TBI Treatment Coverage Should NOT Be “Optional”

Lt. Cdr. Scott Mitchell, officer-in-charge of the Carl R. Darnall Traumatic Brain Injury clinic at Fort Hood, Texas, helps a patient practice with a balance board at the clinic’s Functional Rehabilitation Center

Unless people are living under a rock – which I guess a lot of people are – the question of whether or not TBI treatment should be accessible to all should NOT be optional.

Neither should it be at the discretion of insurance companies.

I know that we’re “still learning” about effective treatments, and the science is still out on some of them, but there are enough approaches out there that have shown great results, that it should NOT a question of whether or not to treat TBI — rather how best to treat TBI.

Of course, no insurance company is going to go for this, right now. But at the same time, I would think that some private foundation or non-profit would realize how important it is to pony up the funds to treat this very treatable condition. Yes, it can be chronic and long-term. Yes, there will likely be ongoing needs and maintenance activities. But it is manageable with the right approach(es), and I don’t see any reason why it shouldn’t simply be done.

Let’s do the math around this.

Say you’ve got a qualified, productive worker who holds down a job that makes them $50,000 a year. They participate in life, with their income flowing back into the economy, and their presence contributing to society’s overall health. Say they have a family — a spouse and a couple of kids, a mortgage, a college savings / retirement fund, and a couple of cars in the garage. Their spouse has a job that earns the same $50,000.

All in all, their total “dollar value” to society is around $100K – plus the interest from their credit cards and the long-term value of their college expenditures. And that’s not including the intangible value they bring to their community. They contribute to the well-being of their employer, and they make their company’s ongoing success possible.

Now, let’s throw TBI into the mix.

Long story short, they lose their job in the six months after their injury. The employer is in it for $100,000 (which is the cost to replace a seasoned worker), and they’ve also lost a top performer who contributed a lot to their ongoing success.

The spouse is now carrying the whole financial burden for the family, as well as everyday logistics, which puts a strain on them and makes it practically impossible for them to function at their customary level at work. The spouse’s employer has now also lost a valuable member of their workforce, and between the time lost to caring for the now-disabled spouse and their reduced productivity, the employer has taken a hit.

Our TBI survivor goes on disability, which costs the government x-number of dollars, and their behavioral, cognitive, and other related problems at home cause their kids a ton of problems, so they end up acting out at school, which puts another drain on the overall system. The kids need counseling, which puts another strain on the system, and given the hell that goes on at home, it’s anybody’s guess whether it’s actually going to work.

Eventually, the TBI survivor does something really “brain-injured” in the presence of the wrong person, and they end up in jail. They go into the legal system, and eventually they end up in prison. That’s another $100K per year society needs to spot them for. And that’s not even accounting for further problems with the kids.

Any number of wretched scenarios can come out of this. And it happens everyday. With people of all walks — and especially veterans (why, by the way, sacrificed so my for US, so that WE can live in peace and prosperity).

All this happens because TBI treatment is in the dark ages… and the techniques that have been shown to work — or at least show promise — have been marginalized as “fringe” so that self-respecting doctors everywhere shy away from them.

As a society, we get what we deserve when we allow this to persist.

But the TBI survivors and their loved-ones? What exactly did they do to deserve it?

The idea that treatment is “unavailable” and inaccessible because of cost is unconscionable.  Yes, some of the treatments are expensive. But people pay far more for things like cars and bottles of wine, than TBI recovery for one person would ever cost. The money is there. And the opportunity for a real “return on our investment” is there, as well.

It just needs to be a priority.

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Author: brokenbrilliant

I am a long-term multiple (mild) Traumatic Brain Injury (mTBI or TBI) survivor who experienced assaults, falls, car accidents, sports-related injuries in the 1960s, '70s, '80s, and '90s. My last mild TBI was in 2004, but it was definitely the worst of the lot. I never received medical treatment for my injuries, some of which were sports injuries (and you have to get back in the game!), but I have been living very successfully with cognitive/behavioral (social, emotional, functional) symptoms and complications since I was a young kid. I’ve done it so well, in fact, that virtually nobody knows that I sustained those injuries… and the folks who do know, haven’t fully realized just how it’s impacted my life. It has impacted my life, however. In serious and debilitating ways. I’m coming out from behind the shields I’ve put up, in hopes of successfully addressing my own (invisible) challenges and helping others to see that sustaining a TBI is not the end of the world, and they can, in fact, live happy, fulfilled, productive lives in spite of it all.

5 thoughts on “TBI Treatment Coverage Should NOT Be “Optional””

  1. BB – I agree with you on this – and in fact have written articles about it – but here’s the drawback to this – there is virtually no return to work program post tbi – the rehab is a medical model based on return to home and ADL’s. Many many many people with tbi see themselves as broken and are dis-incentivised to go back to work. Employers don’t want them either.

    People with tbi have the highest rates of poverty. Return to work rehab is different that regular rehab- a few places do it – but it cost mucho mucho bucks – all out of pocket. And, alas, it is not always as successful as one would like. In fact there is no model to date that shows overwhelming success. Many factors -family support, economic stability (people can lose their homes or get evicted in the first 6 months after an injury), education, training etc. The whole system has problems. Voc rehab in many states doesn’t have the training to guide a person with a BI. And most businesses do NOT want to hire in any professional reasonable paying position a person with a brain injury.

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  2. Yes, sure wish it was a priority. We are using complementary medicine as we have finished up what insurance will cover for traditional medicine. I sure hope for breakthroughs with the VA for our veterans as this may eventually help civilians too –though more likely adults and the pediatric data would be extrapolated from that. Maybe we will one day be in a clinical trial to help further treatment research for the TBI population. In the meantime, reading what we can to further our knowledge and trying to devise homemade treatments that approach meeting the goals of various non-traditional treatments. We can’t afford it all, so prioritizing and budgeting for what we can, though it is far below optimal of what is recommended. An avenue I wish we could explore further include examining hormonal changes, but for how we are trying craniosacral therapy and vision therapy. Eventually, we may try NovaVision. The budget though may eventually limit us. So frustrating. The only comforts are that the Internet has been a great resource for connecting us with information and other TBI survivors for support.

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  3. It is frustrating. I’m doing research, myself, on DIY hormone therapy, eating certain foods, and getting certain kinds of exercise. There are a lot of people doing research in the space, right now, and while it is definitely NOT kid-safe, the Joe Rogan Experience podcast has a lot of people talking about hormone therapies, life extension, etc. I find folks in the life extension space are very helpful. I find that the things they recommend also help with TBI. I also found that the chiro I have been seeing is basically doing “moves” with me that I can pretty much do at home. And of course, exercise and balanced breathing and good sleep do wonders. Good luck with your “protocol” development.

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  4. Right, which is why we need alternative and complimentary treatments. I’m not just talking about standard treatments – we need more. And maybe it’s for the best that people on the “fringe” are developing treatments – because insurance company restrictions would suck the life out of them, most likely. Insurance companies really are evil, in some ways.

    As for return to work, there’s a reason I never tell anyone I work with about my TBI history. People don’t get it, unless they’ve been through it. And the people who have been through it don’t get hired in the kinds of environments where I work.

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