Malformation

Chapter 4: Habilitation?

You may be familiar with rehabilitation. There is a general understanding of rehabilitation or rehab. But there is a missing part of our vernacular simply using habilitation regularly. The simple definition of which is “to make fit”. While the doctors, nurses, and medical personnel can acclimate you to your new normal, this new normal is a fluid concept. For instance, in the author’s life, he was employed roughly a year after the initial bleed into 2000. Further, he was able to work full-time as both an IT worker for around 15 years and a pastor for 5 years, until due to his multiple brain injuries, he was forced to quit his job. What do you do if your circumstances are similar? After counsel with colleagues, friends, and family, it was determined that the best option would be to apply for the Social Security Administration filing for disability. Now before misleading you into this process, this is difficult, arduous, exhausting, and mentally taxing. The social security workers are going to need your medical records pertinent to your condition. This will include records of doctor’s visits, surgeries, medical device implants if included, tests run, and more. Additionally, you will be expected to have access to these records, as well as all treatment facilities you were treated in. To be frank, it may prove too much for the family and survivor to do.

It can be extremely helpful to keep records and copies of all medical visit and expenses. Many times, the receipts for payment are kept online. For the medical records, a quick phone call you your medical provider can provide you with this information. If you were not aware that this information was needed, it may prove helpful to secure either a lawyer or a legal representative. Alternatively, for Virginia residents, contacting the Virginia Department for Aging and Rehabilitative Services can help expedite and coordinate the gathering of information for the social security office. For Virginia, the VADARS office can be located by contacting your regional office at:

Office Name Phone City

Disability Determination Services Fairfax

(703) 934-7400 Fairfax

Disability Determination Services Roanoke

(540) 857-7748 Roanoke

Disability Determination Services Norfolk

(757) 466-4300 Norfolk

DRS Southwest District Office

(276) 679-2262 Abingdon

DRS Eastern District Office

(757) 686-4988 Portsmouth

17Disability Offices Virginia

Also, it is for this reason, it may prove useful to secure a lawyer who is able to draw together all of this data in chronological order so as to present it before the Social Security administration. Consider as a section of your life introduction this brief section of text from the Social Security office, “TBI Outcomes TBI related impairment in function depends on the mechanisms of injury as well as the location and the extent of brain damage. TBI can result in a simple concussion with no impairment in functioning. Alternatively, TBI can result in a mild, moderate, or severe impairment or a devastating irrecoverable vegetative state. Fortunately, the vast majority of TBI cases are mild with limited permanent impairment in functioning. However, at least 20% of individuals sustain moderate to severe TBI which can result in long lasting and significant impairment in functioning, disability and inability to maintain a job” (Social Security Administration).

These individuals are most commonly young men (aged 15 to 24) with a lifetime of disability, employment limitations, requiring significant support from family and caretakers at a significant cost to society. The CDC estimated that lifetime costs can range from $600,000 to $1,870,000 to care for a survivor of severe TBI. The costs associated with caring for Iraq and Afghanistan soldiers who have sustained a TBI are estimated to reach $35 billion over the course of the soldiers’ lifetime. Approximately 80,000 individuals develop long-term disability from TBI each year in the US” (MD & PhD, November 18, 2008).

Given this lengthy delay and archaic application process, securing legal representation may prove to be a beneficial purchase. Before that decision is made however, please consider “Curriculum-based advocacy training was not superior to a self-directed approach in improving Advocacy Behavior Rating Scale scores. A significant improvement in expression of an advocacy message was observed when intervention groups were combined” (Allen W. Brown, 2015). This the bad news. The good news, there are some accommodations available which may speed up this process while you wait. Of note, studies conducted on young patents show “Yet, these study designs have to be weighted with caution, as infants 'are not small adults’. The maturing brain makes key-aspects of AVM characterization difficult to assess, as eloquent brain areas are characterized by a large plasticity in the young patient” (Stein, et al., Cerebral arterio-venous malformations in the paediatric population: Angiographic characteristics, multimodal treatment strategies and outcome, January 2018). Further, “From our data we suggest that patients’ age impacts the clinical presentation. Particularly young children seem to bear a higher risk for haemorrhage from their AVM. Treatment of paediatric AVMs can be achieved safely in experienced hands with a high rate of complete elimination and good clinical outcome” (Stein, et al., Cerebral arterio-venous malformations in the paediatric population: Angiographic characteristics, multimodal treatment strategies and outcome, 2018).

17 https://www.vadars.org/offices.aspx#Administrative, Virginia Department for Aging and Rehabilitative Services, Commonwealth of Virginia.