TY - JOUR
T1 - Understanding the impact of mild traumatic brain injury on veteran service-connected disability
T2 - results from Chronic Effects of Neurotrauma Consortium
AU - Dismuke-Greer, Clara Elizabeth
AU - Nolen, Tracy L.
AU - Nowak, Kayla
AU - Hirsch, Shawn
AU - Pogoda, Terri K.
AU - Agyemang, Amma A.
AU - Carlson, Kathleen F.
AU - Belanger, Heather G.
AU - Kenney, Kimbra
AU - Troyanskaya, Maya
AU - Walker, William C.
N1 - Publisher Copyright:
© 2018, © 2018 Taylor & Francis Group, LLC.
PY - 2018/8/24
Y1 - 2018/8/24
N2 - Objectives: Disability evaluation is complex. The association between mild traumatic brain injury (mTBI) history and VA service-connected disability (SCD) ratings can have implications for disability processes in the civilian population. We examined the association of VA SCD ratings with lifetime mTBI exposure in three models: any mTBI, total mTBI number, and blast-related mTBI. Methods: Participants were 492 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans from four US VA Medical Centers enrolled in the Chronic Effects of Neurotrauma Consortium study between January 2015 and August 2016. Analyses entailed standard covariate-adjusted linear regression models, accounting for demographic, military, and health-related confounders and covariates. Results: Unadjusted and adjusted results indicated lifetime mTBI was significantly associated with increased SCD, with the largest effect observed for blast-related mTBI. Every unit increase in mTBI was associated with an increase in 3.6 points of percent SCD. However, hazardous alcohol use was associated with lower SCD. Conclusions: mTBI, especially blast related, is associated with higher VA SCD ratings, with each additional mTBI increasing percent SCD. The association of hazardous alcohol use with SCD should be investigated as it may impact veteran health services access and health outcomes. These findings have implications for civilian disability processes.
AB - Objectives: Disability evaluation is complex. The association between mild traumatic brain injury (mTBI) history and VA service-connected disability (SCD) ratings can have implications for disability processes in the civilian population. We examined the association of VA SCD ratings with lifetime mTBI exposure in three models: any mTBI, total mTBI number, and blast-related mTBI. Methods: Participants were 492 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans from four US VA Medical Centers enrolled in the Chronic Effects of Neurotrauma Consortium study between January 2015 and August 2016. Analyses entailed standard covariate-adjusted linear regression models, accounting for demographic, military, and health-related confounders and covariates. Results: Unadjusted and adjusted results indicated lifetime mTBI was significantly associated with increased SCD, with the largest effect observed for blast-related mTBI. Every unit increase in mTBI was associated with an increase in 3.6 points of percent SCD. However, hazardous alcohol use was associated with lower SCD. Conclusions: mTBI, especially blast related, is associated with higher VA SCD ratings, with each additional mTBI increasing percent SCD. The association of hazardous alcohol use with SCD should be investigated as it may impact veteran health services access and health outcomes. These findings have implications for civilian disability processes.
KW - Concussion
KW - disability evaluation
KW - military veterans
KW - traumatic brain injury
KW - veterans disability claims
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U2 - 10.1080/02699052.2018.1482428
DO - 10.1080/02699052.2018.1482428
M3 - Article
C2 - 29889561
AN - SCOPUS:85048357649
SN - 0269-9052
VL - 32
SP - 1178
EP - 1187
JO - Brain Injury
JF - Brain Injury
IS - 10
ER -