; TBI vs. PTSD
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TBI vs. PTSD

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									  frontal lobes, such as those with a higher level of education         That bias, he said, coupled with economic factors, is
  or demand for multitaskng. “So, part of the effect of the         reflected in insurance coverage. Except for some policies
  injury is going to be based on what your rank is, what            issued by Aetna, the average health insurance policy,
  your [military operational specialty] is, and what your           including Tricare, fails to cover cognitive rehabilitation.
  responsibilities are,” Dr. O’Shanick said. Thus, while MAJ        “They say that cognitive rehabilitation for brain injury is
  Morningstar may get adequate scores on memory tests               unproven, in spite of the fact that there have been over 400
  post-TBI compared to other patients, she no longer has the        articles and dozens of well-designed studies published,” Dr.
  multitasking capability to fix a meal in her kitchen, let alone   O’Shanick said. “When they do pay for cognitive rehab,
  operate in a hospital emergency room.                             neurorehabilitation, or cognitive remediation, they set
                                                                    artificial and arbitrary time and pay limits that have nothing
  Nobody Understands This                                           to do with outcomes that allow the person to go back to
     Mild TBI is so misunderstood that the patient may be           being independent, to no longer needing a caregiver at
  misdiagnosed and the impact of the injury underappreciated.       home, or to interact in the community, or interact with his
  “The first issue,” Dr. O’Shanick said, “is correct identification.or her kids.”
  The person would get in the wrong system of care, and they            Ten U.S. senators on Aug. 4 and 60 House members on
  are going to go downhill fast.”                                   Sept. 19 sent letters to Secretary of Defense Robert Gates
     As Dr. Ghajar’s eye-tracking tests suggest, the symptoms       urging Tricare coverage of cognitive rehabilitation for brain
  of mild TBI could be taken for fatigue, substance abuse, a        injury patients.
  psychological disorder, or simply a bad attitude. Anecdotal           Both a medical community ignorant of the cause and
  evidence is surfacing that a number of Afghanistan and            effects of mild TBI and an insurance industry disregarding
  Iraq War vets have received disciplinary actions from their       ongoing treatment for mild TBI have disturbing
  commanders for overly apathetic or aggressive behavior,           ramifications, especially for Reserve Component members
  which, investigators are discovering, may result from the         who return home before the symptoms of accumulated
  servicemember incurring a concussion up to two years before.      concussions appear.
     MAJ Morningstar said she encountered ignorance of TBI              MAJ Morningstar wants to be part of an education
  on her journey through the military medical system from           effort for the general pubic on TBI and its effects, but her
  Iraq through Walter Reed Army Medical Center, where               greatest concern is for family members. She attends a weekly
  she spent 11 months. She is currently assigned to a warrior       group therapy session with seven other servicemem
								
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