Is Brain Injury a Disease or a Disability?

Posted by Marilyn Lash

December 29, 2010

How many times have you heard traumatic brain injury referred to as an “incident” or an “event” or an “outcome”?  How often have you used the term “survivor” to mean the person who is living with a brain injury?

Dr. Brent Masel is challenging the way we think about and treat traumatic brain injury.  In his paper Conceptualizing Brain Injury as a Chronic Disease, he proposes that traumatic brain injury is the beginning of a disease process.  Backing up his view with scientific evidence, he reasons that TBI is not a static condition.  A TBI affects multiple organ systems.  The long-term effects of a TBI can continue for many years.  Epilepsy, visual disturbances, sleep disorders, Alzheimer’s disease, endocrine disorders, incontinence, psychiatric diseases, sexual dysfunction, spasticity, fractures – these are the more common disorders or diseases that may follow a TBI.  Masel argues that “As a result of their brain trauma, these individuals now have life-long brain injury disease.”

Classifying TBI as a disease may have significant impact on reimbursement for medical treatment by insurers.  Given the current controversy over insurance payment for cognitive rehabilitation, I encourage you to join this discussion and share your views on TBI – a disability or a disease?  What do you think?

5 responses to “Is Brain Injury a Disease or a Disability?”

  1. Brenda Csatlos says:

    My daughter has an 8 month acquired TBI. She fell off a skateboard. She never had physical/mental issues prior. She is 16.She has had 5 hospitalizations and 2 partial hospitalizations. It is a daily struggle to attempt to recover from this. I do not know what the future holds for her but I know that the daughter that I had is now facing a lifetime of challenges that are different from what they were prior to the TBI.

  2. Janet Cromer says:

    Marilyn, I strongly believe that acquired and traumatic brain injury should be regarded as a chronic disease. My husband Alan suffered a severe anoxic brain injury from a heart attack and cardiac arrest in 1998. The anoxic damage also caused vascular dementia and psychiatric illness right from the beginning. He was able to recover some essential abilities remarkably well even with dementia, and started a new life with meaning. However, three years later the brain injury led to Parkinson’s disease which was harder to treat because of the complexity of juggling medications when a person has a brain injury. Although Alan had stable periods when all his meds were in harmony, Parkinson’s added significantly to our challenges. Alan lived seven years after his fatal heart attack and resuscitation. Family caregivers require and deserve the kind of support and ongoing education that chronic disease management programs for diabetes or heart disease provide with insurance reimbursement. Moderate-severe brain injury should absolutely be recategorized as a chronic disease.

  3. Roberta DePompei says:

    Dr Masel makes a convincing arguement that we clinicians should take seriously. Reimbursement issues will only become more difficult, especially for cognitive retraining. I think we should embrace Dr Masel’s and BIAA’s perspecitve.

  4. Marilyn, I appreciate this approach and if anything needs help it is the way TBI is handled by the insurance companies. We are living with the disintegrating organs, and I cringe everytime we go to a doctor. Yesterday it was the hearing loss in the left ear for the second time. Optic nerve stable SO FAR but we have that test again next week. Medicaid is the only reason my husband can afford to continue care with this chronic condition. If choosing a title will help, then I am with you. So many people living without proper care due to language issues. A shame.

  5. When one is the person living in the new world of brain injury, acquired or traumatic, the legal, i.e. political, babble is meaningless. TBI is as permanent as gender. TBI is to confusing to deal with leaving bureaucracy out of the mix. Yes, I have TBI and have for a decade + a few months. It began as severe but my kids would tell you now it is very inconvenient and that improvement has been a relearning self-repair process that I know will last for the rest of my life.

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