TDRL Re-evaluation - mental health

Hello all, I'll just give the rundown on % and diagnoses right now to get that out of the way. 6 years enlisted in the Navy. 30% TDRL for major depressive disorder - recurrent, discharged 1/13. 70% overall VA, 50% Bi-polar NOS, agoraphobia with panic attacks, generalized anxiety disorder, and panic attack disorder. 20% bilateral neuropathy, 20% bicipital tendinitis.

I have an upcoming TDRL re-evaluation coming up very shortly 10/3 in North Chicago and just recently realized I have no idea what to expect. I am hoping it is just like any other VA or DoD benefits exam but any information on what to expect would be appreciated.

My main concern is that my initial TDRL diagnosis of major depressive disorder was changed to bi-polar NOS. Will the diagnosis that resulted in TDRL be changed? I don't see how anyone (other than the military) could evaluate you for a condition that you no longer have due to diagnostic exclusivity (cannot have major depressive and bi-polar)

Is there any chance they could claim my TDRL condition has been resolved because I am no longer diagnosed with it?

Thank you for any info you can provide

Scott
 
Hello all, I'll just give the rundown on % and diagnoses right now to get that out of the way. 6 years enlisted in the Navy. 30% TDRL for major depressive disorder - recurrent, discharged 1/13. 70% overall VA, 50% Bi-polar NOS, agoraphobia with panic attacks, generalized anxiety disorder, and panic attack disorder. 20% bilateral neuropathy, 20% bicipital tendinitis.

I have an upcoming TDRL re-evaluation coming up very shortly 10/3 in North Chicago and just recently realized I have no idea what to expect. I am hoping it is just like any other VA or DoD benefits exam but any information on what to expect would be appreciated.

My main concern is that my initial TDRL diagnosis of major depressive disorder was changed to bi-polar NOS. Will the diagnosis that resulted in TDRL be changed? I don't see how anyone (other than the military) could evaluate you for a condition that you no longer have due to diagnostic exclusivity (cannot have major depressive and bi-polar)

Is there any chance they could claim my TDRL condition has been resolved because I am no longer diagnosed with it?

Thank you for any info you can provide

Scott

Well, I would suggest that you review DoDI 1332.18, 5 August 2014, Appendix 4 to Enclosure 3, TDRL Management for DoD regulatory guidance at URL http://www.pebforum.com/site/resources/dodi-1332-18.50/ .

From an U.S. Army perspective albeit I am still awaiting the scheduling of my military TDRL re-evaluation for PTSD, my research has lead me to believe that on TDRL re-evaluations, the PEB will re-rate only unfitting, unstable conditions.

A new unfitting condition that develops while on the TDL is compensable when it is caused by one or more noted unstable, unfitting conditions; or directly related to its treatment.

To that extent, any other new medical condition that develops while on the TDRL is not compensable. This includes any new unfitting conditions caused by one or more stable, unfitting conditions; or directly related to its treatment.

Based upon the results of the TDRL re-examination, the PEB may find one or more of the unstable condition(s) is(are) no longer unfitting; therefore, not compensable and determine whether to retain the initial rating or award a higher or lower rating.

Lastly, the retired military service member will retain the DoVA rating for each medical condition designated as "permanent and stable" on the DA Form 199 or DA Form 199-1.

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

Best Wishes!
 
You can't have bi-polar without depressive episodes though, think of bi-polar as a more specific version of MDD. Bi-polar is generally diagnosed after depression, most do not seek treatment during a manic time frame. They have to rate it if the new condition is related to the initial, and I would guess your records show a relationship.

It is definetly a compensation exam, but they may decide you need more time on TDRL, I am guessing likely result if the bipolar is very recent. I am also guessing the TDRL eval is being done by the DOD. DOD evaluators have a tendency to do some funky write ups and get some funky ratings. They have to rate the same as IDES, meaning VA rating and exams. If you can swing it, or already did it, a recent C&P exam from VA is good as evidence if they rate lower.
 
Thank you for reminding me that conditions caused by the original unfitting condition can still be compensated. Definitely will be something to keep in mind as all of my other mental conditions could be linked back to the original unfitting condition. I'm sure the DoD may not see it that way though.

Thanks for the heads up scout. I have assumed it would be with a DoD doc or else they wouldn't have made me go all the way back to Great Lakes for it. Fortunately evidence shouldn't be an issue as I have been going to every type of therapy the VA has available.
 
Thank you for reminding me that conditions caused by the original unfitting condition can still be compensated. Definitely will be something to keep in mind as all of my other mental conditions could be linked back to the original unfitting condition. I'm sure the DoD may not see it that way though.

Thanks for the heads up scout. I have assumed it would be with a DoD doc or else they wouldn't have made me go all the way back to Great Lakes for it. Fortunately evidence shouldn't be an issue as I have been going to every type of therapy the VA has available.

Indeed, you are welcome! :)

Nonetheless, please remain "positively proactive" and favorable results are forthcoming in my opinion! Take care, continue to get well, and enjoy life! :cool:

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

Best Wishes!
 
Here an update about how the evaluation went just in case it may be useful to someone else in the same position.

The evaluation was done by a civilian psychologist which surprised me as I has expected a Navy psychiatrist. Contrary to the letter which stated the appointment would take 1 to 1.5 hours it actually took about 20 minutes. The evaluation was only over my condition from the time of med board through the evaluation. The psychologist did say though that some people will review your entire history which would explain the extra time. I was told the report would reflect the change in my diagnosis from major depressive disorder to bipolar NOS and that agoraphobia with panic attacks would also be added.

All in all things went as well as I could have hoped. I felt that the psychologist had a very good understanding of my current state and I am hoping for positive results. Although I don't expect it to happen in my case both the psychologist and the TDRL liason stated that many results have been coming back PDRL lately.

I hope this helps. If anyone has any more specific questions feel free to ask.
 
This mirrors what is supposed to happen in VA C&P follow-ups - the instructions are to focus on what has happened since the last evaluation, as the last evaluation has already been accepted as the baseline. Glad to hear it went well. Bob
 
Here an update about how the evaluation went just in case it may be useful to someone else in the same position.

The evaluation was done by a civilian psychologist which surprised me as I has expected a Navy psychiatrist. Contrary to the letter which stated the appointment would take 1 to 1.5 hours it actually took about 20 minutes. The evaluation was only over my condition from the time of med board through the evaluation. The psychologist did say though that some people will review your entire history which would explain the extra time. I was told the report would reflect the change in my diagnosis from major depressive disorder to bipolar NOS and that agoraphobia with panic attacks would also be added.

All in all things went as well as I could have hoped. I felt that the psychologist had a very good understanding of my current state and I am hoping for positive results. Although I don't expect it to happen in my case both the psychologist and the TDRL liason stated that many results have been coming back PDRL lately.

I hope this helps. If anyone has any more specific questions feel free to ask.

Hmm, good deal while appreciate the updated feedback! Hope the results are favorable to you! :D

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

Best Wishes!
 
Thank for the feedback on your visit. The form that the examiner should have used follows.

http://www.vba.va.gov/pubs/forms/VBA-21-0960P-2-ARE.pdf

This is the part that drives compensation (for the most part).
3. OCCUPATIONAL AND SOCIAL IMPAIRMENT
3A. WHICH OF THE FOLLOWING BEST SUMMARIZES THE VETERAN'S LEVEL OF OCCUPATIONAL AND SOCIAL IMPAIRMENT WITH REGARD TO ALL MENTAL DIAGNOSES? (Check only one)
No mental disorder diagnosis
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
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 medication
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation
Occupational and social impairment with reduced reliability and productivity
Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood
Total occupational and social impairment


The award is largely tied to Occupational and social impairment
Rating
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
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.70
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
 
So I received my proposed rating from the VA through the Active Duty IDES (MEB) process. I was recommended to be placed on TDRL @ 50% from DOD with a future reexamination date. In the reviewer note it says "Chapter 35 is warranted as SM is P&T independent of conditions with future examinations" and SMC-K code. Does this mean I will retain my 100% rating, regardless of my future TDRL examination?
 
See my post over where you also posted this.
 
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