Traumatic Brain Injury and Veterans Disability | All You Need To Know

In this video, Leah B., a U.S. Army veteran and physician assistant, discusses traumatic brain injuries (TBI) and their impact on veterans' disability claims, focusing on residual effects like headaches. She explains the causes of TBIs, including blunt and penetrating injuries, and the various symptoms that can arise, such as headaches, dizziness, memory issues, and emotional challenges. Leah shares her personal TBI experience and emphasizes the importance of seeking medical care, as TBIs can lead to long-term complications. She also highlights resources available through the VA and encourages veterans to consult accredited professionals when filing or appealing disability claims related to TBI.

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Host

Leah Bucholz

Leah Bucholz is an Army combat veteran, board-certified Physician Assistant, former VA C&P examiner, and the founder of Prestige Veteran Medical Consulting. Through her work in medical evidence review and veteran education, Leah helps veterans better understand the medical side of the VA disability process, including nexus letters, DBQs, C&P exams, and complex medical opinions. She is also the host of The Veterans Disability Nexus podcast, where she discusses VA disability medical evidence from an educational and evidence-based perspective.

What is The Veterans Disability Nexus?

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://prestigeveteranmctx.com/ for more information and to connect directly with us!

Leah Bucholz: 00:07

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 today, I wanted to come on and discuss TBI or traumatic brain injury and some of the residuals, specifically headache, and how that can be related to VA disability. So TBI is a topic that I've wanted to touch on for quite a while, but it's it's sort of daunting because there are a lot of things that go into TBI and how it's rated, specifically based on a series of sets of residuals or side effects that a person can develop over time after that injury.

Leah Bucholz: 00:41

So let's talk about what TBI is first. So traumatic brain injury or TBI is defined by the Cleveland Clinic as a traumatic a traumatic brain injury is a serious medical issue that affects how your brain works. You can get a TBI from a hard bump or jolt to your head, or if you're hit with something that penetrates your skull. TBI injuries are a major cause of death and disability in The United States. They can cause short and long term medical issues that can affect every part of your life.

Leah Bucholz: 01:09

There are treatments for TBI. The VA has a lot of great treatments, and they're just really common. So in 2020, Cleveland Clinic says that over two hundred and fourteen thousand people needed inpatient care for TBI. More than sixty nine thousand people died from issues involving traumatic brain injuries. So there are penetrating and blunt traumatic brain injuries.

Leah Bucholz: 01:31

So, obviously, a penetrating injury would be if you have something that penetrates your skull. So, something pierces your skull, enters your brain tissue, and damages the part of your brain. So in the veteran, space, a lot of times we see this as shrapnel injuries. All a lot of times we think about deployment related injuries but they don't have to necessarily be deployment related injuries. Okay?

Leah Bucholz: 01:54

And then there are also blunt TBIs, which is a non penetrating injury. So I don't really discuss a lot of my health, concerns or my, you know, injuries that I sustain on active duty, but I did have a TBI when I was a young soldier, from a, an airborne operation that I had. I'm sure tons of my paratrooper brothers and sisters out there can sort of understand that when you when you come down, I was actually in airborne school, I slipped into the wind. So we get taught how to, you know, maneuver our risers to kinda go, you know, slow ourselves down or speed ourselves up, and and I sort of slipped the wrong way. And so I slip did what's called slipping into the wind, which made me accelerate.

Leah Bucholz: 02:39

And when I accelerated, I hit the ground, and I lost consciousness only for probably a minute or two. K? I lost consciousness for a minute or two. I got drugged by my parachute for quite some time, and then I woke up and the medics were over the top of me and I just unsnapped my risers and they were like, hey, you know, are you okay? We need to take you in.

Leah Bucholz: 03:00

And I was like, no, I'm fine. I need you know, I didn't want to get recycled out of airborne school and that's something that resonates with tons of veterans whether it's airborne school or another thing. We we sort of just suck it up and try to drive on whether it was during a deployment, you didn't wanna leave your battle buddies, whether it was an airborne school or any other school that you were in, whether it's TBI, a knee injury, or whatever that's just sort of a common thing with service members and you know I was very young I think I was like 21 or 22 years old at the time and so I didn't want to get recycled. I think I was on like my fourth jump or something and so I just kept going right. And I really didn't think about the effects that that could have for many years and so some of those residuals that people can have we're going to talk about today.

Leah Bucholz: 03:45

Okay? I I developed migraines. I had headaches for quite some time. I still suffer from headaches to this day. So getting back to types of TBIs, we have mild TBIs, moderate TBIs, and severe TBIs.

Leah Bucholz: 04:01

So interestingly, you actually don't have to have a loss of consciousness to have a mild TBI. So we're trained on a lot of this medical professionals in the military, medics, PAs, doctors. Just blast injuries alone can cause someone to have a TBI without a loss of consciousness. A lot of times, we would use those MACE cards. I don't know if you guys remember those, and you'd have to go through a whole checklist of things and say apple bubble and all these kind of different, five words memorizing throughout the thing.

Leah Bucholz: 04:33

Some of you may not know what I'm talking about, but those of you that do will probably chuckle because you had to go through that MACE card while while you after you had an injury. So what are some of those symptoms? So, again, a person can develop mild TBI symptoms that can happen right away or within a few days, and you could have nausea and vomiting. Person could have dizziness, balance issues, headaches, fatigue, light sensitivity. So I remember when I was on active duty and I would have people that would have, a concussion or a type of a head injury, we would put them on brain rest for at least twenty four hours, which meant they couldn't be on their phone, their computer.

Leah Bucholz: 05:10

You know, this was stateside, where we, you know, not deploy where people had phones and things like this, devices. So we would not want them to stare at a lot of light because it could, you know, further exacerbate their symptoms. Okay so memory issues a person could have confusion, difficulty concentrating, difficulty thinking clearly, short term memory loss. You can have emotional issues like anxiety, nervousness, irritability. Some of those Cleveland Clinic says some of those moderate symptoms are going to be losing consciousness, lasting more than thirty minutes but fewer than twenty four hours.

Leah Bucholz: 05:48

In a severe case of TBI, you're unconscious for more than twenty four hours. So a person can go into a coma, they can have weakness in their extremities, issues with balance, hearing or vision issues. Again, you can have confusion, difficulty concentrating, thinking clearly, short term memory loss, anxiety, depression, etcetera. So not everybody gets diagnosed with TBI at the time of the incident on active duty, right? So sometimes it's not until many years later where you recount your history.

Leah Bucholz: 06:21

I see this all the time with veterans that I work with that they may not have gotten diagnosed. Hey. They have this injury while deployed. There was not good documentation. Or perhaps, you know, I've had people that were, like, on the army boxing team that got struck in the head repeatedly, right?

Leah Bucholz: 06:36

And they had different concussions throughout the years and so it isn't until many years later sometimes that they're being evaluated at the VA or with their regular provider and they finally get evaluated and get diagnosed with TBI residuals or long term side effects of TBI. So what are some of those side effects? So I'm gonna pull up a little VA document that I found that's kind of helpful. Hang on one second. I'm gonna present this to you guys.

Leah Bucholz: 07:16

Okay, so this is a TBI fact sheet from va.gov. Okay? So let me see if I can make it a little bit bigger here. Okay. So it basically says that the US Department of Veterans Affairs provides medical and rehab services to veterans and service members with TBI.

Leah Bucholz: 07:37

VA's polytrauma TBI system of care is nationwide network for 110 facilities. So we already discussed what a TBI is. We talked about some TBI symptoms. This fact sheet discusses the fact that VA screens all post nine eleven veterans for possible deployment related TBI on their initial entry into VA health care. Veterans with positive TBI screens are referred to specialty providers for comprehensive evaluation and to develop a plan of care as necessary.

Leah Bucholz: 08:04

Case managers are assigned to assist veterans by coordinating services and resources to optimize rehab outcomes. And then TBI outcomes, the VA TBI model system research program tracks TBI rehab outcomes for veterans treated in the VA polytrauma rehab centers and compares these with outcomes for patients treated in the private sector. VA outcomes compare favorably to those from the civilian, TBIMS, and the percentages of patients discharged to home and those living independently years following rehab. Okay. So let me so I'm gonna get to some of the the stuff that I use when I write reports for TBI residuals, especially for headaches.

Leah Bucholz: 08:45

So that's one of the most common ones I see, vertigo, dizziness, headaches, concentration difficulties, aggression, things like that. Those are pretty common as well. So okay. Natural so this is this is I like to give these articles to you guys so that in case you're, you know, pursuing some VA disability for this, you can talk to your treating health care provider. They may be able to assist you with a report, showing that your symptoms are related to that incident and service.

Leah Bucholz: 09:16

One of the most problematic things I see is that people sometimes have difficulty proving that the incident happened. So having buddy statements, you know, incident reports if there was if you were involved in a blast while you were deployed, those types of things can be helpful in the absence of medical records from active duty. So this article was published in September 2011 in the Journal of Neurotrauma, and it was entitled Natural History of Headache After Traumatic Brain Injury. They found a prevalence of post traumatic headache in thirty to ninety percent of patients reviewed in a large retrospective study lasting over one year, at least one year. Another article published in the American Headache Society titled Post Traumatic Headache, Five Years After Traumatic Brain Injury is a good article to take a look at.

Leah Bucholz: 10:09

Another one, a cohort study examining headaches among veterans of Iraq And Afghanistan Wars associations with traumatic brain injury, PTSD, and depression were published in a peer reviewed journal called Headache in 2016. The authors concluded that TB TBI alone is a strong predictor of headache in the first year of VA care among, IAV and that comorbid psychiatric conditions increase the likelihood of headaches among individuals with TBI. K? Another article, Headache Journal of Head and Face Pain reviewed the quantification of headaches. And and, basically, this says that once you develop headaches after a TBI, they can just become chronic and and just last for years.

Leah Bucholz: 10:54

Okay. So I hope this was helpful. Again, there are a lot of residuals that a person can be rated for related to that TBI. It's always best to follow-up with a VSO or another accredited legal professional, like an accredited claims agent or attorney if you have questions regarding filing a claim or appealing a claim for VA disability. I hope this was helpful.

Leah Bucholz: 11:15

Please drop some comments and thank you for watching.