"Traumatic Brain Injury Mistaken for PTSD," Says Iraq Veteran

Turlock, CAMarcel was on patrol in Iraq when a roadside bomb hit his vehicle. He was lucky to be alive, and no one was killed that day. He was later diagnosed with a traumatic brain injury, however, and was recently assessed by Veterans Affairs as 100 percent disabled. To this day, Marcel suffers from severe migraines and dizziness.

"I was the gunner in the second vehicle when a bomb landed in between our two Humvees," says Marcel. "I didn't see or hear the explosion and I don't even know how I got out of the vehicle; the first thing I remember is sitting on the ground.

"I was dazed but I do remember a pain and burning sensation on my neck, then a medic came over. He checked me out and said I had a shrapnel burn on my neck and he put a field dressing on it. Once we all went back to base, I went to the troop medical centre. The doctor checked me out, verified the burn and said that I probably suffered a concussion from the blast."

Marcel wasn't concerned about the concussion. But the next day he went back to the doctor to get something for a headache, which was getting worse. He got home from Iraq in 2006 and filled out all the necessary VA compensation forms. "I told them about my symptoms and my loss of duty report that said I was hit by a roadside bomb," says Marcel.

"Veterans Affairs immediately assumed that my headaches came from post traumatic stress disorder (PTSD) because the symptoms are almost the same as traumatic brain injury, but TBI is a bit more defined; for instance, migraines and dizziness are different." Marcel is correct: It is common to confuse TBI and PTSD because the symptoms are so similar. To make things even more confusing, many TBI patients also develop PTSD. It comes as no surprise that Marcel received VA benefits for PTSD on his first assessment.

"It didn't really matter what I was compensated for but I wanted it on record that I have TBI," says Marcel. "That way the military knows the brain injury came from combat-related injuries and not from my regular, civilian job—I worked for a security company before I went to Iraq. Say you get punched in the head a few times working as a security guard in an apartment complex or a bouncer in a club; I didn't have this TBI before I went to Iraq. And that makes a difference on my benefits claim…

"And TBI is the least recognized injury. I know lots of vets who have TBI but they don't want it known because a lot of employers won't hire TBI victims. For example, The National Guard and Reserve guys have jobs to come back to, but if it's known that they have TBI, they'll get cut loose from their job or maybe just get hired to work 20 hours per week. Sometimes it doesn't matter to the employer if you are disabled. They don't want to take the risk that something might happen to you at work."

Marcel now has a "house-bound" rating from the VA due to his TBI, which means that he cannot work alone in case he gets a migraine or dizziness. Of course this makes it harder for him to find employment.

The VA assessed Marcel again in 2009 and he was rated 100 percent disabled, up from 60 percent from his previous assessment.

"I had a MRI but they couldn't find anything wrong—TBI is soft tissue damage," Marcel explains. "So I had a lot of psychological tests and the VA sent me to a neurologist. He did cognitive and memory tests. As soon as I walked into his office he asked if I knew the right side of my face droops a bit. He said it was more than likely caused by the roadside bomb—I had nerve damage on the side of my face. I didn't notice but my wife had. I asked her that night and she had known but didn't say anything to me; she didn't want me to worry. But I know I have experienced personality changes.

"My migraines will continue because of nerve damage in that part of the body—they are not due to stress. I found out that TBI, no matter how mild the condition, can go unfounded for decades; you may not even know that you have it. Your friends might ask, 'What is up with this guy? He is acting weird and we don't know why.' And the guy who has TBI has no idea that he is acting any differently. You can see a broken limb, but you can't see inside your brain.

"And it is hard to get treatment; there is not really a cure. Sure, I can get painkillers but that is about it. If someone gets into a car accident, which is the most common reason that someone winds up with TBI, I urge them to contact a personal injury attorney right away, and let them know that you might have a TBI along with the accident. And about 99 percent of the time, that attorney, if they are doing due diligence, will have a doctor examine you ASAP."