I am 100% P&T (mental health), can I start work without concerning of a possible re-eval or reduction?

RonG

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I haven’t a clue if I’m TDIU. I know I was retired with 100% ptsd. I don’t even qualify for food stamps in Florida
I saw nothing in your posts to indicate TDIU. Evidently, you have a 100% rating without the "help" of IU.

Ron
 

GUNS'N'STUFF

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Assuming we’re not talking about TDIU, the simple answer is they wouldn’t.

However, if the VA were to ever order a re-evaluation of your condition (if you’re 100 PT this is extremely rare), they may look at your medical records and/or order a CP Exam. If your medical notes disclose your employment history or you reveal this information during your CP Exam, the VA could find out that way.
I do believe the VA can now do what is called "interfacing" with the IRS. Which means, they can see limited screens from the IRS, like what Social Security Admin can do. I keep telling people the VA will do massive re-evals for 100% mental conditions if they are or have been working. By the rating schedule you physically would not be able to. I am a firm believer this needs changed and being proactive is actually therapeutic for the condition(s)/state of mental health. At the same time, the ratings for the spine are so outdated and low. At any rate, being honest and upfront is the best advice.
 

NoleNation

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I do believe the VA can now do what is called "interfacing" with the IRS. Which means, they can see limited screens from the IRS, like what Social Security Admin can do. I keep telling people the VA will do massive re-evals for 100% mental conditions if they are or have been working. By the rating schedule you physically would not be able to. I am a firm believer this needs changed and being proactive is actually therapeutic for the condition(s)/state of mental health. At the same time, the ratings for the spine are so outdated and low. At any rate, being honest and upfront is the best advice.
Do you have any more info on the IRS interfacing ? I’d be curious to read about it. I’ve yet to see see it happen to a veteran but would be interested to know if it’s happened to anyone or you’ve seen it happen yet ?
 

GUNS'N'STUFF

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Do you have any more info on the IRS interfacing ? I’d be curious to read about it. I’ve yet to see see it happen to a veteran but would be interested to know if it’s happened to anyone or you’ve seen it happen yet ?
I read a few articles several years ago about it and I was employed within the gov't at the time and had access to more information. Being that everything tends to be a slow drawn out process I am not sure how far along the VA is with this now. I am pretty sure some regions (selected personnel) do have access to the IRS screens. I think they are keeping this low-key. Even something simple, where there was supposed to be policy change for regulations which would allow active/former military to discuss "classified" or "sensitive" issues to mental health clinicians at the VA was frozen somewhere a couple of years ago. As my earlier and later posts, both things IMO need changed to actually address the health of veterans, not just slam them because they were working, ie. takes your mind of the IED blast, keeps your mind occupied... We're talking about thousands upon thousands of 100% mental health re-exams probably.
 

j4ever

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When it comes to a 100% MH rating, people think that you are mumbling and slobbering all over yourself, not everyone with a 100% MH rating has hallucinations, delusions, hurting oneself or others in their decision letter, I have talked to several people that have Gov jobs including working at the VA that have 100% MH ratings and have held these positions for a few years now, I asked Docs doing C and P exams abut the total occupational and social impairment and was told it has nothing to do with hours worked, it has more to do with the effort that it takes for an individual to work compared to the average person. I think it can very well come down to be an individual thing.
 

tony292

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Total occupational and social impairment is severe enough that if someone truly met the VA criteria below, they wouldn’t be able to work. it’s difficult to say that you are 100% for mental health but can somehow miraculously work.


Total occupational and social impairment, due to such symptoms as:
gross impairment in thought processes or communication;
persistent delusions or hallucinations; grossly inappropriate
behavior; persistent danger of hurting self or others; intermittent
inability to perform activities of daily living (including maintenance
of minimal personal hygiene); disorientation to time or place; memory
loss for names of close relatives, own occupation, or own name 100%.

how could one hold a job and focus on even basic tasks if they are having delusions or hallucinations? how could they arrive at work in the right place and on time if they are disoriented to time and place?

who is going to hire them or keep them employed if they are a persistent danger to themself or others?

if they have the “inability” to perform basic activities of daily living, how could they have the ability to perform work activities?

how could they interact with their managers or coworkers if they don’t even know the names of their own relatives, their own occupation or don’t even know their own name?

you stated that “not everyone 100% for MH has delusions”. That’s fine, I agree,but if they have a 100% rating for mental health then they haveone or more of the other 100% criteria above. And it usually is NOT just one, most of the time to get a rating you have to have more than one in the 100% group. This is straight from the VA general criteria ratings for mental health disorders..... so to get rated at 100%, they need one or more... and how can they hold a job if they do?

my answer is thatThe examples you mentioned, those people have been rated wrong. They have essentially been rated higher than they should or they wouldn’t be able to hold a job. The VA isn’t perfect, they make rating mistakes all the time.
 
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tony292

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The only question I have is one I’ve never found a solid answer to. Let’s say someone has schizophrenia and meets half of the 100% criteria and are rated at100% Then the person is prescribed medication that eliminates all symptoms and the person while on medication is fully functional.

In a case like that, would the VA re rate the person and lower the ratings based on resolving thier symptoms? Or do they still warrant the 100% rating even though they have no more symptoms?
 

oddpedestrian

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@j4ever

I agree with Tony just because you "talked to several people" is hardly enough justification that working with a 100% MH rating is possible based solely off the rating schedule it's clearly not.

@tony292

The reduction would happen if the VA has evidence of "sustained improvement" which is commonly contested because no clear definition exist but I would say two exams one and then another three to five years later if both showed progress then a reduction is warranted. I never agree with just one exam and your medical records show some improvement that's just not enough a lot MH patients relapse.
 

RonG

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The only question I have is one I’ve never found a solid answer to. Let’s say someone has schizophrenia and meets half of the 100% criteria and are rated at 100% Then the person is prescribed medication that eliminates all symptoms and the person while on medication is fully functional.

In a case like that, would the VA re rate the person and lower the ratings based on resolving their symptoms? Or do they still warrant the 100% rating even though they have no more symptoms?
I don't know.

However, as you probably know, veterans with active prostate cancer are rated at 100 percent. That rating continues for six months following the completion of any treatment, such as surgery, radiation, or chemotherapy. After six months, VA requires that the veteran undergo an examination. Changes reported based on the examination will determine the veteran’s new rating. If the cancer hasn’t returned following treatment, then the rating for prostate cancer will be reduced.

The VA will, however, rate the veteran on any related issues being experienced as a result of having had prostate cancer, such as voiding dysfunction.

There are provisions for granting a rating of 100% again if there is a recurrence of prostate cancer.

Conversely, I am also rated for diabetes II. It is controlled by Metformin and I continue to have a VA rating for the disease. This is more in line with the manner in which MH issues are considered.

Just my opinion, I do not have mental health challenges.

Ron
 

RaiderX

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My 10 cents, he is P&T there are no more evaluations. If he wants to work that is his choice at this point whom are we to say that some one shouldn't work if they are able or want to try.
 

tony292

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My 10 cents, he is P&T there are no more evaluations. If he wants to work that is his choice at this point whom are we to say that some one shouldn't work if they are able or want to try.
Nobody is saying they shouldn’t work. If they can work and want to then they should... but they shouldn’t expect to keep getting 100% if they do choose to work.
 

tony292

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Ron, you hit the nail on the head. If the prostate cancer continues, the 100% rating continues... but if the medications fully resolved the cancer then the individual could be re rated at 0% theoretically if the treatment was 100% effective....

So if we apply the same sort of logic to mental health conditions, what would the results be?
 

tony292

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Bottom line is this. If I were rated 100% for cancer, and treatment was 100% effective and resulted in a zero % rating for cancer, then why wouldn’t the same logic apply if I were rated 100% for mental health and treatment were 100% effective resulted in a zero percent rating for mental health?

why would one condition (MH) rated at 100% be totally protected while the other (cancer) totally unprotected?

is this a double standard?

I don’t work for the VA, I’m just playing devils advocate and trying to make sense of their logic for the sake of helping others.
 
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j4ever

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I guess all I can say is I will let the chips fall where they may, i was sent to 2 c and p exams, both examiners were told about me working and that I had to down grade from fulltime to part time, 2 days a week, which I work on sat and sun night to stay away from to many people, the VA was told this as well, I have been at this place for several years so have respect there and if not for that I just might have been kicked to the curb, but for the VA to give me a rating and then think that at the drop of a hat I am going quit my part time job and just give up my retirement that I worked for is ridiculous at best, at one time I worked a lot of hours and went thru a lot of shit not to get my retirement, I am 54 and qualify for early retirement in 1 year and very well may take it but not going to quit right now, I would have to look at letter to see everything there, but like I mentioned I know for sure there is nothing about hallucination, delusions, disorientated to time and place, not knowing family members names or my own name, not knowing occupation and hurting myself or others, thanks to everybody's responses.
 

NoleNation

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The only question I have is one I’ve never found a solid answer to. Let’s say someone has schizophrenia and meets half of the 100% criteria and are rated at100% Then the person is prescribed medication that eliminates all symptoms and the person while on medication is fully functional.

In a case like that, would the VA re rate the person and lower the ratings based on resolving thier symptoms? Or do they still warrant the 100% rating even though they have no more symptoms?
There’s a court case dealing with this question — it’s Jones v. Shinseki, 26 Vet.App. 56, 63 (2012), the Court said that the veteran is entitled to a rating based upon his unmedicated condition – that is, the higher disability evaluation – if the effects of medication are not mentioned under the applicable diagnostic code of the rating schedule. For mental health, check out the criteria for 10% rating.
 

gsfowler

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Bottom line is this. If I were rated 100% for cancer, and treatment was 100% effective and resulted in a zero % rating for cancer, then why wouldn’t the same logic apply if I were rated 100% for mental health and treatment were 100% effective resulted in a zero percent rating for mental health?

why would one condition (MH) rated at 100% be totally protected while the other (cancer) totally unprotected?

is this a double standard?

I don’t work for the VA, I’m just playing devils advocate and trying to make sense of their logic for the sake of helping others.
The logic is the law as it is written by Congress. The VA raters follow the law, and use the M21 manual as guidance on how the law is interpreted.

The only time a rating is fully protected is if the Veteran is 55 years old, or if the condition has been rated for more than 20 years. (38 CFR 3.951b) Even those protected ratings can be changed if there is evidence of fraud.

When a rating decision is granted, it can be considered static (not subject to a future examination) per 38 CFR 3.327b, or be scheduled for a routine future examination (RFE). This is a medical decision and would be made by the examiner and/or the medial treatment records. If there is no indication that the condition is subject to improve, then the VA rater will make it static.

There are some exceptions to this that will fall within the actual laws (CFRs). Mental health is one of them. 38 CFR 4.129 dictates that when a mental disorder that develops in service from a highly stressful event is severe enough to result in the Veteran’s discharge from active military service
  • assign a service-connected (SC) evaluation of at least 50 percent, and
  • schedule an examination within six months of the Veteran’s discharge to determine whether a change in the evaluation is warranted.
This is a very common occurrence here in the PEB forum as many of the members here who post are facing a medical board.

Malignant neoplasms (cancers) are another illness that have specific laws on the rating percentage and how to rate the residuals after treatment has been completed. M21 III.IV.5.B has some guidance that pertains to your questions.

The general rule in rating malignant neoplasms is as written below:

A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 CFR §3.105(e). If there has been no local recurrence or metastasis, you will be rated on residuals.

But, even malignant neoplasms can be rated permanent and total when evidence indicates that cancer or other similarly chronic and progressive disabilities are not expected to improve, the VA will concede permanence for the disability evaluation. Examples of indicators suggesting the likelihood that the disability status is permanent include but are not limited to
  • a prescription for palliative treatment only for a cancer diagnosis
  • a prescription for hospice care, or
  • an indicator in medical evidence that the condition is considered terminal.
 
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