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Federal Workman's Comp & Tdiu

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jdman

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Well let me start this off by saying... I hope I didn't screw myself.

I am 90% SC(70% Depression, 60% CFS, 30% GERD/IBS, and 10% Hypothyroidism). I am also currently a federal employee on Workman's Comp for PTSD for tours in Iraq/Afghanistan. I have been on OWCP since Sept 2011. Been told by multiple OWCP doctors that I am totally disabled and unable to return to work.

I recently filed for IU along with an increase in Hypothyroidism and a few secondary conditions. I am trying to get to 100% like everyone else. I hope I didn't screw myself for filing for IU since I still currently have a job even though I have not worked since 2011. I filed for IU because my doctors consider both of my conditions(Depression and PTSD) as comorbid conditions and they cannot differentiate the symptoms. My VA psychiatrist lists them as both Axis I.

Just need some advice. I went for C&P on Monday for my IU. Basically the VA psychologist told me i am very screwed up and he referred me to Suicide Prevention. Did I make a mistake?

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John999

OWCP did question it at the start. They sent me a letter telling me I can't receive benefits for the same condition. But they aren't the same. My Depression diagnosis came 14 prior to the PTSD diagnosis. When I told them I am SC for Depression they told me I was fine and I could receive both and have been. I am at 90%(technically 93%) now and I will be at a 100% soon. I filed a few other secondary conditions to my hypothyroidism and GERD as well so even if they decline my IU I believe I still will be at 100%.

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  • HadIt.com Elder

You should read the OWCP rulebook on this subject of duel compensation. I am afraid you are going to get a letter one day saying you owe the OWCP a couple of hundred thousand dollars. The VA also has rules on duel compensation from OWCP. I am not BSing you since I had to deal with this. I am not trying to rain on your parade. I would just be very careful and maybe get a real legal opinion on this from a lawyer.

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John999,

Are you stating 7.3 from the OWCP regulation?

B. Department of Veterans Affairs (VA). Individuals entitled to
receive both compensation from OWCP and veterans’ benefits may
need to elect between the two. Such an election is required when the
disability or death resulted from an injury sustained in civilian Federal
employment and the VA has held that it was caused by military service,
or when the VA increases a service-connected disability award due to
an injury sustained in Federal civilian employment. In the latter case the
election involves only the increase in VA benefits due to disability
incurred during civilian employment. No election is required between
OWCP benefits and VA benefits for strictly service-related disability. In
death claims, OWCP may not duplicate any payment made by the VA
for funeral or burial expenses and the total payable by both agencies
may not exceed $800.
In my case, Depression was caused by my military service and PTSD was caused by civilian service. The diagnosis's are 14 yrs apart. I am not going to get hit with a bill by OWCP b/c I did nothing wrong. OWCP knows about my VA compensation and VA knows about my OWCP compensation. I am honest and upfront. I get treatment from the VA for my PTSD b/c very few people where I live know how to treat it. OWCP even referred me to them. I understand what you are saying about mental conditions but mine are 2 separate conditions which are co-morbid. I have gone down the road with them and I have notified them of my increase.
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  • HadIt.com Elder

I notified them of my SC disability and everything was OK until I got TDIU. I see you are familiar with the regs. I think you do have a good case for both disabilities as being separate. Mine was based on aggravation of VA disability. I was honest too. The OWCP never warned me about possible problems.

John

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John999

I am very familiar with regs.. I was personnel in the USAF. OWCP doesnt tell you much... I know how to read and interpret the regs... OWCP calculated my pay wrong when I first got on with Work Comp.. At frist I didn't care then I started reading and figuring out what is going on... I sent them a letter that my pay was calculated wrong because Hazard Pay/Post Differential was not included... They back paid me $40,000 and increased my WC pay by $2,000 a month.. I would have never gotten it if I didn't read and make them accountable to the regulation...

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John

I just went to the VA on Monday for a C&P for my Depression since I filed for IU... This is what the psychologist said in the report.

1. Diagnosis
------------
a. Does the Veteran now have or has he/she ever been diagnosed with a mental
disorder(s)?
[X] Yes[ ] No
If the Veteran currently has one or more mental disorders that conform to
DSM-5 criteria, provide all diagnoses:
Mental Disorder Diagnosis #1: Major Depressive Disorder, Recurrent, Severe
without Psychotic Features
Mental Disorder Diagnosis #2: Post Traumatic Stress Disorder (PTSD)
Comments, if any:
As diagnosed by Dr. C. Repanshek on 1/18/13. The stressor causing his
PTSD occurred outside of his military service, as a civilian
contractor in Afghanistan in 2010, and is unrelated to his diagnosis
of Major Depressive Disorder.
a. Which of the following best summarizes the Veteran's level of
occupational
and social impairment with regards to all mental diagnoses? (Check only
one)
[X] Occupational and social impairment with deficiencies in most areas,
such as work, school, family relations, judgment, thinking and/or
mood
b. For the indicated level of occupational and social impairment, is it
possible to differentiate what portion of the occupational and social
impairment indicated above is caused by each mental disorder?
[X] Yes[ ] No[ ] No other mental disorder has been diagnosed
If yes, list which portion of the indicated level of occupational and
social impairment is attributable to each diagnosis:
The Veteran's social and occupational impairment is primarily
caused by his diagnosis of Major Depressive Disorder, Recurrent, Severe
without Psychotic Features. As a result of his problems with low
energy, diminished interest, and decreased motivation, the Veteran
began to miss work, calling out sick. This also placed a strain on
his family, and his ability to help care for himself, and assist his wife
in caring for their children.
The following exam uses the DSM-5 format, as the referral was seen and
evaluated after the department's conversion to the DSM-5 and the
associated DBQs. The following conclusions would not be different if the DSM-IV
criteria had been used.
The Veteran continues to meet the diagnosis of Major Depressive Disorder,
Recurrent, Severe without Psychotic Features. The Veteran described having
the following ongoing problems: poor sleep; depressed mood, with ruminative
thoughts and worries about his family; low energy and motivation; loss of
interest in most activities; feelings of worthlessness; and reduced ability
to concentrate. These symptoms were first observed and briefly treated
during his military service in 1997.
Additionally, the Veteran meets the criteria for the diagnosis of Post
Traumatic Stress Disorder (PTSD), as a result of his civilian service in
Afghanistan in 2010. He reportedly experienced several stressful events
where he feared for his life. He continues to re-experience these events through
intrusive thoughts and memories. He stated he attempts to avoids reminders
of these experiences by isolating himself at home and avoiding crowds. When he
cannot avoid thinking about it, he described being upset and needing to get
away from others for a period of time. He characterizes himself as
increasingly irritable and watchful since his return from deployment. These
symptoms developed in 2010, and represent a new and separate condition from
his Major Depressive Disorder, and are part of a separate etiology.
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