In the March 4th edition of the American Speech-Language-Hearing Association newsletter Leader, Angela Foehl, Director of Private Health Plans Advocacy, reports on new ratings proposed for Veterans’ suffering from Traumatic Brain Injury. She shares that the proposed ruling would allow medical records from speech-language pathologists and audiologists to become evidence in VA claims. The new rule, proposed on Jan 3, would rename the Diagnostic Code 8045 in the VA Schedule for Rating Disabilities as “residuals of traumatic brain injury” in lieu of “brain disease to trauma”, what does this really mean? More money. The revision would allow for higher disability ratings ergo higher levels of compensation for those individuals suffering from TBI.
Furthermore the new ruling will provide codes for Hearing, and Cognitive Impairment. A diagnosis of hearing impairment will require testing conducted by a state-licensed audiologist, and “is rated with a matrix to calculate the combined disabling effect from the effected ears. Cognitive impairments and subjective clusters of symptoms will be rated under DC 8045, if separable from signs and symptoms of other, rated TBI disorders. . . the VA proposes to rate TBI residuals under either objectively demonstrable cognitive impairments of subjective ‘symptoms cluster’”.
Cognitive Impairment will be split into categories, such as speech-language and writing disorders, with numerous severity levels. Foehl (2008) writes:
ASHA states they provided recommendations about the lack of linguistic precision in the proposed regulation and various technical aspects of the proposed TBI rating methods. ASHA disagrees with the VA’s structural framework to evaluate cognitive impairment, especially the criteria for speech and language disorders, which are grouped into the broader category of speech, spoken language, and written language impairment.
ASHA’s position is that rating criteria for those disorders should be in separate categories, stratified by components. More specific criteria would allow a more precise, uniform rating approach and would reduce numbers of appeals. ASHA suggest that the VA use standard assessment tools for speech and language disorders – specifically ASHA’s function communication measures, used in the national outcomes measurement system data collection system – to more accurately evaluate speech and language disorders by scaled levels with precisely graded criteria.
Foehl, Angela. (2008). New ratings proposed for veterans’ TBI. The ASHA