For almost a year, I have been rated 100 percent schedular (temporary not permanent/total) for anxiety/depression. My "long-suffering" road to the rating began about 15 years ago on active-duty when I began complaining about bouts of lethargy, lack of concentration, confusion, muddled thinking, difficulty prioritizing, difficulty accomplishing tasks or a general lack of or stunting of what I have come to know as "executive functioning" or some similar term. I began re-reading sentences and paragraphs several times to get the meaning. Writing was and still is a chore, even though I have written well on many occasions, all the while thinking no one but me knows how much effort it takes. I ran across a term also that involves having to explain anything and everything and that seems to match up with the convoluted way I sometimes have to use to express myself. I think the term begins with "con...", too. I apologize for how hard it may make to follow this post.

Besides a self-thwarted suicide plan back when my symptoms bounced up against job performance, with subsequent tracking in the mental health pipeline, and two surgeries for chronic sinusitus and finally being diagnosed for sleep apnea, I STILL seem to have cognitive functioning issues. I have been a multiple-list-maker for years and constantly seek out planning/time management tools, trying them and giving up on them. I am a pretty good writer but doing so is like squeezing water out of turnips. My brain or forehead and scalp muscles (around my forehead, ears and down my neck)seem to tense up and there seems to be a lack of fluidity in doing this. Thinking is like pushing play-dough through one of those shape-makers instead of like water going through a garden hose. Getting anything done is like swimming upstream through molasses. I have virtually no self-motivation, self-discipline, even though I want to do so much. This resulted in me barely making it to military retirement (thank God I did) but I had begun getting into low-level administrative disciplinary actions taken against me intermittently and especially towards the end. I actually was more or less threatened into retirement even though my high year of tenure would have given me another two and a half years on active-duty. I would have continued to serve despite the effort it took. I considered challenging some bogus methods to "railroad" me but was advised not to by a military chaplain and others, plus I was too tired to fight any more. I tried civilian employment but was let go after about three months. I have not worked since which was five years ago. I fear trying again but might try some school work of some sort.

I ran across the term "mild TBI" while googling about my symptoms. My anxiety/depression is service-connected per my rating but I/docs never connected it to an event I believe could have been the root of everything to follow (and I think this was aggravated by resulting high stress levels and by separately by a subsequent PTSD stressor event that I have had validated through a buddy/commander statement with VA).

The reason I think I may have mild TBI is this: During a military exercise overseas much earlier in my career, I fell and hit my head falling out of a top-bunk rack. The floor was tile on concrete type. Laugh, I kind of do. I remember that I woke up some time later having missed or come in extremely late for my shift. It is a bit embarrassing to say this, but the symptoms seem to have originated then and there. No one in my chain noticed as I was working with a foreign national who did not speak English (he did give me some pretty intense scowls)/ I did not report this caring more at the time about staying out of trouble for being "AWOL" or "missing movement" or whatever the UCMJ could have thrown at me, or at least getting wrote up. I had been a "super troop" and supervisors at my home bases thought highly of me. After that, things began to change.

I am going to bring this up to my VAMC primary care and mental health providers at my appointments in the next week or so. I have wanted to get to the bottom of this for a very long time and feel this may be part of it.

After all that, my questions (besides any other thoughts welcomed from my explanation) are:


What types of VA or otherwise therapy/assistance are available for mild-TBI?

Any recommended websites (VA or other) would help me better understand these symptoms and how veterans or others cope with this?

I am not 100 percent certain if I would truly be diagnosed with mild-TBI but from what my gut tells me, I do.

If I read correctly, you did not report this to anyone. On top of which you went on to complete several terms of service in order to retire. Now based on your personal history you are asking to be granted mild-tbi. Is that what I am reading?

that is what you are reading. i reported the symptoms of anxiety/depression but i don't think i ever mentioned what i believe was a concussion, i may have, will go back into service medical records to see if it is mentioned, may have been. the anxiety/depression may be secondary to mild tbi but that has never been established, to the best of my knowledge it was just 'oh, you have anxiety/depression. let's treat that with meds and talk therapy.' the concussion was never focused on as a stressor or whatever it would be called. i never really tied the two until the recent focus on tbi.

i don't really care if i ever get pigeon holed as a tbi vet, just that i can learn some constructive ways to deal with what i feel are symptoms of tbi or symptoms that mimic or are those held in common with tbi sufferers.

also, i requested an mri from a neuropsychologist who said it showed no findings other than what a small white lesion deep in my brain which he crassly referred to as a UBO, unidentified brain object, said he'd operate to find out what it was if i insisted, i may have mentioned the concussion to him.

on top of which it was no small order to complete several terms of service in order to retire

What you need is to get your doctor to write a letter saying that your present condition is static and not subject to improvement, thus filing for permanent and total. Once you get that, then you can explore other avenues.

thanks, sharon. i have heard the term static here before but didn't understand what it meant.

I have mild TBI(the word mild is decieving). I'm rated 100%P&T for it.

What you explain in your case does sound like a possible result of a head injury. I can tell you that much of what you explain has and is happening to me. Anxiaty and depression are common results of MTBI and I have both.

I went 12 years before I was properly diagnosed and I had been hospitalized for the injury at the time it happened. Because symptoms often aren't apperent for a few months MTBI is often undiagnosed and/or misdiagnosed.

One of the most common misdiagnoses for MTBI sufferer is PTSD. All of the symptoms for PTSD are included in the possible symptoms for MTBI with the exception of a stressor. I had been diagnosed with PTSD at one time due to my symptoms but it was later dismissed because I lack the main ingredient, a stressor.

To answer some questions for you: I have been away from Hadit for some time due to the amount of time it takes me to respond to posts (it seems you are aware of the time it takes for someone with slowed executive functioning to type theses things out). I felt my life was passing me by while I was sitting here, though I love to do it. Anyway, my memory is such that it may take some time to retrieve much of the information I have.(I basically have to re-learn it) I'm pretty sure I posted a few internet resources when the TBI forum was new, so you may be able to find allot of information if you read through some of the first threads in this forum. I'll find what I can.

Some things come to mind. As for VA TBI treatment, it depends on where you live(the VA facility) but for the most part the VA is unwilling to provide much for a long past TBI. Basically it is felt that it is too late as gains are made in the first three years after the injury. I have had next to nothing in the way of treatment for TBI. I feel I am on my own with dealing with my problems. I've been told to move to a different regoin if I want help.

In my opinion, whether or not you want a tbi diagnoses, it would be very benificial for you to get neuro-psych testing done, especially if your having memory problems and slowed thinking. MRI, 9 out of 10 times, will not show any damage from a MTBI or even a moderate one. neuro-psych tesing usually proves TBI. Even without a tbi diagnoses it may help in your ratings because if a cognative dissorder is found, I think it likely you could prove it started in service and be rated for it. It may not increase your rating but it is likely it would be considered permanent.(brain damage, especially old ones, never heal)

Hope this helps.

Time

In my opinion, the CURRENT war and our new vets entering the VAMC/VBA system
are the reason TBI is even listed, evaluated and being discussed for the past
5 or 6 years.

Prior to OCT 2008 change in 38 CFR Part 4 - Schedule of Rating Disabilities
Diagnostic Code 8045 - was COMPLETELY DIFFERENT than the new criteria.

In my opinion - all vets that were rated under the old DC 8045,
(which limited disability rating percentage to 10%)
that have medical evidence contained in their SMR's
that show a CLEAR CUT DIAGNOSIS of head injury due to trauma --
whether it be mild or listed as Post Concussion Syndrome, or more extensive
damage - can and should request to be re-evaluated under the new
(Oct 2008 DC 8045) rating criteria.
Findings are that TBI - even mild TBI can and does (at times) result in
mental health changes.

Notations in SMR's that refer to Organic Brain Disease due to head trauma
is also good medical evidence to be considered in the new criteria.

jmho,
Hope this helps a vet.
carlie

thank you carlie and time. it means a lot, and i will consider all you have suggested. time, just communicating directly (as much as the internet can provide) with someone who i truly believe understands where i'm coming from eases some of the burden i've carried for so long. i will go back and check the forum and search more on tbi.

out here,
Here's a good link for study and research, it's the new criteria changes
that were put in place Oct 2008.
Hope this helps a vet.
carlie

http://ecfr.gpoaccess.gov/cgi/t/text/text-....67&idno=38


Scroll down to:

8045 Residuals of traumatic brain injury (TBI):

[What types of VA or otherwise therapy/assistance are available for mild-TBI?]

I was diagnosed with TBI in 2004 by a VA neurologist & share many of the symptoms you have discribed.
Haven't recieved any specific treatment for it yet.
From what I've been told is little can be done but treat the symptoms. They tell me the same about MS.

There are several disorders that may cause the white UBO's on brain MRI's besides TBI. Gliosis, Ischemia, MS. It was described to me as holes that fill with water.

Nothing to worry about, is what I was told for over a decade before being diagnosed.

I researched this a bit, and found the following from the CDC:

Sequelae is defined as an aftereffect of disease, condition, or injury.

Other sources recommend rest and OTC pain relievers for MTBI, and hospitalization for moderate and severe TBI. But these options are for recent TBI, and not for TBI that has occurred years ago.

Hope this helps,

Louis

thanks again, i will continue to follow this and research those areas pointed out. makes sense about education and acceptance being a key part of recovery for tbi or similar diagnosis. i rarely get a headache but the numbness and executive functioning associated, as well as what i've called "mental fluidity" are my major concerns.

The VA web site as well as many many sites have info on TBIs.
Technology can rule in or out some TBIs, yet some do not show up on MRIs.

TBI is rated separately from PTSD and VA rates the residuals.

We have done shows at SVR with Dr. Van Boven, an expert on TBIs who VA fired because he reported them to the IG as to squandering TBI research money.

You certainly seem to have some symptoms of TBI but that would take a doctor to fully assess.

TBI is a disability that can affect the physical, mental and emotional status of a veteran.It is called the 'signature wound' of the Iraq War but is probably more prevalent in vets from all wars and peacetime service for many reasons.

The VA gives an extensive TBI C & P exam to determine any residuals from TBI.

thanks, Berta. had my psych appt today and psychiatrist is scheduling a tbi screening appt, which may or not include another mri. i guess the screening will determine if necessary. i think it will.

at my request, i had an mri back in mid-90s and neuropsychogist, i think, reported "no significant findings", but did make note of a small white spot on the mri. he called it a UBO, unidentified brain object, and pretty much told me there was nothing he could do except operate to determine its exact nature. i think he was joking while blowing me off, sending me to follow-up with ent clinic because I was tracking with them, also, to determine why i was having concentration and memory problems.

i have a copy of the mri report somewhere, (pretty sure my VARO has the original, but i discovered yesterday i had copied the BACKS of several of my service medical record pages from that time period, may have other copies in my extras pile)but recall it mentioned something about the location of the white spot being in the virchow-robbins space. i saw mention of that in the link in another thread about white brain matter posted by hadit member "time", allan, i think.

also, my psych doc today noticed that i seem to have excellent recall for many events and details from years ago, but my short-term memory from minutes to hours to days beforehand can be ridiculously forgetful. doc said that is a trait of anxiety. i understand that, but want to rule out tbi, which has many symptoms in common with anxiety and/or depression.

i remember now that another psych evaluator also said that anxiety in and of itself can produce symptoms of mental lethargy, forgetfullness, disorganization and other executive functions, but i am going to follow this up until i get some more up-to-date answers. i have long thought a pet-scan or realtime mri or such would be valuable in chronicling how my brain works, bloodflow, etc.

There is some association between TBIs and Virchow Robbins:

http://www.ncbi.nlm.nih.gov/pubmed/16403696

If they have ruled out vascular disease in arteries of the brain (in your case I am sure they did rule this out with the MRI etc)it would lead one to assume that this stems from a TBI you had.

Sometimes the residuals of TBI are very hard to assess.

VA must rate TBI residuals separately from any mental disability such as anxiety,depression, or PTSD.

Be advised, if the screening your schedualed for is or includes the TBI Screening Reminder program, you won't get past the first question. The screening is for OEF/OIF Veterans. It's the only VA TBI screening tool I'm aware of. It's the first question of the screening, and if the answer is no-no service in OEF or OIF the screening is over. An explaination of the screening with screenshots of the actuall screening program can be found here:

http://www.avapl.org/pub/2007Conference/TB...05-29-07.ppt#10 Microsoft power point required.

Someone else from Hadit had been schedualed for this screening and was turned away. I know some have had success with it but they may have been OEF/OIF veterans.

I also encourage anyone seeking a possible MTBI diagnoses to do so through neuro-psycholgical testing. 1. Using CT and MRI is usually futile. Advanced imaging such as SPECT or PET are still in the experimental phases(in my opinion) and it is very difficult to get a referal for them as they are costly and in high demand. 2. Even in the event that imaging finds something AND that it was caused by TBI, neuro-psych testing is the only way to determine functional impairment and thus get a decent rating. Check the regs, for a rating over a certain percentage(can't remember what percentage, something like 20%) for functional impairment in memory, attention and consentration must be backed up with objective testing. Might as well start out with the testing as it is more likely to prove TBI anyway. 3. Yes, MDD, Anxiaty, PTSD and others can and do cause problems with memory and ect. However, the results of neuro-psych testing can determine the difference between functional impairment due to mood disorder and functional impairment due to TBI. An example: me. For twelve years I complained of memory problems. For twelve years I was told I was depressed-the cause of the memory problems. In that twelve years I took two or three personality assessment tests(these tests are designed to find mood disorders and other psyciatric conditions) and none of them showed any substantial depression, anxiaty or anything else. For twelve years I was treated for depresion anyway. I finally heard about neuro-psych testing and wa-la! I have substantial cognative dissorder due to TBI. And what depression and anxiaty I have developed is Organic, directly caused by the TBI. My opinon is that any psyciatrist that has a patient with MDD and/or anxiaty with a history of concussion that does not order neuro-psych testing is not worth their salt. 4. My MRI's are all clean. This was used against me. Because the MRI's were clean, no one would pursue the TBI any further.

Note: In the link posted above, during the screening there must be a relationship to symptoms complaint and objective findings on, Neuro-psychological testing, Physical examination, Neurological examination.

I am an OEF/OIF intheater vet. I did not suffer concussion there, just dealing with symptoms that may have originated from a concussion. confusison, I suffered way back in 1982. The symptoms of fatigue, shorterm memoyr loss and lower exective functioniing, along with early bouts of anxiety/deppression began there and continued throughout my deployment and to this momemnt.

I am scheduled for a tbi screening with va psychologist friday, and separately with the tbi "specialist" end of month(i guess if i 'pass' go from that process), this according to my psychiatrist who i saw earlier this week. not sure how the two are connected but i will know more by the weekend. whether or not i am an oif/oef veteran (i am both) i don't see why that should factor in my receiving treatment, if in fact i can be screened in as having symptoms of mild tbi. i think i do and have in my service medical records from years ago trying to get to the bottom of the symptoms and have very thick medical records where i was routed through ent, psych, and even had the one mri that showed what may have been a white matter lesion and virchow-robin space irregularity. the smartass neuropsych doc called it a UBO, unidentified brain object (unless this is a real term they use) but although i have short-term memory loss problems i can remember certain things from way back like when i asked about a pet scan and he called them "university playtoys". that was around 1995. now i see there is a study being done by university hospital in st louis and would gladly offer my tired brain for eval.

Good Luck I have my fingers crossed

thanks pete, just got on my laptop (it had it's own tbi this a.m.) but i'm on way to the appt. thanks for seeming to always being around when i need a friend or support.

just an update in case anybody else is in similar situation with tbi screening process:

i had my tbi pre-screen (for cognitive functioning) with a psychologist (non-phd) this morning (friday) and for the most part i did ok. meaning that the little tests, which i told the examiner did not reflect day to day life, did not show any serious abnormalities in executive or frontal lobe damage. i was average in most categories with a slight lower in one (naming as many animals as i could in a minute or something). i did tell psychologist that while performing these that i believed that my mind had to work harder that it felt that i had to "wrench" more or less the information instead of it coming fluidly. i have another appointment on the 31st with, i think, a va/tbi specialist. i did mention a previously unreported with the docs this morning a concussion i had back in early 80s, a requirement to go to the next step, i guess, in possibly getting a follow-up mri and, who knows, maybe a pet scan or more state-of-the-art look at my brain functions.

i was in a pretty anxious, agitated state and the psychologist had to direct me to keep on track, but i got through the tests. what evolved was that i told psychologist that although i scored pretty "average" that i believed before the concussion i was "above average" in intelligence. i cited pre-service aptitude and functioning and even pre-concussion reputation as being a "super troop" who was thought very highly of. after the concussion my performance was not as consistently stellar and my military career was basically one of some high peaks and some very low lows.

all that to say, I KNOW i am a different person now, thank god i made it to retirement and got enough documented in my service medical records (thanks to the advice of my basic training sergeant; no thanks to his telling us that if we were suicidal go ahead, he didn't need us in his air force (i almost laugh about that but not really). but it was by no means easy. like i told the psych doc today, when i first complained about my memory, lack of concentration, lack of mental agility, etc and went through ent for sinusitus and mental health for psych reasons i was only trying to get to the bottom of things and become a better servicemember. and the only reason i went to va today was my continuing quest to get to the bottom, i mean i surfaced with chronic sinusitus and anxiety/depression issues and those were attributed to problems on the job, but WHERE did the real issue begin? i still believe the answer lies in tbd, even if i have somehow maintained a somewhat respectable cognitive functioning.

out_here04

Thanks for the update.

Just for general information purposes, my memory also tests in the normal range. However, I am required to have a fudiciary(the VA will not send me comp money it goes to my wife) because based on the whole of my test scores(complete neuro-psych testing) the evaluater stated "he might forget to pay his bills". My memory is horrible.

So how does my memory test normal, yet my memory is terrible? My "working memory" is horrible. It was explained to me like this.

I have slowed cognative proccessing. So while all the information of daily life like what my eyes, ears, and other sences, plus the other information like the things I'm thinking about, emotions and such all go to my brain, it is proccessed slowly. So if I walk into the house carrying my keys and set them on top of the TV, I might not be able to remember where I put them and they are lost. This is because with everything my brain is trying to keep up with, where I put my keys is never registered into my memory. Basically, I never knew I put my keys on the TV. I don't FORGET where I put them, I don't KNOW I even put them down.

I don't know if any of that was usefull to you or anyone. There is obviously more to it than that and I really don't understand all of it. But I can say without a doubt that my memory tests normal but is horrible and the full scale testing made believers out of the evaluators.

I hope you can get the answers your looking for through continued appointments.

Thanks, time. It does make a lot of sense to me. I have to put my keys and wallet in a cupboard next to a doorway into the kitchen on the way out. I really identify with a lot you just said. My credit is crap and I just recently went through a process with an IRS local tax advocate to settle up with 16 years of unfiled or unpaid back taxes. If the military would have known, I'm sure my security clearance would have been called into question. It was, in and of itself, a great source of anxiety and shame for me, but I am trying to recover from that, too. My wife had two moderate strokes in her 30s and was, understandably, kind of in the same boat with me in regards to getting things important done. Blind leading the blind comes to mind.

Googling from your suggestion about "neuro-psych testing" I ran across a 47-minute streaming video from:
Presented by Teri Horowitz, PhD at the "Diagnosis Brain Tumor- You Are Not Alone" conference at the Neuroscience Institute at JFK Medical Center, Edison, NJ Oct 15,2005. Sponsored by: Musella Foundation The Brain Tumor Society Central NJ Brain Tumor Support Group Monmouth & Ocean Brain Tumor Support Group

...that, while aimed towards brain tumors, does a great job, I think so far, of at least explaining the tbi testing environment.

It's at:

http://video.google.com/videoplay?docid=2020430531982062183

Thanks for the encouragement.

That video was a good find. She does a good job explaining much of it.

I saw allot of doctors in a number of years and maybe two of them believed I was having the problems I explained. The rest simply brushed me aside. When I went to the neuro-psych and got tested, she asked what my goals were(as the lady in the video explained). When I told her I wanted to continue voc-rehab she stiffened right up and suggested I file for SSI. School is not an option.

Anyway, with the testing, I am now believed about my symptoms. Now that I'm service connected for the cognative problems, I guess they can find no reason for me to be lieing about the dizziness, weakness, fatigue, headaches and everything else.

this coming monday i go to the tbi specialist doc. already had the pre-screen for cognitive, it seems a lot of the tests were done in that one. not sure what to expect next. maybe just a consult to see if further neuro psych tests are necesary, possibly mri or additional technological evalutaion. a little apprehensive. will update after i go.

Great video out_here04! I have had a Neuropsychological evaluation at the VA back in May. I can tell you that it was mentally exhausting! I didn't feel very smart afterwards.

I spoke with the doctor for an hour and the testing was two hours. The psychologist notes stated that "My overall profile is highly consistent with diagnosis of PTSD, anxiety disorder, and dysthymia. I filed a claimed for anxiety disorder last week.

On the neuropsyc test, I tested "average" in a lot of areas along with a few "low averages" and a few "high averages". I tested "mild hopelessness" under mood.

Do I stand a good chance of getting a rating for anxiety?

If you have a stressor you can prove,did you claim PTSD?

I assume but could be wrong that they gave you the MMPI testing?

Whatever disability you claim- you will need a nexus (link) to something in your service period that caused the disability.

They will only rate opne mential disorder although sometimes a vet can have PTSD with depression or anxiety with mood disorder.

They lump it all together for one Mental disability rating.

I need a little help. I don't know if any of these are stressors or if the VA will consider them stressors!

Stressor 1. When I was in the Navy during Operation Desert Storm, I saw dead Iraqi soldiers floating by our ship. One of them was even decapitated. 18 years later I can still visualize those images and it makes me nervous. I don't know how I can prove that I saw this though.

Stressor 2. During the war, the USS Tripoli and the USS Princeton were both struck by mines. Our ship was operating in the same area when those ships were damaged. During that same time, our ship also located and destroyed 3 mines by attaching 10 lbs of C-4 to them. I have the mines being detonated by our ship on tape. We operated out of Mine field 5 for 12 consecutive days. It was terrifying!

Stressor 3. Don't know if my skin disorder can be considered. I'm service connected for it. Its a full body skin rash. I only wear long sleeves and long pants. I no longer go swimming with my family because of how much attention and questions the rash bring. I'm very conscious of it and it bothers me a lot when others notice it. Some people even think I'm contagious.

Could either of these be considered a stressor?

Thanks

Ooops! I thought I had started a new thread! I didn't mean to hijack this one! Sorry! I will post in the general forum