VA relaxes rules for benefits for TBI-related illnesses
By LEO SHANE III | STARS AND STRIPES Published: December 7, 2012
WASHINGTON – Veterans Affairs officials are pushing to ease the rules for benefits regarding certain illnesses connected to traumatic brain injury, in an effort to get those injured veterans quicker payouts and less cumbersome access to treatment.
The department has begun the process of adding five illnesses -- unprovoked seizures, dementia, Parkinsonism, some hormone deficiencies and depression -- as “secondary” illnesses connected to a proven TBI injury.
The rule change, announced Friday, would automatically qualify those diagnoses as service-connected conditions, without the need of extra paperwork and review. In a statement, VA Secretary Eric Shinseki said the decision was based on “the best science available” and the most helpful path for injured veterans.
“Veterans who endure health problems deserve timely decisions based on solid evidence that ensure they receive benefits earned through their service to the country,” he said.
Researchers from the National Academy of Sciences’ Institute of Medicine have found relationships between brain trauma and the other illnesses, which prompted the move by VA officials. The rule change will be under public review for 60 days before a final policy is set.
VA officials could not say how many veterans might be helped by the change, but it could easily cover tens of thousands of returning war veterans. Earlier this week, in comments at Walter Reed National Military Medical Center, Defense Secretary Leon Panetta said nearly 250,000 servicemembers have suffered a traumatic brain injury since 2001.
Veterans Health Administration records show that about 51,000 veterans from the Iraq and Afghanistan wars are being treated for traumatic brain injury, but health experts for years have said that moderate TBI may be vastly underreported.
Earlier this year, researchers from Boston University working with VA medical experts found that even mild concussions can lead to long-term problems with brain trauma and related chronic mental problems.
VA officials have made diagnosing and treatment of TBI, post-traumatic stress disorder and other “invisible” wounds of war a focus in recent years. The department has added about 1,900 staffers since the spring to help reduce wait times for mental health care and provide more thorough exams of those patients.
But the department has also been stymied all year in their efforts to decrease their massive backlog of disability claims. Since July, the number of disability claims pending for more than 125 days has remained at nearly 600,000 cases. In fiscal 2012, the average VA pension or compensation claim took more than 260 days to complete.
Much of that backlog problem stems from thousands of new claims brought in 2010, when the VA eased rules related to presumptive illness linked to Agent Orange exposure. Almost 250,000 veterans eligible for compensation and health care flooded the benefits system in response.
VA officials don’t anticipate the same situation with the new rule change, because the secondary illnesses still require an existing TBI diagnosis. The Agent Orange change was much more dramatic, allowing many veterans with illnesses to file a claim for the first time.
Officials did not provide any estimates on how much the change will cost in new payouts or medical care.