VA 100% P&T

MilitaryBlake

Well-Known Member
PEB Forum Veteran
Registered Member
I have had my MSC confirm this and put my concerns to rest, but I wanted to ask the forum and get any feedback. I am 100% P and T by VA and am working on transferring my care. Going forward I will stay on top of my medical care but there are times when medications are prescribed or other forms of treatment that simply do not work or the side effects are not worth it to me. Going through MEB and DOD care I have done everything asked of me in terms of treatment because I understand there is a litigation side to it all - but as I transfer over to VA care, I don't want to have to worry about anything being taken away because I choose to perhaps not engage in a certain form of treatment, therapy, or medication, correct?

The last few years have been so much about medical care for me. And I am grateful. However, I also believe that the way to happiness is working hard and re-engaging life as much as I can with physical limitations, which means not making every day about all about medical care, Dr. visits, refilling prescriptions, etc.

Thoughts? My understanding from MSC and others is 100% P&T will not be taken away. Ever. (Hence the "permanent" along with the "total")
 

Usndocgreen

Well-Known Member
PEB Forum Veteran
Registered Member
I am unfamiliar with your situation. Are you Tdrl or Pdrl? What’s your dod %?
 

MilitaryBlake

Well-Known Member
PEB Forum Veteran
Registered Member
DoD is 20%. So medically separating. No PDRL or TDRL technically b/c it is under 30%. But condition is considered permanent and I am medically separating.
 

Usndocgreen

Well-Known Member
PEB Forum Veteran
Registered Member
Ok was just asking because of treatment ramifications in tdrl status. Regarding VA I don’t know that much about down grading but I have been lead to believe p&t is just that permanent despite your decisions on continued care. Hopefully someone with more knowledge can chime in.
 

chaplaincharlie

Super Moderator
Staff Member
PEB Forum Veteran
Lifetime Supporter
Registered Member
There is a healthy balance between going on with life and seeking medical care for conditions that render a person P&T. Each person choose their own balancing point. I'm all about quality of life and so I take care of my health, so I can enjoy life. By finding the right docs, I've cut the number of medical visits considerably, while maintaining better health and a great quality of life.
 

MilitaryBlake

Well-Known Member
PEB Forum Veteran
Registered Member
Ok was just asking because of treatment ramifications in tdrl status. Regarding VA I don’t know that much about down grading but I have been lead to believe p&t is just that permanent despite your decisions on continued care. Hopefully someone with more knowledge can chime in.
Okay. That is my understanding as well.
 

oddpedestrian

Super Moderator
Staff Member
PEB Forum Veteran
Lifetime Supporter
Registered Member
P&T just has a few rules to keep in mind

Filing any additional claims can result in other disabilities getting re-evaluated or losing your P&T
You have a few sunset clauses. Five years it takes two exams to reduce your rating, 10 years your disabilities cannot be severed and 20 years you cannot be reduced.
 

MilitaryBlake

Well-Known Member
PEB Forum Veteran
Registered Member
P&T just has a few rules to keep in mind

Filing any additional claims can result in other disabilities getting re-evaluated or losing your P&T
You have a few sunset clauses. Five years it takes two exams to reduce your rating, 10 years your disabilities cannot be severed and 20 years you cannot be reduced.
Could you please clarify what you mean here? I am not sure what you mean by "five years it takes two exams to reduce your rating"
 

oddpedestrian

Super Moderator
Staff Member
PEB Forum Veteran
Lifetime Supporter
Registered Member
Being that you are P&T that means you do not have a RFE (Routine Future Exam) if for some case you file a claim within five years the VSR or RVSR can look at all your disabilities and determine a re-exam is warranted. Hypothetically if the examiner said that you were better your rating would be reduced off that one exam alone. After five years it takes two examiners to claim that you are better to reduce. This is why I never recommend veterans file additional claims till at least five years at the minimum, its just too easy for the VBA to reduce you otherwise.
 

Turtlemomplusthree

PEB Forum Regular Member
Registered Member
What if the VA invited a claim on the 100% T&P proposed ratings, would they go back an re-look at the ratings if I file for the claim I was invited to file?
 

tony292

PEB Forum Regular Member
PEB Forum Veteran
Not to change the subject, but what if someone is 100% PT and they get put in for an SMC..... does that trigger another exam that could reduce the rating?
 

MilitaryBlake

Well-Known Member
PEB Forum Veteran
Registered Member
What if the VA invited a claim on the 100% T&P proposed ratings, would they go back an re-look at the ratings if I file for the claim I was invited to file?
Wow.... I am in the same boat. Or was. I had 100 P&T. Final ratings will be when when I am off AD. MSC recommended I don't file them. I already had 100% proposed, so his reasoning was why mess with that? However, I spoke with his supervisor, MSC supervisor in my area, who said that I SHOULD submit the invited claim. She said they will not go back and re-evaluate, and that if the VA is asking someone to submit a claim, they should. Also took this to Soldier Counsel, who previously actually worked as a VA attorney who confirmed MSC supervisor statement. He also said that I should file it and pretty much said the same thing as MSC's boss.

So I did. That was about a month ago. I don't separate until end of Sept. so I have a long time until I actually find out. But based on what I was told by counsel and MSC's boss, I went ahead and filed the additional claims. Hope they are correct.... any others out there?
 

oddpedestrian

Super Moderator
Staff Member
PEB Forum Veteran
Lifetime Supporter
Registered Member
The VA cannot re-evaluate a claim within six months of granting it so there is a small window to file additional claims anything after that is fair game. Although rare the VA reserves the right to review any claim at any time to determined if it was truly warranted or not, if not they can file a CUE on you so anyone claiming that they cant do it is either misinformed or lying. You can research it yourself by reviewing 38 CFR and the M-21 manual.

@tony292

Yes they can only you can make the call on how strong a SMC claim is as well as all of your disabilities. Just last year we had a vet get his SMC approved but notice his T&P was missing, the rater had determine that although he was eligible for the SMC pay some improvement was noted in his records so they removed the T&P and scheduled a RFE in three years.
 

Turtlemomplusthree

PEB Forum Regular Member
Registered Member
My issue is I’m a severance case, and with one more condition with a rating, then I overcome recoupment because I’m 100% without my unfitting condition. So, I think it may be worth it?
 

MilitaryBlake

Well-Known Member
PEB Forum Veteran
Registered Member
Wow.... I am in the same boat. Or was. I had 100 P&T. Final ratings will be when when I am off AD. MSC recommended I don't file them. I already had 100% proposed, so his reasoning was why mess with that? However, I spoke with his supervisor, MSC supervisor in my area, who said that I SHOULD submit the invited claim. She said they will not go back and re-evaluate, and that if the VA is asking someone to submit a claim, they should. Also took this to Soldier Counsel, who previously actually worked as a VA attorney who confirmed MSC supervisor statement. He also said that I should file it and pretty much said the same thing as MSC's boss.

So I did. That was about a month ago. I don't separate until end of Sept. so I have a long time until I actually find out. But based on what I was told by counsel and MSC's boss, I went ahead and filed the additional claims. Hope they are correct.... any others out there?
Mine was in the six month window so I think I am good to go....
 
data-matched-content-ui-type="image_stacked" data-matched-content-rows-num="3" data-matched-content-columns-num="1" data-ad-format="autorelaxed">
Top