tdiu Questions Regarding A Possible Claim For Tdiu

[Lyndenrider]

Let me begin by saying that this forum is a great resource for disabled vets like ourselves to get assistance. Thanks!

I was just approached by a neighbor last week regarding TDIU for myself.

I am rated 60% SC and have been for over 10 years. I'm 40% left knee [had three surgeries], 20% right knee [had two surgeries], 10% back pain [no surgeries....yet], 10% OCD [VA prescribed medication] plus 0%-10% for other SC ailments.

I have been unemployed since September 2008. I had to stop working my last job due to the fact I could not continue working due to the stress and strain on my knees and back. I have made NUMEROUS attempts over the last 1.5 years at finding other employment but have had no luck. Prolonged standing or frequent lifting causes me "issues". A few years back I was given custom-made knee braces from the VA for both knees for stability, which I wear almost daily. I have also been on daily pain meds (Vicodin) for the last 4-5 years, also VA prescribed by my VA PCP. This medication makes driving a vehicle to work everyday somewhat dangerous. Also, three years ago I was told by VA orthopedic surgeons that I am a candidate for bi-lateral knee replacements, but I declined having it done due to my younger age [i'm currently 37].

As for seeing doctors, I have only gone to VA doc's in the last 12 years since I have had a hard time getting health insurance from other resources. So, I only have documentation from the VA, not from other resources.

My questions for this forum are...

Besides filling out VAF 21-8940, what other things should I send with this form to help support my claim?

By submitting a TDIU claim, could the VA possibly require me to have bi-lateral knee replacement?

Am I just asking for trouble for myself by submitting a TDIU claim?

I'm a lifetime DAV member, but is there any other resources for help with this that I can get?

Thanks to anyone for assisting me with my questions and for any advice!

Jay

[cowgirl]

Do you have a current copy of your VA medical treatment records? your C-claims file? Reading and rereading help to see what is 'recorded' versus what is 'mentioned'. Would be good to see 'mention' of IU.

Have you filled out the VA form 28-1902 Counseling Record form? If not, take your time and describe Disability Limitations and support your statements. Remember its 'your' request for help from 'them'. (I felt my counselor rushed me to complete the form. For a redo, I'd take it with me and return it soonest.)

Glad to see you at Hadit, looks like your're proactive for yourself, family to get available benefits result of your military health conditions.

If I had redo vocrehab, I'd claim my depression right in front of my pain, honestly. My personal experience was time consuming and not helpful.

Sometimes vocrehab gives a vet a denial, which isnt necessarily bad and maybe help with ssdi or iu. Some denials I've read say something to the effect of

"we've determined the veteran 'cannot succeed in a program of training or education, and get a job occupation that matchs their skills, talents and interests.' The evidence used shows vet was unable to pursue higher education because 'inability' to work with other people (individually or a group of people). Or unable to physically attend a regularly scheduled program of courses due to debilitating SC health issues."

Hope your vocational rehabilitation process goes smoothly and they offer you direct help, expect good things! <_<

Second Yes, on Carlie's note, point the VA in the right direction - to the strongest evidence in your records/file to support your claim.

A thought, if you are on those meds, ask or even tell your PCP or specialist directly - to validate that you have chronic pain disorder or have them explain why or why not. Also pain management class is good fodder as well as helpful to many.

All the best to ya,

Cowgirl'up2009!

Well, last year at my 2008 annual exam my VA PCP mentioned to me about IU, but I had just stopped working and figured I'd find something I could do. 1.5 years later, still no job. I saw him again in June 2009 and he suggested VocRehab as a way to get training for a job that allows me to sit all day. All VocRehab did was direct me to other employment resources. Needless to say, I have an appt. on Nov 16 with him again to discuss IU and see if he will write up something for me to submit along with VAF 21-8490. I have no plans to submit any medical documentation from my surgeries or other docs since the VA already has this inside my VA medical record.

Should I submit the IU form right now WITHOUT documentation from my VA PCP or should I wait til I see him on Nov. 16????

Also, is the VA likely to schedule me to see more docs to support my claim? Or should I do that myself BEFORE submitting VAF 21-8490???

Thanks again for any and all advice.

Jay

[Lyndenrider]

Cowgirl,

I do not have any updated VA medical records at this time since you have to request them in person at a VA hospital. My nearest VAMC is in Seattle, nearly three hours away. I do plan on getting them once I go and see Othro regarding my "likely" knee replacements (hopefully by the end of the year).

As for VocRehab... In June 2009 my VA PCP submitted a request for me for VocRehab eval. Two weeks later VocRehab called me, told me that the 12 yr limit for applying had passed for me, and then directed me to websites and other things to help me find work that I could do. Problem is, I CAN'T WORK due to my SC'ed issues, which is my I filed for TDIU and for a complete reevaluation of my SC'ed disabilities. To my own fault, I'm the type of person that deals with what I have until it "breaks", which tends to make things worse for me then if I had been more proactive. Well, proactive I am becoming, and quickly!

LarryJ,

Thanks for the advice. I see my VA PCP at the CBOC in 10 days and will bring up the "pain disorder" thing. Maybe he can write something up for me and I can attach it as well to VAF 21-4138. I'll submit to the DAV and have it added to my TDIU claim.

As for the depression side..... I've been on VA prescribed Zoloft for my OCD since 1995 (SC'ed at 10%, but have a request for increased eval due to worsened condition) , which helps to ease my depression I get from the chronic pain (which I take Vicodin for and have for the past few years). From what I understand, my rating for the OCD covers for depression as well under the ratings guidelines.

I can see my claim getting very messy and complicated for the VA. A resolution may take some time. <_<

Jay

[Lyndenrider]

BTW, anytime you send the VA any type of "personal statement of fact" as you put it, make sure that it has the proper ending, just above where you sign it.

It goes something to the effect that "all statements contained herein are true and correct to the best of my knowledge and belief".

I did this exactly this on the ending of my Personal Statement. <_< I'm trying to make it as easy as possible for the VA to grant me what I deserve... and want.

[john999]

I agree with what Larry is saying about claiming chronic pain disorder and depression. The VA can waive the 12 year thing regarding your Voc Rehab. However, if you want to get IU then the only reason you would want Voc Rehab is for them to say you are unemployable. Are you seeing a VA psychiatrist on a regular basis? Do you get your narcotics via the Pain Management at the VA? What is your overall rating? If you have been on vicodin for five years you have chronic pain, and are no doubt physically dependent. It is hard for other psychiatric meds to work when you are dealing with severe chronic pain. My VA shrink tells me the naroctics just overwhelm the other meds. The TDIU thing may take some time unless you are already rated at least 40% for one disability and 60% combined.

However, you have to start some place and it might as well be right now. I would make the claim for IU as soon as I could fill out the form. You will no doubt be sent for C&P exams for all the conditions you claim, so it will take time. Is your knee injury a service connected problem? You might need a IMO for the psychiatric problems to get a higher rating. The SSD may be a problem because of your age, but you have to file to find out.

[halos2]

Jay, Have you written to your VAMC under the freedom of information act requesting copies of your records there? I have gone in person, faxed them my requests, and written to them, and have always received all my records. Sometimes I get them immediately, other times they advise me when they will mail them to me.

There is a form you can use to request these too. I'll post form# when I remember it...some others might remember form numbers and give you a shout out on the form # and you can download it to mail/fax to them. They have the form in Medical Records/Medical Information Technology dept too.

You need these copies so you will be able to read what they will be reading. Underline pertinent documentated/validated information that relates to your main issues you are putting in for claim purposes. You will see what you have, what you don't, and what else you need. <_<

Ok form # is 10-5345a It is titled as: Individual's request for a copy of their own Health Information...which the medicalrecords/information dept puts a check in the space (as to how the records were delivered to the veteran) received in person/ or mailed to address.

So request them and they should mail them to you if you can't make it there. Go to www.va.gov/forms and type the form # in the area, or under search the title of the form. Good luck.

Edited November 6, 2009 by halos2

[john999]

If you know that your long term prospects to be able to work again are dim you have to begin to treat your VA claims as a job. You have to get in treatment and stay in treatment. You have to begin to build a mountain of documentation and keep building until the day you die. You can't treat your disability as something you can just get, and then walk away from to get on with your life. It is your life now. It is going to pay you and your familiy the rest of their lives once you become P&T. You don't need to become obsessed with the VA, but you need to cultivate the doctors and play the game. If you are compliant and show up these guys at the VA will help you rather than hurt you. Your PCP and your psychiatrist are the ones who will do the most because they deal with people and not just with cutting people open and sewing them back up.