Objective evidence - Neuropsych test

EOD08

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After the VA gave me a hard time about my neuropsychology test not being objective evidence, I contacted the Defense Veterans Brain Injury Center (DVBIC) for clarification and this is what I was told. BLUF, the test is objective evidence. The VA said I only had subjective memory, concentration, processing issues, while the examiner stated I had severe issues.

"Hello Mr. XXXXXX:

Neuropsychological tests are objective measures of cognitive functioning and related factors relevant to questions of neurological health and illness. Domains typically assessed include attention, speed of information processing, memory, executive functioning, language, and visuospatial functions. Neuropsychologists use neuropsychological tests along with other assessment methods including a clinical interview to interpret test results and draw conclusions about the factors negatively impacting cognitive functioning including disease, injury, emotional status, and individual pre-morbid characteristic. functioning. Neuropsychological evaluation is a standard of care for moderate to severe traumatic brain injury and is recommended for those who sustain mild traumatic brain injury if symptoms persist beyond the acute phase of recovery.

We hope this response was helpful to you and thank you for contacting DVBIC.org

Very respectfully,

XXXXXXXXX Ph.D."
 
Even if they think it is subjective, shouldn't be the problem. Many symptoms are subjective, almost all tinnitus is subjective and that is the most common rating granted. Subjective isn't a problem unless they feel you are somehow unreliable or there is some other problem with the evidence. If they are going to say its too subjective, I'd also demand they say you are unreliable to report subjective symptoms. That should make it sink like a stone I think. They have to provide some pretty clear rational for you to be unreliable.
 
There is more than a couple ways that are used to assess the residuals of TBI, for the purpose of keeping this short I'm going to share two common ones: MoCA and the RBANS.

Montreal Cognitive Assessment (MoCA): short exam, easy to conduct, takes about 10 minutes to administer, no additional resources needed beyond a writing instrument and a piece of paper, somewhat the abbreviated version of the next test.

Repeatable Battery for Neuropsychological Status (RBANS): longer exam, focus' on six areas and consist of 25 subtests, more in depth, results and performance is able to be cross referenced to detect abnormalities such as intentional skewing etc, is considered the gold standard for the purpose of neuropsychological testing.

RBANS was initially established to screen for dementia in our older population but has blossomed into more than just a test for dementia.

For anyone who has or will be administered the RBANS, ensure you have a personal copy of the results and a backup, hopefully this impresses upon you importance and the value of the test.

This does not take into account other exams such as xrays, MRIs, vestibular, nystagmus, balance, gait etc.

EOD - perhaps the individual who said is not objective needs to be tested for MJ, their response is more full of hot air than car full of Rastafarians.
 
Great to know! My PEB attorney totally agrees. They submitted a VARR for my TBI for a 2nd look at the cognitive issues.

Thanks!
 
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