, the level of amnesia present, and scores on the Glasgow Coma Scale representing responses to defined stimuli.
Since TBIs are often caused by violent combat events such as blasts or gunshot wounds, it can be difficult to determine whether it’s the experience of being injured or the injury itself that leads a Veteran to develop PTSD. However, many experts believe the structural and functional changes in the brain associated with a TBI can increase the effect of existing risk factors in those who are already susceptible to PTSD. This is sometimes why PTSD and TBI are referred to as the “perfect storm” of disabling conditions.
Separating Symptoms Can Be a Challenge
Veterans with a TBI and PTSD can face challenges getting approved for necessary VA disability benefits because many of the symptoms of these conditions overlap. However, there are some key differences:
- A TBI often causes unpredictable outbursts that can include anger, laughter, and sadness. PTSD tends to result in emotional avoidance or trouble feeling any emotions at all.
- Someone with PTSD typically remembers their triggering event in vivid detail. A TBI can cause memory gaps.
- Veterans with PTSD tend to voluntarily isolate themselves from others, while those with a TBI may feel isolated if loved ones check-in less frequently as they continue with therapy and rehabilitation.
Getting an accurate diagnosis is important because the VA will not pay Veterans for the same disability or manifestation. To receive separate ratings for TBI and PTSD, you need to show which symptoms are caused by your TBI and which are caused by your PTSD. For example, a Veteran may need to produce records showing a TBI has led to physical problems such as seizures and balance issues and the PTSD has led to behavioral issues such as anxiety, depression, and difficulty interacting with others in a socially appropriate way.
If your PTSD and TBI are rated separately, keep in mind that your total disability rating is not obtained by adding the two ratings together. Since a Veteran can’t be more than 100% disabled, “VA math” calculates total disability ratings using the percentage of the whole body after the initial disability is taken into consideration. This approach compares the effects of the least disabling condition against the most disabling condition and rounds to the nearest 10%.
PTSD and TBI Can Often Qualify for TDIU Benefits
Both TBI and PTSD are often severe enough to interfere with a Veteran’s ability to hold full-time employment. In this case, the Veteran may qualify for increased payments via Total Disability Individual Unemployability (TDIU) benefits. TDIU allows a Veteran to receive compensation at the 100% rating level even though they don’t qualify for a total disability rating using schedular criteria.
TDIU requires a Veteran to have one service-connected disability with a rating of 60% or higher. Veterans with two or more service-connected disabilities can receive TDIU if they have a combined rating of 70% or higher with one disability that is rated 40% or higher.
Let Us Help You Get the Benefits You Deserve
If you’re a Veteran struggling with service-connected PTSD and a TBI, a Veteran's benefits attorney can help you access the benefits you’ve earned in service of your country. Call the office of Sean Kendall, Attorney-at-Law today to schedule a free, no-obligation initial consultation.