Racial/Ethnic and Geographic Differences in Traumatic Brain Injury (TBI) Service-Connected Disability Determination and Monthly Compensation Among Post-9/11 US Veterans.

PURPOSE: Veterans who incur a traumatic brain injury (TBI) during active duty service may be eligible to receive service-connected disability (SCD) compensation. This study examined potential racial/ethnic and geographic disparities in TBI SCD determination and overall monthly SCD compensation. Federal Tribal Land (FTL) was incorporated into existing VA geographic designations of urban, rural, highly rural, and US Territories (UST).

METHODS

The association of race/ethnicity and geographic status with TBI SCD was estimated using logit models. Generalized linear models were used to assess the association of Veteran race/ethnicity and geographic status with overall monthly SCD compensation in 2022.

RESULTS

Of the 1,319,590 Veterans with any SCD rating, 7.1% had a TBI SCD determination. Adjusting for demographic and military characteristics, relative to non-Hispanic Whites, Asian American Pacific Islanders (AAPI) (OR 1.19; 95% CI 1.16-1.22) had the highest odds of a TBI SCD, followed by American Indian Alaska Natives (OR 1.12; 95% CI 1.06-1.18). Bivariate analysis showed that relative to urban areas, highly rural (OR 1.44; 95% CI 1.38-1.49) areas had the highest odds of TBI SCD, followed by FTL (OR 1.28; 1.03-1.59). Bivariate analysis indicated that non-Hispanic Blacks ($433; 95% CI 428-439) and UST ($149; 95% CI 92-206) had the highest incremental monthly SCD compensation, while FTL Veterans had decremental compensation (- $80; 95% CI - 157 to - 4).

CONCLUSIONS

This study found that AAPI and FTL Veterans ranked lower in SCD compensation relative to their likelihood of a TBI SCD. These findings could be due to several factors that warrant further study.