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Granted an Earlier Effective Date for TBI, But Not as Early as Hoped

Learn how a veteran secured an earlier effective date for their TBI rating, but faced challenges getting an even earlier date due to unappealed claims.

What Happened

The veteran served on active duty from October 1987 to January 1992. Their journey with VA claims for a brain injury began in September 1993 with a claim for a skull fracture, which was denied in October 1994. This decision was not appealed and became final. In October 2002, the veteran requested reconsideration of the skull fracture claim, but it was again denied in December 2002, and again, no appeal was filed. The current claim for service connection for a "brain lesion" was submitted in August 2010. This claim eventually led to service connection for residuals of a traumatic brain injury (TBI), including memory loss, with an initial effective date that was later determined to be August 30, 2010. The veteran continuously pursued this claim since August 2010, eventually appealing a March 2022 rating decision to the Board of Veterans' Appeals (BVA) in December 2022. The veteran elected the Evidence Submission docket, meaning the BVA could only consider evidence submitted by specific deadlines. The BVA reviewed the case, specifically focusing on whether the veteran was entitled to an effective date prior to October 29, 2021, for their 10 percent TBI rating. The Board ultimately granted an effective date of August 30, 2010, for the 10 percent disability rating for TBI residuals. This date was prior to October 29, 2021, fulfilling the specific request in the Order. However, the BVA denied an effective date earlier than August 30, 2010, concluding that the criteria for such an earlier date had not been met. The Board also found that the evidence only supported a 10 percent rating, "but no higher," for the period since August 30, 2010, indicating that the TBI residuals manifested no more than "level 1" impairment of mild memory loss during that time.

Why the VA Denied It

What Would Have Won

To have secured an effective date earlier than August 30, 2010, the veteran would have needed to demonstrate continuous pursuit of their claim from an earlier point. This means appealing the initial skull fracture denials in 1994 and 2002. If those appeals had been filed and maintained, and the connection between the skull fracture and the TBI residuals (like memory loss) had been established, the effective date could potentially have been much earlier, possibly even tied to their separation from service if the claim was filed within one year. Alternatively, if the August 2010 claim was the first time TBI residuals were formally claimed, the veteran would have needed to show that the disability (or an increase to the 10% level) became "factually ascertainable" within one year before August 2010. The BVA found it manifested more than one year prior, thus limiting the effective date to the claim receipt date. To achieve a rating higher than 10 percent for TBI residuals, the veteran would need to provide new and relevant medical evidence demonstrating a higher level of impairment under Diagnostic Code 8045. The BVA specifically noted that the evidence only supported "level 1" impairment (mild memory loss) for the period on appeal. A winning strategy for a higher rating would involve a comprehensive TBI examination by a qualified medical professional, clearly documenting the severity of cognitive, emotional/behavioral, or physical dysfunctions. This examination should address the 10 facets of TBI listed in 38 C.F.R. § 4.124a and assign a level of severity (0, 1, 2, 3, or Total) for each. For example, if the veteran's memory loss was more severe, impacting daily routine or requiring supervision, it could warrant a higher level of impairment and thus a higher percentage rating. This new evidence would then need to be submitted via a Supplemental Claim (VA Form 20-0995). The veteran should also consider obtaining a medical opinion (nexus letter) from an independent expert that directly addresses the severity of their TBI residuals and how they meet the criteria for a higher rating under DC 8045, specifying the period for which this higher level of impairment existed. Without clear medical documentation linking current symptoms to a higher level of impairment as defined by VA regulations, it's difficult to overcome the "no higher" than 10% finding.

The Rule From This Case

Continuously appealing denied claims and submitting new, relevant medical evidence that directly addresses VA's rating criteria are essential for securing the earliest possible effective date and the highest deserved disability rating.

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