TDRL Evaluation

E

EODStew44

PEB Forum Regular Member
Registered Member
Hey guys....
It's been a while, so long, I forgot my password and had to set up a new account. Brief rundown.... I was medically retired on TDRL May 2013. Since then I have moved from Vegas to Maryland, and now reside in California. I have had some difficulty going to the doctors because of work schedule, and the moving back and forth. I have not been able to get into any kind of routine with it. I have only gone to the VA twice I believe for any sort of treatment.

Well, today, I got an email stating I have to go to Madigan Army Medical Center for my TDRL evaluation. This is my first evaluation since May 2013 (they said they were backed up). I am worried for a few reasons:

I do not have a very active appointment log. Meaning, I have barely had any time to attend due to my work schedule.

Should I be worried that I don't really have any documentation to bring to the appointment? Is this going to screw with my retirement?

Also how long does this process take? I have seen in the letter, "1-3 days".... I have a job I must go to in order to make a living. I am extremely worried about this. Could someone give me some insight on this process. Thank you.
 
EODStew44 said:
Hey guys....
It's been a while, so long, I forgot my password and had to set up a new account. Brief rundown.... I was medically retired on TDRL May 2013. Since then I have moved from Vegas to Maryland, and now reside in California. I have had some difficulty going to the doctors because of work schedule, and the moving back and forth. I have not been able to get into any kind of routine with it. I have only gone to the VA twice I believe for any sort of treatment.

Well, today, I got an email stating I have to go to Madigan Army Medical Center for my TDRL evaluation. This is my first evaluation since May 2013 (they said they were backed up). I am worried for a few reasons:

I do not have a very active appointment log. Meaning, I have barely had any time to attend due to my work schedule.

Should I be worried that I don't really have any documentation to bring to the appointment? Is this going to screw with my retirement?

Also how long does this process take? I have seen in the letter, "1-3 days".... I have a job I must go to in order to make a living. I am extremely worried about this. Could someone give me some insight on this process. Thank you.
Click to expand...


I can't answer your question.

BUT, Jason just recently posted this DoD Manual & I believe it applies to your TDRL review.

http://www.pebforum.com/site/threads/dod-manual-1332-18-volume-2.23566/


Better read it as it lays out what is supposed to happen so you can make sure your re-exam is IAW this DoD Manual.

page 36 enclosure 5 I think....

nwlivewire
 
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Do you have the link? Just trying to get this stuff answered... the anxiety from this stuff drives me nuts.
 
nwlivewire said:
I can't answer your question.

BUT, Jason just recently posted this DoD Manual & I believe it applies to your TDRL review.

http://www.pebforum.com/site/threads/dod-manual-1332-18-volume-2.23566/


Better read it as it lays out what is supposed to happen so you can make sure your re-exam is IAW this DoD Manual.

page 36 enclosure 5 I think....

nwlivewire
Click to expand...

I am still not really understanding. I went to the VA once or twice after getting out. Thats it. Really nothing else as far as documentation except my VA ratings. So, should I just bring that? I am curious as to what they do for the exam. I take it another Psyche eval type thing for PTSD?
 
EODStew44 said:
I am still not really understanding. I went to the VA once or twice after getting out. Thats it. Really nothing else as far as documentation except my VA ratings. So, should I just bring that? I am curious as to what they do for the exam. I take it another Psyche eval type thing for PTSD?
Click to expand...


OK. Let's back up a second and get some data.

You were rated at what % & placed on TDRL?

How many issues did you have? Just psych or other things that got you on TDRL?

Was your TDRL based on just one issue - your MH issue?

Have you been seeing a civilian MH professional? Or a medical Doctor?

Have you been prescribed medications? Are you taking any RX meds now?

nwlivewire
 
nwlivewire said:
OK. Let's back up a second and get some data.

You were rated at what % & placed on TDRL?

How many issues did you have? Just psych or other things that got you on TDRL?

Was your TDRL based on just one issue - your MH issue?

Have you been seeing a civilian MH professional? Or a medical Doctor?

Have you been prescribed medications? Are you taking any RX meds now?

nwlivewire
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I was rated at 60% Army, 90% VA.
Army UNFITTING CONDITIONS:
PTSD 50% (Army)
Migraine Syndrome (residual of TBI) (Army)
Cognitive Disorder (residual TBI) (Army)
Depressive Disorder

TDRL was based on those 4 conditions.

I have NOT been seeing a civilian MH Professional or a Medical Doctor.
I was prescribed an anxiety medication, but have not refilled it in about a year (I moved VA clinics).

Please advise... thanks.
 
EODStew44 said:
I was rated at 60% Army, 90% VA.
Army UNFITTING CONDITIONS:
PTSD 50% (Army)
Migraine Syndrome (residual of TBI) (Army)
Cognitive Disorder (residual TBI) (Army)
Depressive Disorder

TDRL was based on those 4 conditions.

I have NOT been seeing a civilian MH Professional or a Medical Doctor.
I was prescribed an anxiety medication, but have not refilled it in about a year (I moved VA clinics).

Please advise... thanks.
Click to expand...


Well, this is just my opinion - and everyone's got one.

But you are employed and have been working outside the home for a good part of the time.

You're not taking any meds, nor have you for quite some time.

You are not doing therapy and haven't for quite some time.

I opine that chances are highly likely you will get a downgrade from 50% PTSD to - if lucky - 30%.

Hopefully, you'll be able to get 30% and be retired onto PDRL.


Here's what the VASRD says for 50%, the 30%, the 10%, and the 0%


Occupational and social impairment with reduced reliability and
productivity due to such symptoms as: flattened affect; circumstantial,
circumlocutory, or stereotyped speech; panic attacks more than once
a week; difficulty in understanding complex commands; impairment
of short- and long-term memory (e.g., retention of only highly learned
material, forgetting to complete tasks); impaired judgment; impaired
abstract thinking; disturbances of motivation and mood; difficulty in
establishing and maintaining effective work and social relationships ............... 50

Occupational and social impairment with occasional decrease in work
efficiency and intermittent periods of inability to perform occupational
tasks (although generally functioning satisfactorily, with routine
behavior, self-care, and conversation normal), due to such symptoms
as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or
less often), chronic sleep impairment, mild memory loss (such as
forgetting names, directions, recent events) ...................................................... 30


Occupational and social impairment due to mild or transient symptoms
which decrease work efficiency and ability to perform occupational
tasks only during periods of significant stress, or; symptoms controlled
by continuous medication .................................................................................. 10

A mental condition has been formally diagnosed, but symptoms are not
severe enough either to interfere with occupational and social
functioning or to require continuous medication.................................................. 0

nwlivewire
 
nwlivewire said:
Well, this is just my opinion - and everyone's got one.

But you are employed and have been working outside the home for a good part of the time.

You're not taking any meds, nor have you for quite some time.

You are not doing therapy and haven't for quite some time.

I opine that chances are highly likely you will get a downgrade from 50% PTSD to - if lucky - 30%.

Hopefully, you'll be able to get 30% and be retired onto PDRL.


Here's what the VASRD says for 50%, the 30%, the 10%, and the 0%


Occupational and social impairment with reduced reliability and
productivity due to such symptoms as: flattened affect; circumstantial,
circumlocutory, or stereotyped speech; panic attacks more than once
a week; difficulty in understanding complex commands; impairment
of short- and long-term memory (e.g., retention of only highly learned
material, forgetting to complete tasks); impaired judgment; impaired
abstract thinking; disturbances of motivation and mood; difficulty in
establishing and maintaining effective work and social relationships ............... 50

Occupational and social impairment with occasional decrease in work
efficiency and intermittent periods of inability to perform occupational
tasks (although generally functioning satisfactorily, with routine
behavior, self-care, and conversation normal), due to such symptoms
as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or
less often), chronic sleep impairment, mild memory loss (such as
forgetting names, directions, recent events) ...................................................... 30


Occupational and social impairment due to mild or transient symptoms
which decrease work efficiency and ability to perform occupational
tasks only during periods of significant stress, or; symptoms controlled
by continuous medication .................................................................................. 10

A mental condition has been formally diagnosed, but symptoms are not
severe enough either to interfere with occupational and social
functioning or to require continuous medication.................................................. 0

nwlivewire
Click to expand...


I am aware of what it says for VASRD. I actually am more toward 75. I still have suicidal ideation, migraines are weekly, depression is terrible, anxiety the same. These things are causing problems... you of anyone should know just because someone is working, not taking meds (They cause unnecessary weight gain---which leads to even more problems), and not going to counseling (out of fear I will lose my job)... doesn't mean someone is okay.

I live in arguably the most beautiful place in the world (southern california) yet... I Still have terrible depression bouts, anxiety, it cause problems with my day to day. Words slur when trying to have a conversation, get mixed up when coming out... Just giving you a heads up since, you were making a decision and forming an opinion based off of a small bit of information.
 
EODStew44 said:
I am aware of what it says for VASRD. I actually am more toward 75. I still have suicidal ideation, migraines are weekly, depression is terrible, anxiety the same. These things are causing problems... you of anyone should know just because someone is working, not taking meds (They cause unnecessary weight gain---which leads to even more problems), and not going to counseling (out of fear I will lose my job)... doesn't mean someone is okay.

I live in arguably the most beautiful place in the world (southern california) yet... I Still have terrible depression bouts, anxiety, it cause problems with my day to day. Words slur when trying to have a conversation, get mixed up when coming out... Just giving you a heads up since, you were making a decision and forming an opinion based off of a small bit of information.
Click to expand...


I totally get what you saying. Believe me!

But I'm pretty sure you will need some type of medical "evidence" to back up what you are saying.

Just because you say something, unfortunately that doesn't always make it so.

Can you get into a civilian shrink and have a reassessment done - like from a medical shrink that can write out medications? Like have him do an MMPI and do an assessment & get meds started BEFORE your re-eval appt?

That way you have something fresh and recent and can hand them "evidence".

I think you're going to need a Doctor's current evaluation to counter your long term lack of documented treatment and meds.

I'm not trying to be a D!@# about this. It's just that the re-eval has rules to follow and I am concerned for you and your case.

nwlivewire
 
nwlivewire said:
I totally get what you saying. Believe me!

But I'm pretty sure you will need some type of medical "evidence" to back up what you are saying.

Just because you say something, unfortunately that doesn't always make it so.

Can you get into a civilian shrink and have a reassessment done - like from a medical shrink that can write out medications? Like have him do an MMPI and do an assessment & get meds started BEFORE your re-eval appt?

That way you have something fresh and recent and can hand them "evidence".

I think you're going to need a Doctor's current evaluation to counter your long term lack of documented treatment and meds.

I'm not trying to be a D!@# about this. It's just that the re-eval has rules to follow and I am concerned for you and your case.

nwlivewire
Click to expand...

I appreciate it. Thank you. I still have some time to stop by the docs. I also dont like the "Psychologist" at the VA and some MTF, because one told me "Oh, you have PTSD? I can cure you in 2 weeks".... NO LIE. Dude really said that. I talk to my friends who have been to combat, like a peer group, except over the phone. They are the only ones who really understand.

Each of them are writing me a letter outlining symptoms I have had over the past year... So hopefully that may help. ******* Do you think? They are also wounded warriors, one is 235% (lost both arms).

Other than that... I only have 2 or 3 VA visits and the medication made me fat... so I stopped taking it (It was causing stress on my knees and back). Since being off I dropped all the excess weight.
 
EODStew44 said:
I appreciate it. Thank you. I still have some time to stop by the docs. I also dont like the "Psychologist" at the VA and some MTF, because one told me "Oh, you have PTSD? I can cure you in 2 weeks".... NO LIE. Dude really said that. I talk to my friends who have been to combat, like a peer group, except over the phone. They are the only ones who really understand.

Each of them are writing me a letter outlining symptoms I have had over the past year... So hopefully that may help. ******* Do you think? They are also wounded warriors, one is 235% (lost both arms).

Other than that... I only have 2 or 3 VA visits and the medication made me fat... so I stopped taking it (It was causing stress on my knees and back). Since being off I dropped all the excess weight.
Click to expand...

Indeed, @nwlivewire provided sound insightful feedback in a "helpful" manner in my opinion; we all are here to lend assistance whenever feasiblely possible.

Wow! You are definitely in a challenging position at this point in time with numerous factors which the DoD LDES PEB may try to implement to their fullest advantage unfortunately during the TDRL re-evaluation final adjudication.

Nonetheless, do what you can in reference to obtaining additional medical evidence/medical documentation at this point PRIOR to the forthcoming TDRL re-evaluation at the Madigan Army Medical Center. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
EODStew44 said:
I appreciate it. Thank you. I still have some time to stop by the docs. I also dont like the "Psychologist" at the VA and some MTF, because one told me "Oh, you have PTSD? I can cure you in 2 weeks".... NO LIE. Dude really said that. I talk to my friends who have been to combat, like a peer group, except over the phone. They are the only ones who really understand.

Each of them are writing me a letter outlining symptoms I have had over the past year... So hopefully that may help. ******* Do you think? They are also wounded warriors, one is 235% (lost both arms).

Other than that... I only have 2 or 3 VA visits and the medication made me fat... so I stopped taking it (It was causing stress on my knees and back). Since being off I dropped all the excess weight.
Click to expand...


I wonder if someone reading this thread has gone through a TDRL re-eval for psych and would care to share their experience.

Or any other moderators?

Buddy statements might work a bit - but are they Doctors?

I understand the med thing, but there are other meds out there that don't cause weight gain.

I assume you have Tricare.... I had a GREAT civilian shrink (MD type who could write RXs) through Tricare.

Just because the VA shrink was a rotten apple, doesn't make all shrinks rotten apples.

And if that shrink says you don't need meds, than you have more "evidence" - not just your word for how things are.

Good luck to you and keep us posted.

V/R,
nwlivewire
 
nwlivewire said:
I wonder if someone reading this thread has gone through a TDRL re-eval for psych and would care to share their experience.

Or any other moderators?

Buddy statements might work a bit - but are they Doctors?

I understand the med thing, but there are other meds out there that don't cause weight gain.

I assume you have Tricare.... I had a GREAT civilian shrink (MD type who could write RXs) through Tricare.

Just because the VA shrink was a rotten apple, doesn't make all shrinks rotten apples.

And if that shrink says you don't need meds, than you have more "evidence" - not just your word for how things are.

Good luck to you and keep us posted.

V/R,
nwlivewire
Click to expand...

Indeed, you make some good points in my opinion!

Albeit, I am still awaiting the official scheduling of my DoD LDES PEB TDRL re-evaluation for a behavioral health condition only (e.g., PTSD), I was informed by the Chief of SPEBC at NCRPEB during my numerous FPEB hearings to perform the following actions:
  • To potentially combat the DoD LDES PEB's TDRL re-evaluation trend of lowering a behavioral health condition (especially for PTSD) within the NCRPEB region, be very proactive with all healthcare matters.
  • Establish and maintain all medical appointments whether via DoVA healthcare, DoD healthcare, and/or civilian healthcare systems.
  • Establish or re-establish all prescription medications then continue to maintain the medication regime as authorized by the medical healthcare providers.
That said, for sure, there are not any guarantees for a favorable outcome during the DoD LDES PEB TDRL re-evaluation process albeit performing the aforementioned actions shall definitely increase an individual's opportunities for any potential success of meeting their desired expectations!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
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Warrior644 said:
Indeed, you make some good points in my opinion!

Albeit, I am still awaiting the official scheduling of my DoD LDES PEB TDRL re-evaluation for a behavioral health condition only (e.g., PTSD), I was informed by the Chief of SPEBC at NCRPEB during my numerous FPEB hearings to perform the following actions:
  • To potentially combat the DoD LDES PEB's TDRL re-evaluation trend of lowering a behavioral health condition (especially for PTSD) within the NCRPEB region, be very proactive with all healthcare matters.
  • Establish and maintain all medical appointments whether via DoVA healthcare, DoD healthcare, and/or civilian healthcare systems.
  • Establish or re-establish all prescription medications then continue to maintain the medication regime as authorized by the medical healthcare providers.
That said, for sure, there are not any guarantees for a favorable outcome during the DoD LDES PEB TDRL re-evaluation process albeit performing the aforementioned actions shall definitely increase an individual's opportunities for any potential success of meeting their desired expectations!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
Click to expand...

Warrior is right on target with his assessments.

"It ain't over (TDRL) until the fat Lady sings (PDRL, severance, or RTD)."

nwlivewire
 
nwlivewire said:
Warrior is right on target with his assessments.

"It ain't over (TDRL) until the fat Lady sings (PDRL, severance, or RTD)."

nwlivewire
Click to expand...

I guess it is too late to make an attempt? I am going to go and try to establish a connection with some sore of doctor. I hope my letters from friends will assist in the process. I know it sounds weird, but because of the tight job market, I have been nervous to take off for psych tests. My first 9 months working... I was M-F 7-5, by the time I got off... and the traffic in Maryland, I couldnt get to the doc in time. Now I work 330 am-2pm Thurs-Sun. I have time on M,W,F... but this is a new shift, so now I finally have time to go. I do have 1 or two assessments since getting out.. .but they were very brief meetings.

I take it I can go to the VA and request my medical records? I would try at home on Ebenefits, but my CACReader isn't working properly.

From what I was reading they do a whole evaluation again. If I am upfront and honest with them... It should be fine.... Nothing has changed as far as "employment" I was full time Active Duty when I was Med Boarded, and going to school full time.

Would it help if I get an "assessment" done by a civilian doc. here before I go, so I have evidence supporting? I can still do that... I have to give them my TDRL paperwork by Dec. 1st, then I will be given an appointment date.
 
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