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Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans (2019) / Chapter Skim
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Appendix D: DBQ Initial Evaluation of Residuals of Traumatic Brain Injury (I-TBI) Disability
Pages 119-126

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 119...
... : Traumatic brain injury (TBI) ICD code: _________ Date of diagnosis: _____ Other diagnosed residuals attributable to TBI, specify: _________ Other diagnosis #1: _________ ICD code: _________ Date of diagnosis: _________ Other diagnosis #2: _________ ICD code: _________ Date of diagnosis: _________ Other diagnosis #3: _________ ICD code: _________ Date of diagnosis: _________ Other diagnosis #4: _________ ICD code: _________ Date of diagnosis: ______________ 1 Published by the Department of Veterans Affairs.
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From page 120...
... Veterans Health Administration medical records (CPRS treatment records) Civilian medical records Military service treatment records Military service personnel records Military enlistment examination Military separation examination Military post-deployment questionnaire Department of Defense Form 214 separation document Previous disability decision letters Correspondence and non-medical documents related to condition Interviews with collateral witnesses (family and others who have known the Veteran before and after military service)
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From page 121...
... Objective evidence on testing of severe impairment of memory, attention, concentration, or executive functions resulting in severe functional impairment. If the Veteran has complaints of impairment of memory, attention, concentration or executive functions, describe (brief summary)
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From page 122...
... May be unable to touch or name own body parts when asked by the examiner, identify the relative position in space of two different objects, or find the way from one room to another in a familiar environment. If the Veteran has impaired visual spatial orientation, describe (brief summary)
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From page 123...
... If the Veteran has any neurobehavioral effects, describe (brief summary)
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From page 124...
... Unable to communicate basic needs. If the Veteran is not able to communicate by or comprehend spoken or written language, describe (brief summary)
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From page 125...
... Yes No If yes, describe (brief summary)
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From page 126...
... Are there any other significant diagnostic test findings and/or results? Yes No If yes, provide type of test or procedure, date and results (brief summary)
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Key Terms

  • traumatic brain
  • written language
  • brain injury
  • subjective symptoms
  • neurobehavioral effects

  • spoken language
  • motor activity
  • executive functions
  • complete appropriate
  • comprehend spoken

  • impaired judgment
  • functional impairment
  • functions resulting
  • severely impaired
  • moderately severely

  • decreased due
  • treatment records
  • pertinent physical
  • communicate complex
  • military service

  • visual spatial
  • repeat testing
  • appropriate questionnaire
  • functional status
  • unfamiliar decisions

  • physical findings
  • residuals attributable
  • complex ideas
  • current functional
  • diagnostic test


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