Veterans & Essential Tremor

HERE TO HELP

​We advocate for individuals, including Veterans, who live with Essential Tremor Disease.

It addresses their physical, mental, and emotional needs, ensuring they feel valued and respected. The ultimate goal is to improve their well-being and health outcomes.
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- Active Participation: Patients are encouraged to participate actively in their care decisions.
 
- Respect and Empathy: Treating patients with dignity, understanding, and compassion is crucial.
 
- Recognizing emotional and social needs.

- Providing resources and support groups.
​Essential Tremor (ET) can be recognized as a disability, but only if its severity substantially limits your ability to perform everyday life functions or work. 
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  • Veterans Affairs (VA): Veterans diagnosed with ET that is linked to their military service may be eligible for VA disability compensation. The VA assesses the severity and frequency of the tremors in affected limbs to assign a disability rating.​​
Receiving a disability rating
  • The VA does not have a specific rating for ET. It is often rated analogously under Diagnostic Code 8515, which covers paralysis of a nerve, such as the median nerve in the arm.
  • Ratings for tremors can range from 10% for mild impairment to 70% for severe impairment that significantly affects motor function.
  • For cases where the tremor is so severe it prevents a veteran from maintaining a "substantially gainful" job, they may be eligible for Total Disability based on Individual Unemployability (TDIU).
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​​For veterans with essential tremor (ET), the primary concerns involve navigating the VA disability benefits process and accessing specialized treatments available through the Veterans Health Administration (VHA). 

​It's critical to note that veterans experience a higher prevalence of tremors, often due to stress or mental health conditions such as PTSD, anxiety, and depression—conditions that are inherently linked to their military service.

Treatment options for ET, many of which are covered by the VA or Tricare, include effective medications, focused ultrasound therapy, and innovative devices like the Cala kIQ™ System.
Veterans deserve top-notch care and research to address service-related trauma and stress risks.

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​For more information, visit: 
https://www.va.gov/disability/
https://www.va.gov/health-care/about-va-health-benefits/
​Veterans are entitled to VA disability benefits for Essential Tremor if they can establish a connection to their service, whether directly or indirectly.
VA Disability Benefits for Essential Tremor
  • Service Connection: To receive VA disability benefits, a veteran must demonstrate: 
    • A current diagnosis of essential tremor.
    • An in-service event, injury, or illness.
    • Aggravated service connection: If a veteran had a pre-existing ET, they must prove that their military service worsened the condition beyond its natural progression.
    • A medical "nexus" or link connecting the tremor to the in-service event. A veteran can also receive benefits if their ET is medically related to a service-connected condition, such as PTSD or TBI. 
  • Secondary Connection: Veterans can also get a secondary service-connected rating if their service-connected condition worsened their pre-existing or acquired essential tremor. 
  • VA Rating: There is no specific ET VA rating, but the VA often uses Diagnostic Code 8515 to rate tremors affecting the arms or hands, assessing the degree of impairment. ​
  • Poverty and Disability: If tremors prevent a veteran from working, they may be eligible for total disability based on individual unemployability (TDIU) benefits. 

Conditions Linked to Service and Essential Tremor
  • Mental Health Conditions: Extreme stress during military service can lead to PTSD, anxiety, and depression, which are associated with a higher risk of tremors. 
  • Chronic Stress: Stressful military experiences can exacerbate the burden of essential tremor by increasing overall stress levels.

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​VA treatment options for essential tremor

The VHA offers several treatment approaches for veterans with ET, especially for those whose symptoms are refractory to medication.
  • Pharmacological treatments: Standard medications include primidone and propranolol, though they are often only partially effective.
  • Deep Brain Stimulation (DBS): This surgical procedure, available at some VA health care systems, can provide a high rate of tremor reduction for patients with disabling, medication-resistant ET.
  • Focused Ultrasound (FUS): This noninvasive procedure uses focused sound waves to ablate a small area of the thalamus. Veterans are eligible for FUS treatment reimbursement through Tricare.
  • Transcutaneous Afferent Patterned Stimulation (TAPS): This bio-electronic medicine device, worn like a watch, sends electrical pulses to stimulate nerves in the wrist and is covered by the VA.
  • Lifestyle management: Veterans are also advised on managing lifestyle factors that can worsen tremors, such as stress, fatigue, and caffeine intake. 
  • Cala KIQ System: The VA covers this wearable device, the first of its kind, to treat ET. 

How to Get Started​
Seek a Diagnosis and Treatment Plan: Your neurologist can provide a diagnosis, recommend a treatment plan, and determine eligibility for specific therapies.
Veterans Information website pages
https://californiahealingcenters.com/equine-assisted-therapy-for-veterans/ ​
​Confidential crisis support! Dial 988 then press 1​
Are you a Veteran in crisis or concerned about one?
You're not alone—the Veterans Crisis Line is here for you.
You don't have to be enrolled in VA benefits or health care to call.
24/7, confidential crisis support for Veterans and their loved ones.
Association between ET and veteran-related conditions
  • A 2018 study of the VA database found that veterans with ET were significantly more likely to have a diagnosis of PTSD, anxiety, and depression compared to those without ET.
  • The study suggests chronic stress, which is often associated with military service and combat, may not only increase the risk of these psychiatric conditions but in some cases may also directly induce ET.
  • TBI, another condition strongly linked to military service and combat, was also more common among veterans with ET. ​​
The cause(s) of (ET) remains poorly understood. Observers agree that persons with ET are prone to anxiety and depression; however, the reason for this is not clear.1 Furthermore, the greater rate of hearing loss,2 dementia,3 and mortality in ET remains unexplained.4
We have noted an association of ET not only with depression and anxiety but also with post-traumatic stress disorder (PTSD), all of which are causes of chronic stress. We thus asked whether conditions known to be associated with chronic stress are also more common in persons with ET. If so, poor health features of ET may be interpreted as constituting part of a larger pattern that arises ultimately from stress/distress. To address this notion, we queried the United States Veterans Affairs (VA) database to ascertain whether the frequency of various conditions was altered in ET veteran patients compared to those without ET.

Increased depression, hearing loss, dementia, alcoholism, and mortality in essential tremor patients remain unexplained. We investigated whether conditions associated with tremor are linked to cPost-traumatic stress disorder, anxiety, and depression were the most common psychiatric diagnoses in tremor patients, with the odds ratio exceeding 2 in all 15-year cohorts. Depending on age, patients with ET were more likely than those without to have obsessive–compulsive disorder, bipolar illness, schizophrenia, use tobacco and abuse alcohol, have hypertension, obesity, hyperlipidemia, diabetes, vitamin D deficiency, coronary and cerebrovascular diseases, congestive heart failure, stroke, asthma, hypothyroidism, irritable bowel syndrome, renal insufficiency, alcoholic liver disease, hearing loss, glaucoma, macular degeneration, migraine, epilepsy, idiopathic polyneuropathy, history of head trauma, and ‘Alzheimer’s dementia. In contrast, lung and colorectal cancer, amyotrophic lateral sclerosis, psychostimulant abuse, and rheumatoid arthritis were not more common.

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This page provides general info only. The Diann Shaddox Foundation for Essential Tremor does not endorse medications, treatments, or companies but offers information. Consult your medical provider for care decisions.
Diann Shaddox Foundation for Essential Tremor