TDRL to PDRL Offer Lowers PTSD Rating NARSUM disagrees

K9cop

K9cop

PEB Forum Regular Member
Registered Member
I have posted this already, but I hijacked another thread (which is not cool) so I'm making my own now. I've gotten a little bit of knowledge about this system, but I am far from understanding everything.

Ok, so check it out. Believe it or not, I'm still confused :confused:. I've attached a copy of my most recent eRAS (FOUO not visible ;)) for reference.

Anyway to break it down I get paid $2276.84 from the VA and $203.70 from DFAS monthly. That pay is based on a 90% VA rating and 70% AF rating respectively. My unfitting condition from the AF was PTSD. The VA pay is based on on me, my spouse, four children under 18, and one over 18. The AF pay is based on 18 yrs 4 days at pay grade E-7.

In addition to that I also receive $476 a month for CRSC.

I just had my re-eval not long ago and the PEB is offering me 50% AF rating now. My main question, that I can't seem to understand yet, is will I get a pay cut? I just want to do what's best for me and my family. Not trying to be an Uncle Sam Gold Digger.

The newest AF FM 356 states that my condition "has remained the same and has stabilized". If you read my newest NARSUM the doctor directly states that my condition has gotten worse since the initial PEB. I'm confused why they are only offering me 50% now if my condition has gotten worse and not better. If I'm not going to loose money then I'm not even going to worry about it, but I foresee a formal board in my future.

In block 10E of my 356 stated my injury was not combat related. I got this changed already through AFPC (corrected AF FM 356 in hand), because it was just a clerical error, but initially this was another reason I was going to fight it.

Not pertinent, but I also receive Social Security Disability every month as well.


****EDIT****
I also had my re-eval C&P appointments and my rating did not change for anything including the PTSD. PTSD for the VA was still 70%. Other little things like migraines up my % to 90% if that is helpful.
 

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DFAS has a calculator on their sight under military members - wounded warriors, that you can plug the numbers into and compare. That might give you a starting point. Bob
 
PsychOfficer said:
DFAS has a calculator on their sight under military members - wounded warriors, that you can plug the numbers into and compare. That might give you a starting point. Bob
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Thanks Bob! That did give me a starting point. If I accept the offer of 50%, then I will indeed loose around $500. This would indeed not be good for my family and I.

Follow-up question:
If I accept the 50%, would my CRSC % go up since it will be based off of the 50% now instead of the 70%? Hopefully that makes sense. Meaning they said 30% of my disability (70%) was CRSC payable. So now since my disability will be 50%, would my CRSC possibly go up to say 40 or 50%?

Man I just re-read that and it is very confusing. I hope someone can understand it.
 
if your narsum and frile has the evidence to support tyhe 70% rating, then formal board is in your future. no ifs and or buts about it.
 
What file are we talking about? The NARSUM does indeed contradict what the 356 narrative States, but if no pay will be lost then I'm not going to worry about it. My main question now is if my crsc will increase with my rating going down to 50%?
 
the file would be your medical file, You are concerning yourself with money vs rating, which is important no doubt, but if your VA percentage drops in 3-4 years, 70% DoD would be significantly more than your VA pay.

DoD once assigned PDRL is perm. no changing, hopefully with your effort and doctors help you will improve, this would equal a lower VA percentage and monies. Fighting for whats right in lieu of whats the "best dollar value" now often is the tougher path, and I understand the "wanting to be done" factor as well. So you decide, justice based on what your doctors tell you is your condition now, or capitulation and injustice now and for a long time to come.
 
Does anyone know if it is common practice to always lower your PTSD rating when they feel you have stabilized and offer you PDRL? Is it even possible to keep a TDRL rating of 70% or is the 70% just given because it is considered not stabilized?

I guess the main question is if you are initially rated at a certain %, is it possible to keep that % once they deemed you stabilized?

Sorry for the ramble.
 
I do not know if it is common practice. I do know some get better, some get worse and some stay the same. You indicated above the doc indicates you are worse or stay the same, so I'd push for the rating that is right.
 
Have you requested TDIU from the VA?

If it were me, I would request a formal board to ensure the rating matches what the medical providers have documented.

I noticed that you have four dependents, have you combed through your medical records to see if there are any conditions that may have not been or could potentially increase if you do a VA appeal. You are so close to 95% that it certainly should be looked at. Dependents Educational Assistance (DEA) is a cash benefit that is currently valued at over $45K per dependent.
 
gsfowler said:
Have you requested TDIU from the VA?

If it were me, I would request a formal board to ensure the rating matches what the medical providers have documented.

I noticed that you have four dependents, have you combed through your medical records to see if there are any conditions that may have not been or could potentially increase if you do a VA appeal. You are so close to 95% that it certainly should be looked at. Dependents Educational Assistance (DEA) is a cash benefit that is currently valued at over $45K per dependent.
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I tried to submit a a TDIU/UI request and eBenefits stated that I must have a claim in the pending stage or something like that. If that is the case then that is stupid. I would have to submit a new claim stating something has gotten worse or a new claim for some other ailment. That makes zero sense. I just found out about the TDIU from you, but I can't file for it. Doesn't sound right. Anyway, I'll have to copy and paste the exact wording later, because eBenefits is currently down. Imagine that.

I'm going to request a formal board just based solely on the fact that the opinion of the re-eval TDRL Doc doesn't match the NARSUM that is being used to substantiate the percentage that they are offering me.
 
That sounds like a plan. Do you have VSO and attorney backup?
 
Good deal on the Formal, I believe you will be victorious, I also would highly encourage you to contact someone by voice or get a DAV during the appeal/va rating reconsideration to file your TDIU. Yes in filing for TDIU, you have to have/file a claim for an increase simultaneously for one of or a newly added condition. The reason behind that is, you are basically stating that one of your conditions (you identify the condition or conditions that make you unemployable), then they see if that condition warrants a rating increase, if that/those increases make yuo schedular 100% (regular) then non IU is needed. If they do not, then the TDIU claim is considered as extra schedular etc.

It has happened in the past, and likely will again that they (the va), automatically consider someone IU, but it is infrequent and is useally done during an appeal where the issue of employment has been brought up directly with a VA doctor.
 
TSgt Twitch said:
Good deal on the Formal, I believe you will be victorious, I also would highly encourage you to contact someone by voice or get a DAV during the appeal/va rating reconsideration to file your TDIU. Yes in filing for TDIU, you have to have/file a claim for an increase simultaneously for one of or a newly added condition. The reason behind that is, you are basically stating that one of your conditions (you identify the condition or conditions that make you unemployable), then they see if that condition warrants a rating increase, if that/those increases make yuo schedular 100% (regular) then non IU is needed. If they do not, then the TDIU claim is considered as extra schedular etc.

It has happened in the past, and likely will again that they (the va), automatically consider someone IU, but it is infrequent and is useally done during an appeal where the issue of employment has been brought up directly with a VA doctor.
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That is just weird that I have to file a new claim. That's basically saying that my condition has gotten worse when it hasn't. I just found out about this tdiu / ui thing so that's why I'm filing for it. I understand it's the VA way and we just have to follow their rules. I'll see if there is a local DAV around here and see if they can help me. Thanks for the advice. I really appreciate it.
 
Do not look at it as you are claiming your condition has gotten worse, look at it as they did not count your condition properly, or you feel they need to make an extra schedular decision that the SUM of your injuries is greater than their individual parts.
 
K9cop said:
Does anyone know if it is common practice to always lower your PTSD rating when they feel you have stabilized and offer you PDRL? Is it even possible to keep a TDRL rating of 70% or is the 70% just given because it is considered not stabilized?

I guess the main question is if you are initially rated at a certain %, is it possible to keep that % once they deemed you stabilized?

Sorry for the ramble.
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From an U.S. Army perspective within the USAPDA NCRPEB region, I would say the typical TDRL to PDRL for PTSD re-evaluation rating shows a trend which indicates a "yes" to your inquiry unfortunately!

In retrospect, the Chief attorney at NCRPEB stated that the trend for Ivan Walks and Associates (IWA) (a civilian subcontractor) TDRL re-evaluation is resulting in a lower rating for PTSD by the USAPDA NCRPEB.

To that extent, it's understood there exist an abundance of external factors specific for each re-evaluated TDRL participant, but the leverage converts back to the DoD (Army) which more likely than not that an accurate military disability rating would be determined; in my opinion.

Indeed, the USAPDA in the NCRPEB region is not following the DTM 11-015 requirement. Simply stated as based upon the trend for a significantly lower military disability rating on TDRL re-evaluations, I am definitely not looking forward to my TDRL six-month re-evaluation with IWA then potentially a new lower non-DoD IDES process rating determination by the USAPDA NCRPEB.

Naturally, if the DoVA D-RAS determines a PTSD final rating which is higher than the USAPDA NCRPEB's rating upon their PDRL finding then I will definitely appeal the USAPDA NCRPEB's finding for sure!

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

Best Wishes!
 
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I don't know what a VSO is, but I do have an attorney for my formal peb appeal.
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VSO is a veterans service officer - DAV, VFW, IAVA, people who work with the VA to facilitate the claims process for veterans. Some are good, some aren't, but a good one that knows the system is worth their weight in gold. (You could ask around here for possible suggestions)

Actually, as you move forward, the SSD is very important - although the two systems are different, yada, yada, yada, the fact is one government organization has found you incapable of working ANY job for the foreseeable future, and that would contribute, IMHO, to a rating higher than 50%, and arguably higher than 70%. Push back hard on this. Bob
 
Though it has been pointed out above, I just restate that the VA should be providing the final rating under IDES/DTM 11-015.
 
Jason Perry said:
Though it has been pointed out above, I just restate that the VA should be providing the final rating under IDES/DTM 11-015.
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Well in my case there is no way the VA provided the final rating. I had my re-eval with the VA months prior to my TDRL appointment and the VA upheld my 70% for ptsd. Screw it. After advice from my attorney and my wounded Warrior program liason I decided to take the 50% and PDRL from the af. I'm sick of fighting. It would go no where anyway. That's what they want you to do anyway. Give up. It's what is the lowest % we can offer so they'll take it and we don't have to pay. Pretty shitty process. After 18 of serving I have loved everything about my career, but now when people ask me, I'm not even proud I served. I'm embarrassed. Who does 18 years?
 
K9cop said:
Well in my case there is no way the VA provided the final rating. I had my re-eval with the VA months prior to my TDRL appointment and the VA upheld my 70% for ptsd. Screw it. After advice from my attorney and my wounded Warrior program liason I decided to take the 50% and PDRL from the af. I'm sick of fighting. It would go no where anyway. That's what they want you to do anyway. Give up. It's what is the lowest % we can offer so they'll take it and we don't have to pay. Pretty shitty process. After 18 of serving I have loved everything about my career, but now when people ask me, I'm not even proud I served. I'm embarrassed. Who does 18 years?
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Hmm, indeed; it seems to be exactly what you have stated above unfortunately in my opinion! :(

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

Best Wishes!
 
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