Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans (2019) / Chapter Skim
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5 Summary and Recommendations
5 Summary and Recommendations
Pages 97-104
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From page 97... ...
A determination of the adequacy of the tools and protocols used by the Department of Veterans Affairs to provide examinations; and (B) A determination of which credentials are necessary for health care specialists and providers to perform such portions of such examinations that relate to an assessment of all disabling effects.
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From page 98... ...
Screening instruments vary in the extent to which their psychometrics have been established, with single-item screens tending to be the least reliable and to be unlikely to capture all TBIs. Many mTBIs incurred during deployment are not evaluated at the time of injury and must be evaluated retrospectively, typically with the Brief Traumatic Brain Injury Screen, a four-item measure that is typically completed upon return from deployment as part of a comprehensive health screening.
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From page 99... ...
The committee believes that it is the training and experience and not necessarily the specialty that renders a health care professional capable of an accurate diagnosis. The committee recommends that the Department of Veterans Affairs allow health care professionals who have specific traumatic brain injury (TBI)
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From page 100... ...
convene experts from both the Veterans Health Administration and the Veterans Benefits Administration, including clinicians who diagnose and assess residuals of traumatic brain injury (TBI) , to regularly update the VA Schedule for Rating Disabilities and disability benefits questionnaire for residuals of TBI to better reflect the current state of medical knowledge.
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From page 101... ...
The committee recommends that the Department of Veterans Affairs provide Veterans Benefits Administration contractors with the same training and access to medical records as Veterans Health Administration clinicians in order to ensure equitable disability determinations for all veterans. ADEQUACY OF THE ADJUDICATION PROCESS The committee was tasked with evaluating the "adequacy" or quality of the adjudication process for impairments resulting from TBI.
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From page 102... ...
The committee recommends that the Department of Veterans Affairs institute processes and programs to measure the reliability and validity of the adjudication process, identify opportunities for improvement in the quality of outcomes, and implement modifications of the adjudication process as needed to optimize the quality of both the adjudication process and the reliability and validity of the outcomes.
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From page 103... ...
Shifting from a focus on the consistency of the process (e.g., for the rating step in disability determination) and on practitioner qualifications to a focus on the accuracy of the outcome of the evaluation is intended and expected to identify steps or components in the disability evaluation process that warrant improvement.
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