When evaluating whether to grant veterans’ disability benefits for a traumatic brain injury (TBI), VA examiners tend to operate under the assumption that there is a direct correlation between how long the veteran was unconscious after their injury and the severity of the TBI. In reality, research suggests that a single concussion can cause lasting structural damage to the brain. A study published in the journal Radiology demonstrates that the brain undergoes a measurable loss of volume after a concussion. These volume changes correlated with cognitive changes in memory, attention and anxiety.
The research results are interesting because mild traumatic brain injury or MTBI accounts for at least 75 percent of all traumatic brain injuries. This means that individuals suffering from what appears to be routine concussions may actually be suffering far more extensive structural brain damage than previously realized. The symptoms of a TBI include headaches, dizziness, memory loss, attention deficit, depression, and anxiety. Some of these symptoms can persist for months or years. The researchers found that even one year after a concussion, there was noticeable global and regional brain atrophy in a mild traumatic brain injury patient. The takeaway lesson from this is that a TBI does result in structural injury to the brain even though it may not be seen on routine radiographs.
I think the practical effects of this research are that traumatic brain injuries can cause significant problems years later even though there may not be any routine clinical imaging to support it. I have a client who suffered traumatic brain injury during his time in the service but did not develop psychotic disorders until 20 years later. In addition, I have veteran clients who had multiple traumatic brain injuries in service and then later become delusional. The scary thing is that their delusional disorder did not manifest until several years after their TBI. How many psychiatric basket cases are suffering today as a result of a head injury that happened many years ago?
It’s hard not to conclude that the connection between the TBI and later psychosis are often missed because of the time delay between the injury and symptoms of long term damage. Certainly, it is standard operating procedure for VA adjudicators to deny claims when there is a lengthy hiatus between the events of service and the onset of a diagnosis or symptoms in the years following service. But in light of the research regarding structural injury to the brain following traumatic brain injury, VA adjudicators must be more cautious about summarily rejecting claims for veterans’ disability benefits.
Finally, VA disability advocates must look very carefully to determine if structural injury to the brain has occurred after a TBI because injury to the brain can result in a whole host of problems including mood disorders and neuroendocrine problems.
Whenever a traumatic brain injury is involved, and the VA has denied the claim, it is highly advisable that a disabled veteran consult with an experienced veteran’s disability attorney to have his case properly evaluated.