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Trends in the Epidemiology of Disability Related to Traumatic Brain Injury in the US Army and Marine Corps: 2005 to 2010

Gubata, Marlene E. MD, MPH; Packnett, Elizabeth R. MPH; Blandford, Caitlin D. MPH; Piccirillo, Amanda L. MPH; Niebuhr, David W. MD, MPH, MS; Cowan, David N. PhD, MPH

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

The Journal of Head Trauma Rehabilitation: January/February 2014 - Volume 29 - Issue 1 - p 65–75
doi: 10.1097/HTR.0b013e318295f590
Original Articles

Background: Traumatic brain injury (TBI) has been recognized as a major public health issue for several decades. Despite technological advancements in protective equipment and medical care available during recent military conflicts, TBI is the most common neurological condition among Soldiers and Marines evaluated for discharge from service. This study describes the demographic, service-related, and disability characteristics of Soldiers and Marines referred for combat-related TBI disability evaluation.

Methods: Cross-sectional analysis of Soldiers and Marines evaluated for combat-related disability between October 1, 2004 and September 30, 2010 was performed. Traumatic brain injury cases were identified using the Veterans Affairs Schedule for Rating Disabilities code for TBI and compared with other combat-related disabilities.

Results: Combat-related TBI disability rates have significantly increased in both the Army and the Marine Corps since 2005. Significantly more unfitting conditions are present on average in combat-related TBI cases than in other combat-related disability cases. Combat-related TBI disability cases are more likely to be medically retired than other types of combat-related disability.

Conclusions: Because veterans with combat-related TBI disabilities are likely to require chronic care for TBI-associated medical conditions, disability evaluation policy and programs must ensure that combat-related TBI disabilities are accurately identified and compensated, and the potential long-term care needs are addressed.

Department of Epidemiology, Preventive Medicine Program, Walter Reed Army Institute of Research, Silver Spring, Maryland (Drs Gubata, Niebuhr, and Cowan and Mss Packnett, Blandford, and Piccirillo); and Allied Technology Group, Inc, Rockville, Maryland (Mss Packnett, Blandford, and Piccirillo and Dr Cowan).

Corresponding Author: Marlene E. Gubata, MD, MPH, Department of Epidemiology, Preventive Medicine Program, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD 20910 (

This study was supported by funds provided by the Defense Health Program.

The views expressed are those of the authors and should not be construed to represent the positions of the Department of the Army or Department of Defense.

All authors are employees of or contracted to the United States Army.

The authors thank Ms Rhonda Jackson, MPH, for her assistance in compiling and reviewing literature in support of this study.

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins