Care Coordination

Because of growing concern about traumatic brain injury (TBI), Congress requires that military and Veterans Affairs (VA) hospitals screen all service members returning from combat for TBIs. This ensures early treatment; however, it also creates the need for additional management of care as service members and veterans move through military, VA and civilian health systems nationwide.

DVBIC’s network of regional TBI care coordinators make sure that patients are connected — and stay connected — to appropriate treatment resources as they move between treatment settings.

Service members and veterans with TBI are at risk of dropping out of treatment or “falling through the cracks” for many reasons. TBI makes it difficult for patients to successfully participate in treatment. They may forget appointments or medications, be unable to drive themselves to medical appointments, or get confused about what is happening with the treatment they are receiving. TBI patients also may experience emotional symptoms such as mood swings, irritability and frustration.  Behavioral symptoms such as aggressiveness and lack of self-control can cause fear, confusion or discomfort for patients and their family and friends.

To address these challenges, DVBIC created a nationwide network of regional care coordinators (RCCs) in 2007 to help patients with TBI achieve the best results. The DVBIC Care Coordination Program is for service members, including National Guard and Reserve, and veterans who were injured while serving in support of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND).

Service members typically enter the program after a diagnosis or by referral from a provider or case manager. Once a service member or veteran enters the program, an RCC will speak with them by phone or in person about issues they are having in treatment, other medical or mental health conditions, strengths and limitations, family issues, changes in duty status, and other relevant clinical information. If the service member agrees to participate in the program and has ongoing TBI-related symptoms, they will be contacted by the RCC at regular intervals as long as they are having issues.

Families and caregivers also are provided support through the program. Service members and veterans who were injured prior to the program’s creation in November 2007 may request eligibility information by contacting us.

For more information on where our RCCs are located, view our Interactive Map.

Related Content

TBI Case Management: DVBIC provides helpful resources to case managers such as a nationwide and several regional resource compendiums for military case managers. It includes the Military TBI Case Management Quarterly Newsletter, which is intended for case managers and other providers to identify and share best practices regarding TBI case management across the military. - DVBIC Military TBI Case Management Resources

DCoE also offers a Military TBI Case Management National Resource Fact Sheet.