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Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities. Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Tuesday & Wednesday at 7AM Central.
Take control of your medical evidence related to your benefits and visit https://podcast.prestigeveteranmctx.info/veteran/ for more information and to connect directly with us!
Hey guys, it's Leah B from Prestige Veteran Medical Consulting. I'm a US Army veteran physician assistant and former compensation and pension examiner. So welcome back to the Prestige Veteran Podcast where we try to do our best to make sense of VA disability and help you from a medical perspective, kind of understand some of the relationships between conditions, medical evidence and service connected disabilities. So today I wanna talk about something that's misunderstood, but incredibly important when comes to VA claims and that's epilepsy and seizure disorders. So whether you were diagnosed during service or started experiencing symptoms after discharge, this episode is for you.
Leah Bucholz:So what is a seizure disorder? Okay, so let's start with the basics of what a seizure disorder is. So a seizure disorder is a condition where a person experiences recurrent unprovoked seizures, which are sudden surges of electrical activity that can occur in the brain. The most well known type of seizure disorder is epilepsy, though there are other types as well. So seizure disorders can range from anything from like grand mal seizures, which they were formerly called grand mal seizures.
Leah Bucholz:Those are generalized tonic clonic seizures, which involve full body convulsions and loss of consciousness, to focal or partial seizures, which might involve staring spells, muscle twitches, or confusion. A lot of people have used the term absence seizures before. So for veterans, seizure disorders can be life altering, affecting the ability to drive, maintain employment, handle daily tasks safely, and even personal independence. That driving is a really major piece a lot of times in veterans and just people in general that have seizure disorders. So what is some of the medical literature?
Leah Bucholz:What are some medical articles that we can sort of use to discuss with our treating providers? So let's look at what the research says because military service is a known risk factor for developing seizure disorders in some cases, especially when linked to like head trauma or TBI or certain environmental exposures. So let me pull up some of my research here. So studies published in journals like neurology and the journal of head trauma and rehabilitation show that traumatic brain injury or TBI is one of the strongest predictors of post traumatic epilepsy or PTE. In fact, a 2020 study in epilepsy and behavior reported that veterans with moderate to severe TBI are twenty five times more likely to develop epilepsy than the general population.
Leah Bucholz:So the VA's own research confirms that seizure disorders are significantly more prevalent in veterans with documented TBI, even years after the initial injury. I think I've talked before in the past about the fact that I had a TBI related to a jump injury. Thankfully, I've never had any seizure disorders, but there's also emerging literature around blast exposure, chemical exposures, and even psychogenic nonepileptic seizures, which often mimic epileptic seizures and are linked to PTSD. So if you served in a combat zone, experienced a concussion or had a head injury, even if it was mild at the time, it's crucial to consider how that might relate to seizure activity later on in life. And we've done other videos on TBI that you might wanna check out as well.
Leah Bucholz:So how do some veterans link seizures to their service? So to get rated for a seizure disorder, you need to establish a nexus or a link, which is a connection between your military service and the development of that condition. This can happen in a variety of ways. So direct service connection or primary service connection is if you were diagnosed with or had a seizure in service. A secondary service connection, maybe you your seizures are due to another service connected condition like TBI, PTSD, or even, like I said, a toxic exposure.
Leah Bucholz:You can have aggravation. So if you had a preexisting condition that worsened because of your service, worsened beyond its natural progression. Keep in mind that just because a seizure didn't happen on active duty does not mean that it's not related. Many seizure disorders develop months or even years after the original trauma occurs, like like I mentioned before. So how does VA rate seizure disorders?
Leah Bucholz:So that's a really great great question. So seizure disorders are rated under the 38 code of federal regulation 4.124A neurologic conditions specifically under diagnostic codes 8,910 through 8,914 for different types of epilepsy. So the general breakdown for generalized or grand mal type seizures and psychomotor seizures are that a person can be a hundred percent if they're averaging at least one major seizure per month over the last year, They can be at eighty percent if they have at least one major seizure in three months or more than 10 minor seizures weekly. Sixty percent if they're having one major seizure in four months or nine to 10 minor seizures weekly. Forty percent if there's one major seizure in six months or five to eight minor seizures weekly.
Leah Bucholz:You can get twenty percent if you're one major seizure in two years or two minor seizures in six months. And ten percent is a confirmed diagnosis with a history of seizures. Okay? Maybe they're under control. So it's important to document the frequency and severity of your seizures.
Leah Bucholz:Journals can help. If you've had ER visits, caregiver statements, prescription records can also be helpful, your neurologist records. So medical evidence. So, again, like, what is your neurologist saying? What are some of those ER records saying?
Leah Bucholz:You know, you should have a current diagnosis of a seizure disorder or epilepsy if that's what you're trying to receive disability for. If you've got detailed medical records showing the frequency of those seizures, that can be helpful. Those neurology evaluations, EEGs, or brain imaging. If your doctor's willing to write a Nexus statement in your records, it doesn't have to be some robust report. It can just be, you know, something that explains maybe your TBI or your blast exposure are in play.
Leah Bucholz:Again, a Nexus letter is never required. Sometimes they can be helpful. If your seizure disorder came on after service, a medical expert, whether it's your C and P examiner, your treating provider, or another healthcare provider believes that they're related to service, if they're willing to document that for you, that can be helpful. So, know, doing a good job of keeping track and reporting your seizure activity consistently can be helpful. If you don't have a formal diagnosis, that could be problematic.
Leah Bucholz:Missing the link between seizures and your prior head injuries or secondary conditions, you know, just really doing a good job of explaining your history. So I hope this was helpful. Also, it's really important that if you're having someone help you with the filing of this type of claim or the appeal of this type of claim, to use a BSO, an accredited claims agent, or an accredited attorney. I've got another video that shows where you can go and find these folks. You should be able to find VSO in your town or in somewhere near where you live.
Leah Bucholz:Also, va.gov has a really great, database where you can go in and sort of look them up, by state or, you know, what whatever, by ZIP code. So I hope this was helpful to you guys. Please drop some comments. Let me know what your experiences have been. And if this helps anybody, I always love hearing from you guys and and hearing feedback about how this video shined a light on some things.
Leah Bucholz:Maybe we'll do another video later about seizure disorder, BBQs and what happens in a C and P exam. So again, thank you for watching and I'll talk to you guys soon. All right, bye.