VA ANNOUNCES EXPANDED BENEFITS FOR TBI

FROM:  U.S. VETERANS ADMINISTRATION 
VA to Expand Benefits for Traumatic Brain Injury
Adds Five Illnesses Related to Service-Connected TBI
WASHINGTON – Some Veterans with traumatic brain injury (TBI) who are diagnosed with any of five other ailments will have an easier path to receive additional disability pay under new regulations developed by the Department of Veterans Affairs.

The new regulation, which takes effect 30 days from today, impacts some Veterans living with TBI who also have Parkinson’s disease, certain types of dementia, depression, unprovoked seizures or certain diseases of the hypothalamus and pituitary glands.

“We decide Veterans’ disability claims based on the best science available,” said Secretary of Veterans Affairs Eric K. Shinseki. “As scientific knowledge advances, VA will expand its programs to ensure Veterans receive the care and benefits they’ve earned and deserve.”

This regulation stems from a report of the National Academy of Sciences, Institute of Medicine (IOM) regarding the association between TBI and the five diagnosable illnesses.  The IOM report, Gulf War and Health, Volume 7:  Long-Term Consequences of Traumatic Brain Injury, found “sufficient evidence” to link moderate or severe levels of TBI with the five ailments.

The new regulations, printed in the Federal Register, say that if certain Veterans with service-connected TBI also have one of the five illnesses, then the second illness will also be considered as service connected for the calculation of VA disability compensation.

Eligibility for expanded benefits will depend upon the severity of the TBI and the time between the injury causing the TBI and the onset of the second illness.  However, Veterans can still file a claim to establish direct service-connection for these ailments even if they do not meet the time and severity standards in the new regulation.

Veterans who have questions or who wish to file new disability claims may use the eBenefits website, available at www.eBenefits.va.gov/ebenefits.

Servicemembers who are within 180 days of discharge may also file a pre-discharge claim for TBI online through the VA-DoD eBenefits portal at www.eBenefits.va.gov/ebenefits.

The published final rule will be available Dec. 17 at http://www.regulations.gov.

U.S. DEFENSE DEPARTMENT: THE COMPLICATION OF NEUROENDOCRINE DYSFUNCTION POST TBI

FROM: U.S. DEFENSE CENTERS OF EXCELLENCE

Neuroendocrine Dysfunction: Hidden Complication Following TBI

Posted by Diana Moon, DCoE Public Affairs on March 27, 2013
Health care providers understand that making the correct diagnosis is key to effective treatment and recovery. If you’re a provider, did you know that for your patients with traumatic brain injury (TBI), there’s a fair chance you could overlook a diagnosis of
neuroendocrine dysfunction (NED) post TBI? NED is a condition that can be tricky to diagnose because it has many symptoms in common with other conditions that co-occur with TBI, such as sleep disorders, depression, substance abuse disorder and posttraumatic stress disorder. Health care providers should be aware that because screening for NED is not performed routinely in the acute post-injury period, the dysfunction is under-diagnosed, under-treated and may affect the patient’s rate of recovery.

According to Therese West, subject matter expert with Defense and Veterans Brain Injury Center clinical affairs division, research has noted that an estimated 15 percent of patients with mild TBI experience persistent symptoms, and the incidence of NED in those mild TBI patients ranges from an estimated 16 to 40 percent. Simply put, NED refers to a variety of conditions caused by imbalances in the body's hormone production. There are two areas of the brain responsible for regulating the production of hormones, the hypothalamus and the pituitary gland; both are potentially vulnerable to traumatic brain injury.

Medical guidance to evaluate and treat NED is available to providers in the Neuroendocrine Dysfunction Screening Post Mild Traumatic Brain Injury Clinical Recommendation and Reference Card developed by Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE). The tools clarify the indications for post-injury neuroendocrine screening and provide a reference point for screening following traumatic brain injury.

Hard copies of the clinical support tools are available for order through DCoE. To download electronic versions of these tools and other TBI clinical resources, visit the Resources section of the DCoE website. If your patient has symptoms that suggest NED and they don’t resolve after three months, you should consider referring your patient to an endocrinologist.