TBI Combined With PTSD: How the VA Handles Overlapping Symptoms

Many veterans experience both traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) as a result of military service. These conditions often occur together, especially after combat exposure, explosions, or training accidents. They often share similar symptoms, which can make VA disability claims complicated and lead to underestimated or improperly assessed claims if the law is not applied correctly.

It is essential to understand how VA assesses TBI and PTSD in order to ensure that you receive all the benefits you are entitled to under federal law.

Understanding TBI and PTSD as Service-Connected Disabilities

Both TBI (traumatic brain injury) and PTSD (post-traumatic stress disorder) may qualify for service-connected disability compensation through the United States Department of Veterans Affairs if they are linked to military service. 

TBI is typically caused by a head injury, blast exposure, or rapid acceleration or deceleration forces, while PTSD is a mental health condition resulting from exposure to traumatic events such as combat, assault, or life-threatening situations. 

VA disability compensation is authorized under 38 U.S.C. § 1110 and provides benefits for injuries or diseases incurred or aggravated during active duty.

Why TBI and PTSD Symptoms Often Overlap

One of the biggest challenges in dealing with these conditions is that traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) share many symptoms. These include:

• Memory loss and concentration problems
• Irritability and mood swings
• Sleep disturbances
• Anxiety and depression
• Difficulty with executive functioning

Because of this overlap, the VA must be careful not to double-count the same symptoms. This is known as pyramiding, which is prohibited under 38 C.F.R. § 4.14. Avoiding pyramiding does not mean that veterans are limited to a single rating, but rather the VA should properly evaluate which symptoms belong to which condition and rate them accordingly.

How the VA Rates TBI

TBI is assessed under 38 C.F.R. § 4.124a, Diagnostic Code 8045. This regulation requires the VA to evaluate three main areas of impairment: cognitive impairment (memory, attention, judgment), emotional/behavioral dysfunction, and physical dysfunction (headaches, vision issues, balance problems).

Importantly, the regulation instructs the VA to separately assess residuals of TBI that can be clearly differentiated from other conditions.

How the VA Rates PTSD

PTSD is rated under the Veterans Affairs’ mental health schedule, specifically in 38 CFR § 4.130. The rating ranges from 0% to 100%, based on occupational and social impairment.

When PTSD and TBI occur together, the VA needs to determine whether emotional and cognitive symptoms are caused by PTSD, TBI, or a combination of both. If the symptoms cannot be distinguished medically, the VA has to assign them to the condition that leads to the highest evaluation in order to protect the veteran’s benefits.

Separate Ratings Are Still Possible

Veterans may receive separate ratings for traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), when medical evidence shows distinct symptoms. For example, PTSD may be rated based on anxiety, depression, and trauma-related symptoms, while TBI may be separately rated for headaches, seizures, vision problems or balance issues. 

The Veterans Affairs (VA) are required to follow the medical opinions of experts when distinguishing between these conditions. Failure to do so could lead to an incorrect decision about a veteran’s disability rating.

Common VA Errors in TBI and PTSD Claims

Unfortunately, VA rating decisions sometimes contain errors. These errors can include:

• Incorrectly combining TBI and PTSD to give a low rating.
• Ignoring the physical effects of TBI.
• Misapplying the pyramiding rules.
• Failing to conduct adequate medical examinations.

Veterans have the right to appeal these decisions under 38 U.S.S. § 7105.

Protecting the Benefits You Earned

Veterans who suffer from both traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) often experience greater functional impairment than those who have either condition separately. The law acknowledges this, but only if it is applied correctly.

If you believe that the VA has not properly evaluated your traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), or overlapping symptoms, you don’t have to fight the system alone. Veterans Benefits Law Group, PLLC, is here to help you navigate the complex process and pursue full compensation for your service.
Contact us today to schedule a free consultation and take the first step towards securing the benefits you deserve.