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VA Failed to Cover TBI Treatment for 24,000 Veterans

The US Department of Veterans Affairs (VA) has offered to reassess the claims of over 24,000 military veterans with Traumatic Brain Injury (TBI) whose disability claims were rejected between 2007 and 2015. Claims were initially denied to some veterans because their TBI exams weren’t conducted in compliance with the VA’s coverage requirements at the time.

VA Corrects Past TBI Claims

Previously, to get treatment for TBI, veterans needed an initial exam conducted by one of only four “recognized” medical specialties: a psychiatrist, physiatrist, neurosurgeon, or neurologist. If the veteran had been diagnosed by a doctor in a different medical specialty, he or she was denied coverage for TBI under the VA.

VA Secretary Provides Equitable Relief

However, with the release of Secretary of Veterans Affairs Robert McDonald’s statement on June 1, 2016, the VA will now provide “equitable relief” for those TBI claimants who were denied between 2007 and 2015.

Equitable relief is “a unique legal remedy that allows the Secretary of Veterans Affairs to correct an injustice to a claimant where VA is not otherwise authorized to do so within the scope of the law.”

What Is TBI?

TBI occurs when a person experiences a blow to the head that impacts normal brain function. The most common TBIs are categorized as “mild” and are commonly called concussions. Diagnosis is complex because symptoms can manifest in many different ways, such as:

  • Physical symptoms like headaches, balance problems, or light sensitivity
  • Cognitive symptoms like memory gaps, concentration problems, or language impairments
  • Emotional symptoms like irritability, anxiety, or depression

VA Review Revealed Wrongly Rejected Claims

Secretary McDonald’s announcement came about as the result of a national review of over 24,000 TBI examinations and disability compensation claims made between 2007 and 2015.

McDonald called TBI a “signature injury” for veterans of wars conducted in the 21st century. He acknowledged that “we let these veterans down” and proclaimed that it is “a privilege” to help them.

Retroactive VA Benefits for Veterans

The VA will award benefits to veterans retroactively to the date of their initial claim. The department will contact all the TBI vets affected by the study. Vets won’t be required to file new claims. However, it is unclear if the new policy will assist vets whose injury occurred prior to 2007.

TBI and the Military

In 1992, the US Congress created the Defence and Veterans Brain Injury Center (DVBIC) as a response to the increased severity of head injuries soldiers sustained in the first Persian Gulf War. The DVBIC helps veterans with TBIs coordinate exams and treatment with their claims benefits as well as conducting ongoing studies of military TBIs.

Some facts about TBI in the military:

  • Since the first numbers were tracked in 2000, cases of TBI have increased over 51% – from about 11,000 cases in 2000 to over 22,000 last year.
  • Cases in the military peaked in 2011 at almost 33,000 injuries and have been gradually declining since then due to a substantial drawdown of Army personnel in both reserves and on active duty.
  • The vast majority of these cases are classified as “mild” by the Department of Defense. However, although mild diagnoses are falling, the rate of severe TBIs has held steady since 2000.
  • Soldiers in the Army are by far the most at-risk branch of the military for TBIs.
  • Military members exposed to blast injuries had the highest risk. However, military personnel are also exposed to TBIs caused by bullets, falls, and vehicle accidents.

If you or a loved one has TBI and has been unable to get proper healthcare coverage, talk to our legal team. You could be entitled to reimbursement for lost wages, medical costs, and more.