Professor Stacey-Rae Simcox Stetson University College of Law Director, Veterans Advocacy Clinic

Transcription

1 Professor Stacey-Rae Simcox Stetson University College of Law Director, Veterans Advocacy Clinic

2 To assist veterans with filing claims for VA disability compensation/pension benefits Serve the veterans who are most in need Select the cases that will provide best training value for the students Help active duty members in medical retirements To inform veterans about available benefits via educational outreach 2

3 Traumatic Brain Injury (TBI) Injury that disrupts the normal function of the brain Results from damage to brain tissue due to an external force Post Traumatic Stress Disorder (PTSD) a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.

4 : 321,454 servicemembers suffered a TBI 83% are mild TBIs (mtbis) Combat vets from Iraq and Afghanistan: mtbi = 15-30%

5 Explosions Vehicle Roll-overs IEDs/Vehicles Body Armor

6

7 DoD 2012: DoD standardizes TBI evaluations in theater. ú mtbi vs. moderate/severe ú MACE assessment ú Mandatory rest PDHA/PDHRA VA 2007 = mandatory screening.

8 32,822 Pre-2012 in combat theater Symptoms of mtbi Lost Diagnosis Failure of PDHA Failure of Command Failure to Report Co-morbidity

9 Studies of troops who deployed to Iraq and Afghanistan have found that service members who have suffered a concussion or mild traumatic brain injury are far more likely to develop PTSD, a condition that can cause flashbacks, nightmares and severe anxiety for years after a traumatic event.

10 Symptoms: Irritability Sleep problems Depressed mood Anxiety Memory deficits Attention problems Headaches Dizziness Balance problems Fatigue Symptoms Irritability Sleep problems Depressed Mood Anxiety Memory Deficits Attention problems Intrusive Thoughts Hypervigilence

11 No Treatment Misconduct Alcohol abuse/drug abuse/prescription abuse Violence Poor Judgment Bad Paper Discharges Military Catch-22

12 VA Benefits Bad Paper Discharges Lack of Service-Connection Lack of Adequate Medical Evaluations/Misdiagnosis Other Benefits

13 Staff Sergeant Jones, U.S. Army: Before deployment received the highest ratings on his evaluations Deployed to Iraq: 12/8/2007 1/10/2009 Assigned to 2d Stryker Brigade Combat Team, Camp Taji, Iraq.

14

15

16

17 IED SSG Jones sees stars and blacks out Fellow soldier SPC Smith: SSG Jones had scrapes on his helmet from the impact and didn t seem to be himself following the incident. All soldiers in the Stryker suffering headaches. Evaluated and treated with ibuprofen. Platoon leader: There were no formal procedures to determine if a Soldier had a traumatic brain injury. SSG Jones was given only a routine examination following the incident and did not receive any in-depth exam.

18 SSG Jones symptoms continue. January, 2009: He redeploys back to U.S. Fills out PDHA Indicates he had been in IED explosion Indicates dazed after incident, sleeping problems, irritability. Does not check the box next to knocked out. Health care provider: SSG Jones has potential for TBI with persistent symptoms. No referral for further evaluation.

19 SSG Jones returns to US and begins to receive his first ever Marginal ratings on evaluations. January, 2010: Transfers to the Old Guard at Fort Meyer. Earned the nickname Crazy Joe. Fellow soldier at Old Guard: He was like an adolescent child. He would talk to us and get lost in mid-conversation and just wander off. It was kind of sad at times, but we all respected him and tried to just joke about it to keep him from getting embarrassed. We called him Crazy Joe. He would have severe headaches, forget things, lose focus, space out completely

20 Team Leader at the Old Guard: It would take SSG Jones two weeks to learn routines other Soldiers would learn in a couple of days. He usually had problems. I remember once SSG Jones went completely in the wrong direction during a funeral procession and then started going in circles. One of the younger Soldiers who didn t know any better followed right behind him. These problems were the rule and not the exception.

21 January 2011: SSG Jones has a sleep study for sleep apnea. During this study the doctors determine that he should be referred to mental health/neurology. February, 2012: first appointment with the Traumatic Brain Injury Department at Fort Belvoir. Immediate diagnosis of mtbi. Occupational therapist notes specific TBI symptoms include: visual impairment and slurred speech. Also notes: constantly losing things, forgetting things, can no longer comprehend what he is reading, zoning out, chronic headaches, mood changes, sleep problems, dizziness, tingling in the hands, ringing in the ears. April, 2012: transfer to the WTU

22 Chief of TBI at Fort Belvoir: confluence of TBI and PTSD symptoms create a complex interaction. SSG Jones TBI denied initially for medical retirement. Previous Unit puts SSG Jones and others injured during the Stryker explosion in for a Purple Heart for TBI Requires that loss of consciousness occurred, restriction from full duty due to symptoms of TBI, and impaired brain function for a period greater than 48 hours. Denied by Army. No contemporaneous evidence and did not acknowledge he was knocked out by IED.

23 mtbis in our servicemembers and veterans are still underdiagnosed and often misdiagnosed Information, outreach, and understanding

24