Comment on AN89-Proposed Rule-Stapera, Benjamin

1) The proposed rule does not address situations where a veteran with an existing rating for a secondary illness is higher than the tbi rating they would receive under the new rule, which could result in a reduction in the veterans compensation and schedular rating from the application of this rule. This could also result in situations where a veteran is not adequately compensated for the severity of the secondary illness and its impact on quality of life/functioning. 2) the rule does not address applicability to prior determinations made by the VA regarding service connection for tbi and/or the severity of secondary illnesses in relation to those ratings, or with regard to impact on those veterans with service connected ratings. 3) the rule does not appear to identify or clarify which Hormone deficiencies or disorders that will be construed or assumed as a result of a tbi injury, as well as any changes/impacts to those illness areas affected within the existing ratings schedule (deletion/superseding/non-tbi caused). 4) the rule only provides for a service connection for tbi that do not have the necessary medical documentation to be assessed under the new section proposed if there are also secondary illnesses that may warrant a rating greater than under the new rule. This could result in veterans receiving a lower schedular rating and subsequent reduction in category grouping for treatment of their illness than previously received.