Association of Clinical TBI Severity and Military Factors With Veteran TBI Service-Connected Disability Ratings and Total Compensation: A Long-Term Impact of Military Brain Injury Consortium (LIMBIC) Study.
Clara E Dismuke-Greer, Aryan Esmaeili, Mary Jo Pugh, Terri K Pogoda, Megan Amuan, David X Cifu
{"title":"Association of Clinical TBI Severity and Military Factors With Veteran TBI Service-Connected Disability Ratings and Total Compensation: A Long-Term Impact of Military Brain Injury Consortium (LIMBIC) Study.","authors":"Clara E Dismuke-Greer, Aryan Esmaeili, Mary Jo Pugh, Terri K Pogoda, Megan Amuan, David X Cifu","doi":"10.1097/HTR.0000000000001052","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To understand how traumatic brain injury (TBI) clinical severity and military factors were associated with the likelihood of receiving a TBI service-connected disability (SCD) determination and monthly total SCD compensation among Veterans.</p><p><strong>Setting: </strong>Veterans Health Administration (VHA) and Veterans Benefits Administration (VBA).</p><p><strong>Participants: </strong>1 319 590 veterans with a VBA SCD rating who entered the VHA between October 1, 2000, and September 24, 2019.</p><p><strong>Design: </strong>This retrospective study analyzed the association of TBI severity and military factors with a TBI SCD determination, TBI SCD rating percentage, and monthly total SCD compensation. Administrative VHA and VBA records were utilized.</p><p><strong>Main measures: </strong>Any TBI SCD determination, TBI SCD rating percentage, and monthly SCD compensation.</p><p><strong>Results: </strong>93 911 (7.1%) Veterans had an SCD rating for TBI. TBI SCD increased monthly total compensation by $362 (95% CI 353, 370) in bivariate and $45 (95% CI 38, 52) in adjusted models. Females had lower TBI SCD percentage (-3.03; 95% CI -3.92, -2.14) but higher monthly compensation ($37; 95% CI 33, 42). TBI severity was associated with increasing TBI SCD percentage and monthly SCD compensation. In adjusted models, deployment (-2.36; 95% CI -3.02, -1.69) was associated with lower TBI SCD percentage but not monthly compensation, while combat exposure was not associated with TBI SCD percentage but was associated with higher compensation ($46; 95% CI 40, 53).</p><p><strong>Conclusion: </strong>TBI severity was significantly associated with TBI SCD determination and TBI SCD rating percentage, in addition to overall SCD compensation. Although deployment was significantly associated with TBI SCD determination, non-deployment was associated with higher TBI SCD percent ratings. These results may be explained by TBI occurring in non-deployment military settings, such as training. This highlights the need to study risk for TBI in the general military environment to ensure that all military-related TBI exposures are recognized and that any related disability is appropriately compensated.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Head Trauma Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HTR.0000000000001052","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To understand how traumatic brain injury (TBI) clinical severity and military factors were associated with the likelihood of receiving a TBI service-connected disability (SCD) determination and monthly total SCD compensation among Veterans.
Setting: Veterans Health Administration (VHA) and Veterans Benefits Administration (VBA).
Participants: 1 319 590 veterans with a VBA SCD rating who entered the VHA between October 1, 2000, and September 24, 2019.
Design: This retrospective study analyzed the association of TBI severity and military factors with a TBI SCD determination, TBI SCD rating percentage, and monthly total SCD compensation. Administrative VHA and VBA records were utilized.
Main measures: Any TBI SCD determination, TBI SCD rating percentage, and monthly SCD compensation.
Results: 93 911 (7.1%) Veterans had an SCD rating for TBI. TBI SCD increased monthly total compensation by $362 (95% CI 353, 370) in bivariate and $45 (95% CI 38, 52) in adjusted models. Females had lower TBI SCD percentage (-3.03; 95% CI -3.92, -2.14) but higher monthly compensation ($37; 95% CI 33, 42). TBI severity was associated with increasing TBI SCD percentage and monthly SCD compensation. In adjusted models, deployment (-2.36; 95% CI -3.02, -1.69) was associated with lower TBI SCD percentage but not monthly compensation, while combat exposure was not associated with TBI SCD percentage but was associated with higher compensation ($46; 95% CI 40, 53).
Conclusion: TBI severity was significantly associated with TBI SCD determination and TBI SCD rating percentage, in addition to overall SCD compensation. Although deployment was significantly associated with TBI SCD determination, non-deployment was associated with higher TBI SCD percent ratings. These results may be explained by TBI occurring in non-deployment military settings, such as training. This highlights the need to study risk for TBI in the general military environment to ensure that all military-related TBI exposures are recognized and that any related disability is appropriately compensated.
目的：了解创伤性脑损伤（TBI）临床严重程度和军事因素与退伍军人接受TBI服务相关残疾（SCD）鉴定和每月SCD总赔偿的可能性之间的关系。设置：退伍军人健康管理局（VHA）和退伍军人福利管理局（VBA）。参与者：2000年10月1日至2019年9月24日期间进入VHA的1319590名具有VBA SCD评级的退伍军人。设计：本回顾性研究分析了TBI严重程度和军事因素与TBI SCD测定、TBI SCD评定百分比和每月总SCD补偿的关系。利用VHA和VBA管理记录。主要措施：任何TBI SCD测定，TBI SCD评级百分比，每月SCD补偿。结果：93911例（7.1%）退伍军人有创伤性脑损伤的SCD评分。在双变量模型中，TBI SCD使每月总薪酬增加362美元（95% CI 353,370），在调整模型中增加45美元（95% CI 38,52）。女性较低的TBI SCD百分比(-3.03；95% CI -3.92, -2.14)，但每月薪酬更高(37美元；95% ci 33,42)。TBI严重程度与TBI SCD百分比和每月SCD补偿增加有关。在调整后的模型中，部署(-2.36；95% CI -3.02, -1.69)与较低的TBI SCD百分比相关，但与每月薪酬无关，而战斗暴露与TBI SCD百分比无关，但与较高的薪酬相关($46；95% ci 40,53)。结论：除了总体SCD补偿外，TBI严重程度与TBI SCD测定和TBI SCD评分百分比显著相关。尽管部署与TBI SCD测定显著相关，但未部署与更高的TBI SCD评分相关。这些结果可以解释为在非部署军事环境中发生的创伤性脑损伤，例如训练。这突出表明有必要研究一般军事环境中创伤性脑损伤的风险，以确保所有与军事有关的创伤性脑损伤暴露得到确认，并确保任何相关的残疾得到适当补偿。
期刊介绍：
The Journal of Head Trauma Rehabilitation is a leading, peer-reviewed resource that provides up-to-date information on the clinical management and rehabilitation of persons with traumatic brain injuries. Six issues each year aspire to the vision of “knowledge informing care” and include a wide range of articles, topical issues, commentaries and special features. It is the official journal of the Brain Injury Association of America (BIAA).
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
