TDRL PTSD 18 Month Reassesment. What is the Typical Ruling

Eric,

I need to make some assumptions (which may not be correct, tell me if you know I am not understanding correctly) here:

1) You were found unfit for PTSD, rated at 30%, and paid at 50% since you were placed on TDRL

2) They did not rate you initially as required according to 38 CFR 4.129, that requires a 50% rating

3) This time around, they found your condition was still not stable, so decided to keep you on TDRL. At the same time, they made an admin correction rating you at 50% initially under 4.129, and continuing that rating now...because there is no change in pay due to TDRL status, you neither gain nor lose money through this.

If my above assumptions are correct, you have no right to a hearing. You have that right after they find you stablilized OR they have to rate you because 5 years have passed and you can't stay on TDRL. Unfortunately, it appears you have to wait until the next re-eval to see if there will be a change.

Your question about IU is a little complicated (i.e., the explanation is lengthy). but I think the answer is "no." You are already at a schedular 100%.

I hope all goes well for you.
 
Your assumptions were correct with one thing being that the board made me 50% this time because of my condition worsening not because they followed the law. So I have no right to question the TDRL continuation decision and request an appeal for a PDRL and request a formal board at this point? I do not want to be on this TDRL for another evaluation period. I hate TDRL. I believe I am stable and my Doctors all stated this in their letters which were included in my TDRL re-evaluation package. The Air Force can drag this out for another 3 and a half years before issuing a permanent finalized decision? This September will make 2 years that I have been on the TDRL. The Doctor said I was borderline psychotic which I nor my wife nor anyone who knows me including medical doctors both psycholigist and psychiatrist all being both V.A. or civilian doctors believe. There is also one more thing to this. The board made a decision and in the packet that they mailed me with the narrative it has medical documentation on another patient that is not me. This leads me to believe that there has been an error in their applied logic and determination of my case. What do I do at this point because I have no right to a hearing as you have stated? Yet there has been obvious error committed and additionally misquotes by my TDRL evaluator of my Doctor's statements and my own.
 
Jason Perry said:
Eric,

I need to make some assumptions (which may not be correct, tell me if you know I am not understanding correctly) here:

1) You were found unfit for PTSD, rated at 30%, and paid at 50% since you were placed on TDRL

2) They did not rate you initially as required according to 38 CFR 4.129, that requires a 50% rating

3) This time around, they found your condition was still not stable, so decided to keep you on TDRL. At the same time, they made an admin correction rating you at 50% initially under 4.129, and continuing that rating now...because there is no change in pay due to TDRL status, you neither gain nor lose money through this.

If my above assumptions are correct, you have no right to a hearing. You have that right after they find you stablilized OR they have to rate you because 5 years have passed and you can't stay on TDRL. Unfortunately, it appears you have to wait until the next re-eval to see if there will be a change.

Your question about IU is a little complicated (i.e., the explanation is lengthy). but I think the answer is "no." You are already at a schedular 100%.

I hope all goes well for you.
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Jason,
I know this is several years later... but I found this post on Google, and since I am a PEBForum member... I wanted to ask you a few questions.

I have my TDRL evaluation coming up. I was rated 60% Army for PTSD, Migraine, Cognitive Disorder, and Depressive Disorder.

Since being placed on TDRL (May 2013)... I have moved from Vegas to Maryland found work, but only stayed at the job for 9 months, then Moved from Maryland to California, and have been working here for about 5 months (Where I am having trouble with work relationships, have been written up several times, and suspended (currently on suspension) for 5 days due to performance issues.

I have NOT been to treatment regularly... in fact I have rarely gone. Everytime I try to make an appointment it is either several weeks down the road or on days where I cannot get off work.

The lack of treatment has me worried for my upcoming evaluation... I fear they are going to either take me off TDRL or downgrade my ratings because I have not gone to treatment.

I am in constant communication with friends (combat friends) and they understand the situation better than the psychologist. I go to them during my low points of suicidal ideation, depression, and at my worst points of anxiety. I have a panic attack several times a week, headaches the same.

Due to the anxiety I have at work, and the need for the income to support myself and my wife... I have not been able to go to the doctors like I would want.

In your opinion, do you think the lack of treatment is detrimental to my claim?

My friends I speak with regularly, are all willing to write letters to the PEB about things we talk about and the symptoms I show.

Please let me know what you think. Thanks.
 
EODStew44 said:
In your opinion, do you think the lack of treatment is detrimental to my claim?
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Yes (in the sense that you would be better off with evidence that would have been developed by the treatment, as well as the fact of frequent treatment is indirect evidence of the severity of the disability).

That said, it is not a "fatal" issue to your case. You mentioned lots of folks who can attest to your problems. (I am always reticent, though, with having folks draft things without having it reviewed by a skilled attorney; I see again and again statements that end up hurting folks inadvertently). The problems at work are indicative of severity of your disability.

I had a case about a year and a half ago (IIRC) where my client came was reduced off of TDRL for PTSD by IPEB to 10% based on no treatment and no prescribed medication. Was able to show that due to geographic distance, treatment was hard to get. Due to meds having been tried in the past and having bad side effects with negligible value in treating symptoms (verified by doctors several times over the years), and showing impact on work (reduced hours, job with little contact with public and reduced contact with co-workers- it was a night shift job, and impact on his marriage) was able to successfully get a retirement finding (I don't remember the percentage off the top of my head).

The above said, recall that favorable evidence will only help your case. Lack of evidence will hurt it. I do not mean to suggest that it is a walk in the park to get a good outcome. But, it can be done.
 
Jason Perry said:
Yes (in the sense that you would be better off with evidence that would have been developed by the treatment, as well as the fact of frequent treatment is indirect evidence of the severity of the disability).

That said, it is not a "fatal" issue to your case. You mentioned lots of folks who can attest to your problems. (I am always reticent, though, with having folks draft things without having it reviewed by a skilled attorney; I see again and again statements that end up hurting folks inadvertently). The problems at work are indicative of severity of your disability.

I had a case about a year and a half ago (IIRC) where my client came was reduced off of TDRL for PTSD by IPEB to 10% based on no treatment and no prescribed medication. Was able to show that due to geographic distance, treatment was hard to get. Due to meds having been tried in the past and having bad side effects with negligible value in treating symptoms (verified by doctors several times over the years), and showing impact on work (reduced hours, job with little contact with public and reduced contact with co-workers- it was a night shift job, and impact on his marriage) was able to successfully get a retirement finding (I don't remember the percentage off the top of my head).

The above said, recall that favorable evidence will only help your case. Lack of evidence will hurt it. I do not mean to suggest that it is a walk in the park to get a good outcome. But, it can be done.
Click to expand...


Thank you. I will still have the option to appeal, or even get JAG or some sort of Lawyer involved. With that option.... who would you suggest as the best source for that?

The reasoning behind not getting frequent treatment was mostly because of duty hours, work schedule, etc. I do have a few, maybe 3 visits to the VA since.. .and they set me up with a PTSD group, however, due to the meeting time, I was not able to attend.

So, should I have a lawyer review their statements if they write them? They are mostly going to discuss the fact I contact them on a regular basis to talk about problems (anxiety, depression, suicidal ideation)... they are able to help some, and at least keep me from acting upon ideation.

From the DODI I was reading and the TDRL information I have, they are basically conducting another "MEB" and the findings will go to the PEB again. However, instead of having a years worth of weekly visits to the doctor, I will not have them. I do have my VA ratings, but it dates back to my Discharge in May 2013.
 
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