Photophobia VA Disability Ratings
What is Photophobia?
Photophobia is best described as extreme sensitivity to light. Photophobia can vary from person to person, meaning that some may experience extreme sensitivity to light while others may experience minor sensitivity. Some people may only experience photophobia when faced with bright lights, while others may experience the condition when exposed to any form of light at all.
Typically, photophobia is not a condition itself, but rather a symptom of another underlying condition, such as traumatic brain injury. This means that the condition does not necessarily occur physically in the eye like other eye problems, such as glaucoma, but rather happens as the result of a condition affecting the brain most commonly. Additionally, photophobia is a common side effect of migraines, which can also be a symptom of traumatic brain injury.
What Specifically Causes Photophobia?
There are certain cells in the eye which communicate directly with the brain and detect when light hits the eye. With photophobia, these cells can trigger the brain to create the sensation of feeling overly sensitive to light.
As mentioned above, photophobia is most commonly a symptom indicative of a larger condition. Below are some common conditions linked to photophobia:
- Traumatic brain injury
- Progressive supranuclear palsy
- Lesions of the thalamus
- Subarachnoid hemorrhage
- Lyme disease
- Bipolar Disorder
- Panic Disorder
An optometrist, or an eye doctor, can help diagnose photophobia if you are experiencing sensitivity to light or any related symptoms. For the purposes of VA disability benefits, VA will often not recognize a diagnosis of photophobia unless it is from a licensed optometrist or ophthalmologist.
In order to diagnose someone with photophobia, an optometrist will usually physically examine the eyes, as well as investigate the connection between the eyes and the brain. For example, if the person suffers from headaches, tinnitus, and has difficulty remembering things, they may have a condition affecting brain function.
An optometrist may also perform an eye MRI to further examine eye health. This can help ensure that the optometrist makes the correct diagnosis. Sometimes a person may be experiencing an ocular migraine, which presents with sensitivity to light but does not necessarily mean there is an issue with brain function.
Oftentimes, the best way to treat photophobia is to avoid triggers that bring on the sensitivity. However, since the sensitivity is usually brought on by any light exposure, this may not always be possible.
Some doctors may prescribe dark glasses to help dim the bright intensity of the light. If photophobia is linked to another underlying condition, then treating that condition may help lessen the person’s photophobia. Specifically, if migraines are contributing to a person’s photophobia, some migraine medication may help treat both the migraines and the photophobia. In instances of traumatic brain injury (TBI), this may be more complicated.
VA Service Connection and Photophobia
In order to receive service connection for any condition, veterans usually need to submit three things to VA:
- An in-service event, injury, or illness;
- A current diagnosis by a medical professional; and
- A medical nexus, or link, between your in-service event, injury, or illness and your current diagnosis.
Secondary Service Connection
Secondary service connection is a form of service connection for a condition that results from or is aggravated by an already service-connected condition. Since photophobia is most often a symptom of an underlying condition, pursuing secondary service connection for the condition is very common. For example, if a veteran suffers a concussion during their service which leads to a traumatic brain injury, and then they do on to experience migraines with photophobia, the veteran may be able to receive primary service connection for their traumatic brain injury with secondary service connection for their migraines.
To file a claim for secondary service connection, veterans will follow the same steps they would if filing a claim for primary service connection. Veterans may submit a claim for secondary service connection using VA Form 21-526EZ.
In order to file a claim for secondary service connection, veterans will typically need to submit:
- A diagnosis for the secondary condition; and
- Medical evidence indicating the link between the service-connected condition and the secondary condition.
VA Disability Ratings and Photophobia
As photophobia occurs most often as a symptom rather than a stand-alone condition, there are multiple ways veterans with this condition may receive a VA disability rating:
Ratings for Photophobia Associated with An Eye Condition
There are a number of eye conditions VA issues ratings for, including:
- Corneal conditions
- Inflammatory eye conditions
- Neurological conditions
- Ptosis of one or both eyes
- Retinal conditions
- Tumors of the eye
- Loss of one or both eyes
- Loss of eyelashes, eyelids, or eyebrows
Conjunctivitis is one of the most common eye conditions in which photophobia is a symptom.
When issuing ratings for the eye, VA will use 38 CFR § 4.79, which is the schedule of ratings for the eye specifically. VA will consider how often the condition affects the veteran, the types and frequency of treatments the veteran has undergone, and whether one or both eyes are affected. Specifically, VA has three categories for measuring eye conditions: central visual acuity, visual field, and muscle dysfunction. While photophobia is generally not considered an eye condition, veterans who experience photophobia as the result of an eye condition like conjunctivitis may receive VA disability benefits through ratings for the eyes.
Ratings For Photophobia as a Symptom of Migraines
If the veteran experiences photophobia in conjunction with migraines it may contribute to a higher rating for migraines. Specifically, VA rates migraine headaches under 38 CFR § 4.124a, Schedule of Ratings – Neurological Conditions and Convulsive Disorders, Diagnostic Code 8100. This diagnostic code has ratings ranges from 0 to 50 percent, with criteria based on severity and frequency of the migraines. The rating assigned will correspond to the amount of VA disability compensation a veteran will receive.
Below are the criteria for each rating given:
- 50% – with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability
- 30% – with characteristic prostrating attacks occurring on an average of once a month over the last several months
- 10% – with characteristic prostrating attacks averaging one in two months over the last several months
- 0% – with less frequent attacks
If a veteran can indicate that their photophobia symptoms create “prolonged attacks productive of severe economic inadaptability,” such as having to lie down in a dark room and avoiding all sources of light, that evidence may contribute to the difference between a 30 percent rating and a 50 percent rating. Evidence like lay statements can be particularly helpful in indicating how a veteran’s photophobia affects their day-to-day life.
Ratings For Photophobia as a Symptom of Traumatic Brain Injury
Photophobia is a symptom that veterans who have been exposed to a traumatic brain injury may experience. Traumatic brain injury can occur from any sort of blow to the head, but some of the most common causes include IED blasts, combat exposure, motor vehicle accidents, personal assault, or military sexual trauma.
VA evaluates a TBI based on the residual symptoms a veteran is currently experiencing as a result of the trauma, according to an Evaluation of Cognitive Impairment and Other Residuals of TBI not Otherwise Classified, under 38 CFR § 4.124a. Essentially TBI residuals and their severity determine the disability rating the veteran will receive.
There are specific categories into which each residual may fall. Some include inhibited social skills, diminished motor activity, and altered judgement. Photophobia would best fall into the visual-spatial disorientation category. As such, photophobia is a symptom of TBI that can contribute to veteran’s TBI rating, meaning that veterans can receive benefits for their photophobia linked to traumatic brain injury through an increased rating for TBI.
Other Ways VA Rates Photophobia
There are some other miscellaneous ways that VA may assign ratings for photophobia. For example, if the veteran experienced an eye injury, VA may use Diagnostic Code 6009 to rate the veteran’s resulting photophobia.
The only Diagnostic Code which specifically mentions photophobia in it’s rating criteria is Diagnostic Code 6036. This code is used to rate a veteran’s status after a corneal transplant. The criteria list that veterans who experience pain, photophobia, and glare sensitivity after a corneal transplant should receive a minimum rating of 10 percent.
Compensation and Pension (C&P) Exams for Photophobia
To examine a veteran’s photophobia, and the connection it may have to another condition, VA may request a Compensation and Pension exam (C&P). Compensation and Pension exams are usually performed by a VA examiner or a VA contracted examiner to determine if service connection is warranted, as well as to gather evidence to determine a rating if service connection is granted.
A C&P exam can consist of a physical examination, as well as an interview with the veteran regarding the cause of their photophobia. Specifically, if a veteran experiences photophobia as the result of a traumatic brain injury, the examiner may ask questions regarding their traumatic brain injury or their military service. If the photophobia is part of a claim for a secondary service connection claim, veterans may be asked to attend more than one C&P exam. It is important to attend any exams VA requests, as VA may deny a veteran’s claim if they fail to attend.
VA Individual Unemployability (TDIU) and Photophobia
Since veterans who experience photophobia may need to limit their exposure to light, they may find themselves unable to obtain or maintain employment. Veterans in this situation do have benefits available to them.
Total disability based on individual unemployability (TDIU) is a monthly benefit that compensates veterans at the 100 percent rate, regardless of their actual combined rating.
There are generally two ways that a veteran may be eligible for TDIU:
- For schedular TDIU, veterans must meet the criteria listed under 38 CFR § 4.16a. The criteria stipulate that veterans must have one condition rated at 60 percent minimum OR two conditions that can be combined to reach 70 percent, where one condition is at a minimum of 40 percent. A veteran’s photophobia may help contribute to a rating of at least 60 percent through a condition such as migraines or traumatic brain injury or help them reach a combined rating of at least 70 percent.
- Veterans who do not meet these qualifications may be eligible for extraschedular TDIU. For this form of TDIU, veterans must prove that their condition(s) uniquely hinders their ability to maintain substantially gainful employment. Extraschedular TDIU is rated under 38 CFR § 4.16b.
Get Help with Your Denied VA Disability Claim
Veterans seeking VA disability compensation can often have difficulties throughout the claims and appeals process. Specifically, since photophobia is not rated as a condition on its own, with its own specific diagnostic code, veterans may have trouble establishing service connection.
If you need accredited representation to help guide you through your appeal for VA disability benefits, whether it be for migraines, traumatic brain injury, or another condition linked to photophobia, Chisholm Chisholm & Kilpatrick may be able to help. Our experienced team has helped many veterans win the benefits they deserve. Call today at 800-544-9144 for a free case evaluation.
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