mountain tyme

Dbltap1... First,,,,, If you are still active duty and you filed a claim while still in the service, the service will send that application and the service medical records to the VA. However, no action can be taken by the VA to process or provide copies until a service discharge has occurred. I understand fully why you are concern about applying...the most important thing you should be doing now..while you are still active duty is to go over your SERVICE MEDICAL RECORDS...to make sure that everything is documented... EXAMPLE...if you were told to go on a low sodium diet because your blood pressure was too high..that could equal out to hypertention...unless your medical records states you have hypertension while on active duty it will be a up hill battle in some cases to get awarded hypertension...So if you think you have hypertension go in and make a point to be tested to have it for the record!!! ***please note the reason why it is so important to have any condition that occurred during your enlistment service connected really amounts to sercurity for your family...FOR EXAMPLE...if you should have hypertension that emerged during your active duty enlistment...and you drop dead of a heart attact due to your hypertension...then you died of a service connected disabilty and your family will still be able to collect DIC...but lets say you are not service connected for hypertension (even tho it did occur while active duty) or any heart related conditon..and you drop dead of a heart attack..your family may not be entitled to future benifits because you died of a NON-SERVICE CONNECTED DISABILITY...hopefully you are following what I am trying to say. Sleep apena...if you have been told you snore...or if you fall asleep or are tried during the day...go to the base clinic and tell them that you have been snoring loudly lately or that you are falling asleep in your chair have them do a SLEEP STUDY before you get out of the military... once you get out if you do have sleep apena you may not ever be service connected by it...many troops due to shift changes or other factors develop sleep apena...if you are diagnosisd with sleep apena and need to use a cpap machine I believe the VA comp. is 50% compensation. also you will be given a form asking if you have ever been sexually assulted while in service be honest..if you were assulted check yes...I know that this is a senative subject...but it is important that it is done. let me see...if you are feeling stressed or have alot of aniexty step up and make sure that is documented in your MILITARY SERVICE RECORDS... you need to make sure you GET A COPY OF YOUR MEDICAL RECORDS ALL OF THEM WHILE YOU ARE OUT PROCESSING...do not seperate until you get a FULL copy of your medical records... Get names of buddies and a pernmant address...there folks...someone who will know where they are...you many need them down the road take picture's ...they are worth a 1000 words... well...enough said...the point is GET ALL your ducks in a roll before you get discharged...it will make things easier... MT

rentalguy you wrote: Carlie, he has a General, Under Honorable Conditions discharge. He wants to upgrade it to a Honorable Discharge. That is the same kind of discharge that I have. Any time you serve less than what you enlisted for, this it the best that you can ets with, unless you are medically discharged or discharged for the good of the service. I've considered trying to upgrade mine, but never really had a need, so I let it go. Not all veterans who served less then there enlistment will receive a general unless they were medically discharged. I served less then my enlistment period and I received an Honorable discharge...but I was given a re-enlistment code that would have prevented me from re-enlisting...which I did not agree with based on principal...so I contacted the American Civil Liberties Union...and they helped me have my code changed so if I wanted to re-enlist I could...but after what I had experianced during my en-listment I passed. any ways It depends upon the circumstances, your commander mood what type of discharge you could receive...alot of politics if you ask me. MT

MS50111 wrote: "Thanks Carlie i am currently seeing a va mh counsolur every week and a pysh dr. every month, i just started to this year in july and the 4 different anti depressants meds im on makes me even worse than before i am colder to people i show even less emotions to people especially the ones that are closest to me. i guess im going through the motions, i have a claim in for it but im sure they will deny me because of not coming forward and so many years. so i will just live with the confusion and anxiety. but thanks for your concern. " You wrote...I have a claim in for it but im sure they will deny me because of not coming forward and so many years" Maybe this will give you some hope...it took me over 27 years to finally come forward...and after 2 years of documentation letters ect. I was able to prevail in my case...so do not give up hope...the truth will prevail in the end..I know of two wonderful men who have been victims of MST so yes I believe it when you wrote that it happened to you. May God Keep you MT

Dear Southernbelle, His doctor wrote a strong IMO...based on his IMO one would hope the VA would award 70%. Not sure about UI tho because he is in training, now if he can not complete his VO Rehab training due to his PTSD then you could have him ask his VO Rehab counclor to write him a letter outlineing as to why he was not able to complete the program and wheather or not he would be a canidate for Vo Rehab and if they say no then he would have a greater chance at UI. I commend your husband for his valent efforts in taking control of his PTSD I know how difficult it must be for him to even go to class...and many People who suffer from PTSD are not able to take contol of there lives, but it is refreshing to read that your husband is trying to carve out a life for himself and his family it gives hope to others. I have always said I have PTSD but PTSD dose not have me I tell myself that every morning. Everything works out in Gods time...so I will keep you both in my prayers that the VA does right by your husband. There are too many Vets that slipping through the VA Cracks...and I sad to say the crack is getting wider. Be Well MT

Southernbelle...Carlie advice is very sound your husband is seeking an increase in order to be awarded an increase your husband needs to show that his condition has deteriorated to meet the requirment of 70% or 100% to be awarded the increase by the VA. It would help his doctor if you brought in a copy of the Schedual of rating that the VA has est. to meet the higher rating... General Rating Formula for Mental Disorders: 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 His doctor should be the one to determine what % he falls under and write a letter to meet that requirement. it is important if your husband is asking for UI that the doctor states in writing that he strongly feel due to his PTSD that he can not hold substantial empolyment at this time OR ANY TIME IN THE FURTURE... then state why. Hope this helps MT

welcome Ken, Since the military is seperating you due to PTSD you wrote "I was subsequently diagnosed with PTSD by this Psychiatrist. Due to this diagnosis, I was later sent to NAS Pensacola for a Military Psychiatry Evaluation. The Doctor concurred with the initial findings of PTSD and found me Medically Unacceptable for duty with a S-3 and recommended for separation. I've just completed the MEB portion (being found Medically Unacceptable for duty by the board for PTSD) with a recommendation to be referred to a PEB" then the next thing you will need to do is find out how serverly your condition (PTSD) effects your quality of life...and employment possiablity to meet or exceed the VA schedual of rating critia. How The VA Evaluates Levels Of Disability Once the VA has awarded service connection for PTSD, it will then review the most current clinical evidence of record to determine how the severity of your symptoms impairs your social and industrial (ability to work) capacity. The VA has a schedule of rating disabilities, located in title 38 C.F.R., Part 4. The VA has established “Diagnostic Codes” (DC) for various medical and psychiatric disorders, which include a description of the severity of related symptoms and a corresponding disability percentage (called a “rating” or “evaluation”). Although there are different DCs for covered psychiatric disorders, the VA evaluates the level of disability due to psychiatric disorders under the same criteria, regardless of the actual diagnosis. 38 C.F.R. §4.130, DC 9411, governs PTSD ratings. This regulation provides graduated ratings of 0%, 10%, 30%, 50%, 70% or 100%. A 0% rating is noncompensable, This means that you have service-connected PTSD, however, there is little or no impairment as a result. VA compensation payments begin at 10% and increase at each rating level. The VA has adopted the criteria established in the DSM-IV as the basis for its psychiatric ratings, including PTSD. There is also a diagnostic matrix called the Global Assessment of Functioning Scale (GAF) that is used to determine your level of disability. The lower the GAF score, the higher the level of social and industrial impairment. Section 4.130 is reproduced below. You can share this with your psychiatric provider of care, who can prepare a report or opinion letter for submission to the VA that describes your level of impairment. Bear in mind that even if the severity of your symptoms do not satisfy the diagnostic criteria for a 100% (or total) evaluation under the rating schedule, if your rating is high enough, another VA regulation (38 C.F.R. § 4.16) allows the VA to pay you at the 100% level if medical evidence demonstrates that your are unable to obtain or maintain substantially gainful employment as the result of your service-connected PTSD. The technical term for this is a total rating on the basis of individual unemployability due to service-connected disability (TDIU or IU). 38 C.F.R. § 4.130, DC 9411 General Rating Formula for Mental Disorders: Total occupational and social impairment, due to such symptoms as: gross impairment in thought process 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 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% To find the current VA disability compensation monthly payment rates, please go to the VA website at www.va.gov. From the homepage, click on “Compensation”, then on “Rate Tables”. Additional monthly payments may be available based on the beneficiary’s number of dependents. So Ken it is very important that you get your ducks in a roll you will need to determine at what level your PTSD effects you this is where your civilan doctor can help you....bring in the schedual of rating to him and let him review the differnt percentages and he can help you by writing out a letter outlining what percentage your fall under and what conditions you have that warrent that percentage...you should always ask for a percentage not just wait to see what the VA may give you....if you don't get the percentage you request you can then go back and NOD there decision. It is also a good idea to obtain letters from family and friends that can verify the change in you and how it has effected your social ability...perhaps you have withdrawn from family life and no longer want to maintain long term friendships...behaviors along that line. ALSO PUT IN FOR TDUI AT THIS TIME...THIS WILL ensure an EED date...many vets wait to put in for total unemployability then are disappointed that the VA does not retro it back to the origional claim date...if your vet advisor tells you to wait...I would thank him for the advice and put in for it ASAP...esp. since you feel due to all your service connected conditions you will not be able to hold down a sustanital position. Then file for SSD...keep in mind when filing for SSD they should mirror your SC disabilities...the VA WILL NOT TAKE INTO CONSIDERATION ANY DISABILITIES THAT WERE NOT SERVICE CONNECTED...SO KEEP IT SIMPLE...IF YOU ARE APPLY FOR VA COMP. FILE FOR SSD UNDER THE SAME CONDITIONS. BECAUSE IF YOU GET AWARDED SSD BASED ON YOUR SC DISABILITIES IT MAKES IT EASIER TO GET TOTAL DISABILITY FROM THE VA. HOPE this info helps MT

http://www.forms.gov/bgfPortal/agencyDocs....AB&abType=A hope these forms help someone mt

trez...Tri-care is the medical insurance that covers active duty and retired military...unless you are active duty or retired out of the arm forces I don't believe you are eligatable. The VA has Champus VA for disabled veterans. Hope this helps MT

ricky wrote: Just an off the wall answer: Did you mean the child "began collecting or "stopped/became inelgible to collect them. In the latter, if all is in order, (VA has been notified of the childs inelgilibity), I would say that in this instance that the overpayment was not "properly created" and on top of that the veteran has attempted to have the problems resolved. Since the VA had the proper evidence on the child to establish the payments in the first then they definitely had the proper evidence provided by the vet to stop the payments (I would hope the veteran, the school or the child notified the VA of the inelgibility to receive payments if not then VA may have a case of properly created). On top of that the vet has taken more than enough steps to have the situation rectified. I truly believe that in such a case any and all rulings would be aginst the VA. However this is just my opinion. Have you tried to research any such cases at the BVA site? If not I certainly would try to do so. Please keep in mind that the veteran would have had a requirement to insure the VA that the child is /was no longer elgibile to receive the benefits at the time the child became inelgibile depending on the reason of inelgibility. To answer your question...the child is still collecting chapter 35 benifits he will begin his 2nd year of college in about 2 weeks...he only collects the chapter 35 while in attendance and not during breakes. the Vet did contact the VA on there own to inform them that there son will begin collecting VA benifits as of Aug 07 and to stop dependancy pay then sent a letter to follow up on the call back in Aug of 07...Called again in Oct o7 about the money not being deducted...was told to contact the VA education which the VEt did...was told that they could not give out any information regarding there son's chapter 35 benifits the Vet asked if they since they are also part of the VA system if they filed the proper paperwork to stop dependent pay of the VEt..the response was that they could not answer any question regarding there son's benifts...had there son call and was told that when he started to receive chapter 35 benifits that his dad could no longer collect dependent pay on him...and that the proper paper work was submitted...now a year later...the vet is still receiving dependant pay...the vet has been putting the dependant pay in a seperate account because he knows that the VA will be on him like a bee to honey to get there money...but I told him that I feel that the VA is at fault since he has made every effort to have them stop payment...Like Vaf I could not find it anywhere in the va regs that the vet is suppose to inform the VA regarding the child receiving chapter 35 since in many cases some parents do not even know that child even applied...because the VA can not give the VEteran any information regarding there son or daughters benifits....GO FIGure...the child is reciving the benifit due to your disability but the VA can not give you any information regarding the fact wheather or not your child is getting the chapter 35... got to love the system... MT

Ricky...so lets say that your child began collecting chapter 35 education benifits...the Veteran notices that the VA still is paying them the child's dependant rate in there monthly check...the VEt calls the VA to let them know...then sends them a letter the next month for them to fix the problem...a few months later still receiving dependant VA benifits again the VA contacts the VA to have them do an adjustment...one year has now past...and nothing...calls the VA again and is told yes we received your letter and your phone calls are listed...and the VA is still gathering information... Does that VET have to repay all the dependent pay due to there VA error or not deducting the pay after repeated reminders by the vet? just a question MT

I am still preplexed by this whole conversation or should I say debate... My husband and I stopped by the State Veteran Commission both at our State Fair yesterday hoping to catch our state VSO that works in our town there...instead the State VSO that works up at the state RO office was manning the booth...so I broached the question to him regarding a decision that I received recently by the VA regarding a reconsideration I put in for. They increased my claim from 0% to 10% even though the condition clearly warrented a 30% rating based on the medical evidence in accordance with the shed.of rating the VA has est. for the condition. The State VSO told me to go ahead and put in for another reconsideration stating why the condition warrented a higher rating...I told him that I did not see any point because it would only go back to the same rater which low balled it the first time...the State VSO officer said that when you do a reconsideration it DOES NOT GO BACK to the original rater but to a rating officer...now I may be behind the times but I have been told by relaiable sources that when you do a reconsidertion that your claim will go back to the original rater and since the raters do get evaluated based on the accuaracy of there decisions that in more cases then not they will not change it...but if you do a NOD it will go to another rater who will check it over and more likley give it the correct rating if it warrents one. When I told the State VSO officer this he told me that I was wrong and he should know better then I since he works up at the State RO office and at one time that may have been the case but things have changed and when a reconsideration is sent it will not go back to the same rater that rated the claim in the first place...does anyone know if this is true or is he just a good ole boy for the VA and not for the veteran. Thanks in advance

Taking his life will give closure to the families of his victims...but the real justice will be dealt after he leaves this world. MT

web site for VA chapter 35 benifits will tell you how to apply and forms the school will need to fill out http://www.gibill.va.gov/pamphlets/CH35/CH...let_General.htm

Hello Betty... I find this whole sage unbelivable and worthy of a Life time movie...why can that RO office just concede and do what is right! instead of causing you and your family so much grief...at this point I would say it is harassement on there end...and if you could file a complaint with the EEOC due to the VA's incompentance causing a hostile eniviorment I most certainly will...the VA does work for you as a veteran and a tax payer...and should be held accountable for there blanted neglagence on how they have conducted the process of your claim. but anyways lets keep it simple just send in another TDIU form and spray it with skunk scent and I am sure they will not forget who's TDIU form they have! just wanted to let you know I am rooting for a happy outcome for ya MT

Good Morning T-bird.. I found this artical about selecting a VSO that might be helpful if veterans have a clear picture on how important it is to select the right VSO to help them and how to determine if that VSO is right for them it would only benifit the outcome of there claim and how to rank how profiecent the VSO was in there knowledge, willingness to help, if they follow through and most important how well do they communicate and keep you informed. Here is the website I found this information. http://www.theveteransvoice.com/Strickland-VSO01.html and here is the part regarding the repreentative. "Special Series - Understanding the VA Claims Process - Part 3 of 3 - Selecting Your Representative “You have to do it yourself, no one else will do it for you. You must work out your own salvation.” Charles E. Popplestone If you believe that your military service has caused you a disability that has had a negative impact on your life, you may want to file with the Veterans Benefits Administration to receive a monetary benefit; disability compensation. To address your thoughts to an organization as large as the Department of Veterans Affairs (DVA) may be intimidating. You've heard all the propaganda and rumors and stories from your peers and you believe the system is complex and unfriendly. Maybe you've been advised that you need representation for the task ahead or you won't stand a chance of winning any benefits. You might even think that you're required to have a representative. As with most things in our lives, the truth lies somewhere between all the tall tales you hear and the practical side of how the system really works. It's true that facing off with the VA can be frustrating. The laws that govern how the Veterans Benefits Administration (VBA) processes an application for benefits can be as complex as any other law that governs our lives. Like most giant bureaucracies, the VBA isn't very responsive to your personal wants and wishes and it moves only at its own pace. The VBA won't do it your way, whatever happens only happens by their rules. On the other hand, a veteran who is patient and willing to do some work for themselves will usually do just fine handling their own claim. The basic rules and concepts are as simple as can be. Winning a claim only requires that a veteran present evidence of other than dishonorable military service, evidence of a condition caused or aggravated by that service and evidence that the claimed condition is causing a measurable degree of disability. All evidence must be absolute and presented in a format that is acceptable to the VBA. If a veteran chooses the Do-It-Yourself (DIY) method, he or she must be prepared to learn how the game is played. The explosive growth of the information superhighway, the Internet, has made that easier than ever before. With a modern home computer, high speed (broadband) access to the Internet, a printer and a scanner, you're well equipped to teach yourself how to file your claim. In this regard the VBA has gone above and beyond what they might be required to do and put almost everything they have on a web site for you to access at no cost. All the data you need starts here: http://www.va.gov/ From this portal you can link over to benefits: http://www.vba.va.gov/ or health care information: http://www.va.gov/health/ Do you need a form? Click here: http://www.va.gov/vaforms/ You've heard about the Board of Veterans Appeals (BVA) and you want to know more, so the DVA has simplified that by providing you with this link: http://www.va.gov/vbs/bva/ If you want to save some paper, DVA makes it easy to apply for your benefits on-line by clicking here: http://www.va.gov/onlineapps.htm As long as you're in the DIY mode, you may want to use the same guide as the VBA staff is using today. The VBA makes that available to you by clicking this link: http://www.warms.vba.va.gov/M21_1MR.html Maybe you've been scheduled for a Compensation and Pension (C&P) examination at your Veterans Administration Medical Center (VAMC). You want to understand more about what the examiner will look for when assessing your disability. The VBA makes that information available to you if you click here: http://www.vba.va.gov/bln/21/Benefits/exams/index.htm You've discovered that TITLE 38 is that section of law that addresses Pensions, Bonuses, and Veterans' Relief and you want to know more of the details. That's easy, click here: http://www.gpoaccess.gov/ and here: http://ecfr.gpoaccess.gov/cgi/t/text/text-...01bc9b3dc&t pl=/ecfrbrowse/Title38/38cfr3_main_02.tpl or here: http://www.access.gpo.gov/nara/cfr/waisidx_04/38cfr4_04.html and you have a wealth of information available to use. Whatever you may need to validate your claim is readily available for you. It will take work, learning some new skills and organization. You'll also have to be patient. Today's VBA is a year or two behind in processing your claims and falling further behind each day. If all that has overwhelmed you, if you aren't confident with that computer or if you aren't able to devote the time to learn all this new stuff, you'll need some help. The veteran who needs a hand with filing for a DVA benefit will most often seek out a Veterans Service Officer (VSO) who is affiliated with a Veterans Service Organization. These individuals may be called National Service Officers(NSO) or, if they're employed by the state or county you reside in, their title may be that of a County Veterans Service Officer (CVSO). Your Service Officer may be a volunteer who works with a local chapter of their Veterans Service Organization or they may be a full time salaried employee of that organization or your county or state. You aren't allowed to use an attorney or any other representative who will charge you a fee to submit your initial application for benefits. The law has recently changed to allow you to use a lawyer on an appeal of a denial but until then, you must choose a VSO or DIY. No matter who you select to represent you, the initial process is much the same everywhere. The veteran will meet with the representative to discuss whatever condition it is the veteran believes will justify an award of disability compensation. The veteran must sign a Power of Attorney (POA) that will allow the representative to address the VBA on behalf of the veteran, retrieve and review otherwise confidential records and similar activities. At this point the Service Officer will assist the veteran with completing any required forms and then submit them to the VBA. In some locales, the local VSO, the representative that may have an office in a VA health facility, will turn all that paper over to another VSO who has an office at the Veterans Administration Regional Office (VARO). In some states, the CVSO is required to do only the initial piece of work and then that claim is handed off to a VSO at the VARO. From there, the file is given into the VBA at the VARO and only after it's adjudicated will anyone know just what's happened to it. The notification will come in the mail as an award letter or a denial letter. I contend that your chances of winning your award are decided long before your application ever gets to the VBA rater...that individual who is the ultimate decision maker on your case. If your first application is focused, complete and doesn't have any gaps, you're much more likely to be satisfied with your award. Knowing that, who you choose to act on your behalf is one of the more important decisions you'll ever make. Not unlike choosing a heart surgeon or a plumber, if you pick the guy who graduated at the bottom of the class, you may regret it for a long time to come. Unfortunately, Veterans Service Officers aren't as well regulated as plumbers and heart surgeons. There are no national standards, no licenses, no single sets of certifications that are required to show competence. The only real requirement on the books is a certification by the VBA. That requirement is mostly a rubber-stamp sort of process and doesn't offer any assurances of competence or experience. There aren't any governing bodies that track the outcomes of a particular set of representatives so we can't accurately determine who is most likely to do a good job for us. Knowing all that, how can you possibly choose a representative that you can trust? First, do your homework. The sad fact is that most veterans will take a lot of time researching where to purchase a car or they may spend hours buried in technical manuals before they'll buy a new computer. Then they'll freely hand over their lives and potentially hundreds of thousands of dollars of potential benefits awards to the first stranger they meet. “Shop around” is rule number 1. If you'll go to Sears, Best Buy and a local, home-town merchant to compare the values of a new washer-dryer combo, why wouldn't you do at least that much thinking before you sign a POA over to someone? You can find a list of organizations that can represent you by clicking here: http://www1.va.gov/vso/ and here: http://www.va.gov/statedva.htm Once you've contacted those organizations that appeal to you, interview them. As you go about the interview process, pay attention to the details that will make a difference to you a year down the road. Were they receptive to a fixed appointment time? Were they on time and prepared to meet you? Did they welcome your spouse to join the meeting as a partner? Were the surroundings of the offices professional and well organized? Were you given the time to and encouraged to ask questions? Were you afforded privacy so that you felt comfortable enough that you could speak of confidential matters? Did you have a steady stream of interruptions and was the phone ringing off the hook? Did the representative seem to pay close attention to you or were they in a hurry to move ahead? Did the representative appear professional in dress and demeanor? Were you offered or pressured to pay a fee for a membership to join the organization or given some sort of promotional material with a membership application? If you aren't able to answer all of the above and feel good about the answers, you should avoid that organization. It isn't likely to get any better and it may get a lot worse. This is your life and you have every right to be demanding. When you feel like you may have found a representative that you trust, ask some pointed questions. I've developed the questions here from the emails I receive with complaints or comments about the shortcomings of VSO's who are representing veterans. The most common complaint is about a lack of communication. If you have a question or if you need some assurance that your case is at the VARO and will be worked on, nothing will be more frustrating to you than when your VSO won't call or email you. Don't be afraid to ask; How are you certified or otherwise credentialed? How much experience do you have with this kind of work? Are you to be the “point man” in handling my claim or will you assign it elsewhere? What happens if my benefits are denied? Will you handle the appeal or do you pass it up a ladder to another layer in your organization? Who do you report to? If I have trouble reaching you (maybe you're on vacation) who do I call and what can I expect? Will there be someone in your office every day of the week during normal business hours? How long will it take for you to return my telephone call if I have a question? How prompt are you at replying to your emails? If I need copies made or documents scanned, may I bring them to your office to accomplish that? Is there a notary in your office should that task be required? If you can't get these questions answered to your satisfaction, it's time to exit and move to the next one on your list. Finally, ask their opinion on how well your benefits application may be received at the VARO. Ask for a realistic opinion on a time line. If they aren't willing to be open and honest with you, you're in the wrong place. Just because you aren't paying out of pocket for these services doesn't mean they're free. You have a right to demand excellence from a representative. In one way or another, you've paid the price and earned the right to have a high quality of representation for the challenge ahead. Your dealings with BVA will take time and present many challenges along the way. Knowing that you're represented by an experienced professional, one who truly cares about and respects you will be worth the time and effort you put into your selection.

Hello Cherie33... I would say based on what you submitted with your intial claim was enough for them to grant you TDUI...but not P/T...never know what the rater is thinking when they make there decision! It could have been in the wording...you wrote: " My Voch Rehab counselor put me in the Independent Living program and wrote a letter stating that I am basically unemployable at this time because of my disabilities. I believe they said preparing me for work is not feasible at this time."...I think the words "feasible at this time" may have had a slight impact..the VA may be hoping that you will improve...Since you have applied for SSD once you are granted that you can submit that to attest that you are permantly disabled the VA may retro back based on that grant...lisiting you T/P through the VA. you have a well grounded claim like everything to do with the VA it takes persistance. things will turn out alright. mt

cherie33...you could ask your therapist to write out a letter outlining why the prognosis of your condition is not likly to improve to the point that you would be able to substain substantial employment anytime in the near future. But, by what you have posted "The award letter stated that in Approximately 22 months from now or April 2010 the VA will review the symptoms and severity of my recurrent major depression with psychotic features."...the VA is hoping that through treatment you will be able to once again work...I was told once that when the VA makes a decision whether or not an individual is P/T or TDUI they take in consideration how long it has been since the individual was able to maintain some kind of employment and what % did the SC disabilty play in the outcome of why you were not able to keep a job. The VA will not take in consideration any condition that is not SC...as to why an individual is no longer able to work. It would also be helpful if you could have a letter from vo-rehab stating that due to your mh disablity that you are not a canidate for vo-rehab....that also would support your letter from your doctor. just some thoughts on the matter mt

Jayq You wrote: “"Additional" what kind of benefits for dependents of vets rated at 30% ???” Veterans with disability ratings of at least 30 percent are eligible for additional allowances for dependents, including spouses, minor children, children between the ages of 18 and 23 who are attending school, children who are permanently incapable of self-support because of a disability arising before age 18, and dependent parents. The additional amount depends on the disability rating and the number of dependents. Reimbursement of Travel Costs Certain veterans may be provided special mode travel (e.g. wheelchair van, ambulance) or reimbursed for travel costs when traveling for approved VA medical care. Reimbursement is paid at 28.5 cents per mile -and is subject to a deductible of $7.77 for each one-way trip and $15.54 for a round trip; with a maximum deductible of $45.62 per calendar month. Two exceptions to the deductible are travel for C&P exam and special modes of transportation, such as an ambulance or a specially equipped van. These deductibles may be waived when their imposition would cause a severe financial hardship Eligibility: Payments may be made to the following: 1. Veterans whose service-connected disabilities are rated 30 percent or more. 2. Veterans traveling for treatment of service-connected conditions. 3. Veterans who receive a VA pension. 4. Veterans traveling for scheduled compensation or pension examinations. 5. Veterans whose gross household income does not exceed the maximum annual VA pension rate. 6.Veterans whose medical condition requires a special mode of transportation, if they are unable to defray the costs and travel is pre-authorized. Advance authorization is not required in an emergency if a delay would be hazardous to life or health. Dependents Allowance: In addition veterans entitled to compensation whose disability is rated as 30 percent or more, shall be entitled to additional compensation for dependents as follows (monthly amounts): Dependent Status 30% Veteran with Spouse & Child $429 Veteran with Child Only $384 Veteran with Spouse, One Parent and Child $463 Veteran with Spouse, Two Parents and Child $497 Veteran with One Parent and Child $418 Veteran with Two Parents and Child $452 Add for Each Additional Child Under Age 18 $21 Each Additional Schoolchild Over Age 18 $68 Additional for A/A spouse $39

This table will help you understand what benefits you and your eligible dependents are authorized to receive from the VA. If you have any questions or concerns please contact us. Or you may contact the VA Regional Office at (800) 827-1000 or the VA Medical Center in Minneapolis at (866) 414-5058. Service Connected means that you are in receipt of a disability compensation because you (the veteran) were disabled by injury or disease that incurred or was aggravated during military service. The service of the veteran must have been terminated through separation or discharge under conditions that were other than dishonorable. ***If you are 0% and greater service connected • Home Loan Guaranty Certificate of Eligibility • Service Disabled Veterans Life Insurance. Must apply within 2 years from initial notice of service connection of a disability. o Call (800) 669-8477 for more information about o Waiver of National Service Life Insurance premiums o National Service Life Insurance total disability income provisions • Outpatient Treatment for: (1) service connected condition, and (2) for all medical conditions if enrolled in VA healthcare program. Co-payment for treatment may apply for non-service connected conditions. • Travel allowance for scheduled appointments for care of the service connected condition that the VA Medical Centers and VA Out- Patient Clinics. Eligibility based on veteran's family income. • Medical treatment in non-VA facilities for service connected condition. Certain restrictions apply. • 10 Point Civil Service Preference. (10 points added to Civil Service test score.) • Clothing Allowance for veterans who use or wear a prosthetic or orthopedic appliance (artificial limb, braces, wheelchair) or use prescribed medications for skin condition which tend to wear, tear, or soil clothing. • Temporary increased total evaluation with payment at the 100% rate based on hospitalization for a service connected disability necessitating at least one month of convalescence or immobilization by cast, without surgery of one major joint or more. • Dental treatment for: (1) service connected dental condition, OR (2) follow-up dental treatment which was begun while hospitalized at a VA Medical Center, OR and former Prisioner of War with 90 consecutive days, or more, of confinement. Some restrictions may apply based on availability of services. ***If you are 10% and greater service connected All of the above and: • Vocational Rehabilitation which includes full medical and dental. (Chapter 31) • Funding fees waived for Home Loan Guaranty. ***If you are 30% and greater service connected All of the above and: • Additional compensation for dependents. (Spouse, children, dependent parents) • Non-competitive Civil Service appointment. • Affirmative action in employment. • Travel allowance for scheduled appointments for care of all medical conditions (except dental) at VA Medical Centers and VA Out-Patient Clinics. • Additional allowance for a spouse who is a patient in a nursing home. (Either helpless, blind, or so nearly helpless as to require the aid and attendance of another person.) ***If you are 40% and greater service connected All of the above and: • Automobile Assistance. (One-time payment up to $8,000). Veteran must have service connected loss of one or both hands or feet, or permanent loss of use, or permanent impairment of vision of both eyes. (For information, contact Prosthetics, Minneapolis VAMC) • Special Adaptive Automobile Equipment. Veteran must have service connected ankylosis (immobility) of one or both knees, or one or both hips. ***If you are 50% and greater service connected All of the above and: • Medical treatment for any condition (except dental). Enrollment in the VA Health care program is encouraged but not required for treatment of a service connected condition. • No co-payments for treatment at a VA Medical Center and Out-Patient Clinics. • No co-payments on Prescription Drugs for service connected disabilities. Includes prescriptions written by a non=VA physician providing care under an authorized fee basis agreement with the VA Medical Center. (NOTE: Prescriptions written by non-VA physicians may be filled through the VA pharmacy for and (1) WW I veteran (2) veteran entitled to Aid and Attendance or Housebound benefits regardless of evaluation percentage. A co-payment will be charged if the prescription is not for a service connected disability. • Medical treatment in non-VA facilities for any medical condition. ***If you are 60% to 90% with Individual Unemployability and greater service connected All of the above and: • Increased compensation, payable at the 100% rate, based on Individual Unemployability. • Dental treatment ***If you are Permanent and Total Evaluation Either 100% OR 60% 90% with Individual Unemployability All of the above and: • Educational Assistance for Dependents. (Chapter 35) • Civilian Health And Medical Program For Dependents/Survivors. (CHAMPVA) • Commissary and Exchange privileges • Specially Adapted Home. Grant up to $43,000. Building, buying or remodeling adaptive homes or paying indebtedness on existing home. Veteran must be entitled to compensation for permanent and total service connected disability due to: (1) loss or loss of use of both lower extremities or disability which includes (a) blindness in both eyes, having only light perception, plus (B) loss or loss of use of one lower extremity OR loss or loss of use on one lower extremity together with (a) residuals or organic disease or injury, or ( the loss or loss of use of one upper extremity which so affects the functions of balance or propulsion as to preclude locomotion without using braces, canes, crutches, or wheelchair. • Special Adapted Homes. Grant up to $6,500. Handicap adaptations to a veteran's residence disability. Veteran must be entitled to compensation for permanent and total service connected disability due to: blindness in both eyes with 5/200 visual acuity or less, OR anatomical loss or loss of use of both hands. • Veterans Mortgage Life Insurance. Decreasing term mortgage insurance up to $90,000 for veterans who have received a Specially Adapted Housing grant and have an existing mortgage. ***If you are 100% Permanent and Total Evaluation service connected All of the above and: • Emergency treatment in non-VA facilities if VA facilities are not available. Veteran or "SOMEONE" must contact the VA Fee Basis immediately after the veteran is stabilized!

Department of Memorandum Veterans Affairs Date: November 25, 2005 VAOPGCPREC 5-2005 From: General Counsel (022) Subj: Eligibility for a "Temporary" Total Disability Rating Based on Individual Unemployability—38 C.F.R. § 4.16(B) To: Chairman, Board of Veterans’ Appeals (01) .... (Emphasis added.) Further, 38 C.F.R. § 4.15 distinguishes between “total disability” and “permanent total disability” in the following manner: Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation; Provided, That permanent total disability shall be taken to exist when the impairment is reasonably certain to continue throughout the life of the disabled person. The significance of the distinction between “total disability” and “permanent total disability” is made apparent by 38 C.F.R. §§ 3.341 and 4.16, which authorize VA to assign “total disability ratings” for purposes of service-connected disability compensation, and 38 C.F.R. §§ 3.342 and 4.17, which authorize VA to assign “permanent and total disability ratings” for purposes of nonservice-connected pension. The provision in 38 C.F.R. §§ 3.342 and 4.17 for “permanent” total disability implements the statutory requirement that pension be paid only if a veteran is “permanently and totally disabled.” 38 U.S.C. § 1521(a). The absence of any similar requirement in 38 C.F.R. §§ 3.341 and 4.16 for “permanent” total disability clearly indicates that VA did not intend to require a finding of permanence as a condition of entitlement to a TDIU rating for compensation purposes. Russello v. United States, 464 U.S. 16, 23 (1983) (“where Congress includes particular language in one section of a statute but omits it in another section of the same Act, it is generally presumed that Congress acts inten-tionally and purposely in the disparate inclusion or exclu¬sion."); Smith v. Brown, 35 F.3d 1516,1523 (Fed. Cir. 1994) (rules of statutory construction apply equally to interpretation of regulations). Accordingly, we conclude that 38 C.F.R. § 4.16 permits VA to award TDIU ratings based on temporary (i.e., non-permanent) inability to follow a substantially gainful occupation. ..... Tim S. McClain Attachment: C-file >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> §3.340 Total and permanent total ratings and unemployability. (a) Total disability ratings: (1) General. Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. Total disability may or may not be permanent. Total ratings will not be assigned, generally, for temporary exacerbations or acute infectious diseases except where specifically prescribed by the schedule. (2) Schedule for rating disabilities. Total ratings are authorized for any disability or combination of disabilities for which the Schedule for Rating Disabilities prescribes a 100 percent evaluation or, with less disability, where the requirements of paragraph 16, page 5 of the rating schedule are present or where, in pension cases, the requirements of paragraph 17, page 5 of the schedule are met. (3) Ratings of total disability on history. In the case of disabilities which have undergone some recent improvement, a rating of total disability may be made, provided: (i) That the disability must in the past have been of sufficient severity to warrant a total disability rating; (ii) That it must have required extended, continuous, or intermittent hospitalization, or have produced total industrial incapacity for at least 1 year, or be subject to recurring, severe, frequent, or prolonged exacerbations; and (iii) That it must be the opinion of the rating agency that despite the recent improvement of the physical condition, the veteran will be unable to effect an adjustment into a substantially gainful occupation. Due consideration will be given to the frequency and duration of totally incapacitating exacerbations since incurrence of the original disease or injury, and to periods of hospitalization for treatment in determining whether the average person could have reestablished himself or herself in a substantially gainful occupation. ( Permanent total disability. Permanence of total disability will be taken to exist when such impairment is reasonably certain to continue throughout the life of the disabled person. The permanent loss or loss of use of both hands, or of both feet, or of one hand and one foot, or of the sight of both eyes, or becoming permanently helpless or bedridden constitutes permanent total disability. Diseases and injuries of long standing which are actually totally incapacitating will be regarded as permanently and totally disabling when the probability of permanent improvement under treatment is remote. Permanent total disability ratings may not be granted as a result of any incapacity from acute infectious disease, accident, or injury, unless there is present one of the recognized combinations or permanent loss of use of extremities or sight, or the person is in the strict sense permanently helpless or bedridden, or when it is reasonably certain that a subsidence of the acute or temporary symptoms will be followed by irreducible totality of disability by way of residuals. The age of the disabled person may be considered in determining permanence. © Insurance ratings. A rating of permanent and total disability for insurance purposes will have no effect on ratings for compensation or pension. [26 FR 1585, Feb. 24 1961, as amended at 46 FR 47541, Sept. 29, 1981]

Dear Zenarcher...after reading your testimony to the House subcommittee of Disability Assistance...I just sat here for a moment and bowed my head and prayed for you and all the unsung hero's who are out there making a differnce to help fellow veterans when they themselves are ravaged by there own illness...I thank you for being a true American and that you are a credit not only to your family but to all those you will never meet by taking the time to speak up. I know there are no words that I can say that can take away the pain you and your family are enduring...and I am sure that God has a special place for you when your mission here is done...a man is not remembered by what he has but what he has done to make a diffence in the lives around him. God Bless you and may he keep you and all those you love safe in His loving Embrace Mt

Hello... here a website that contains 38 CFR Book B Adjudication that is a good source of information... http://www.warms.vba.va.gov/bookb.html 2. website for 57 Disability Examination Worksheets are in use both by the doctors of VHA (Veterans Health Administration) who do the disability examinations and by the rating specialists, hearing officers, and Decision Review Officers of VBA (Veterans Benefits Administration) who do the disability evaluations. http://www.vba.va.gov/bln/21/Benefits/exams/index.htm 3.Degenartive Disc disease http://frwebgate.access.gpo.gov/cgi-bin/ge...3&TYPE=TEXT 4.)kidney failure http://frwebgate.access.gpo.gov/cgi-bin/ge...3&TYPE=TEXT 5.)Hyptensive retinopathy http://frwebgate.access.gpo.gov/cgi-bin/ge...3&TYPE=TEXT hope this helps mt

you wrote: "A lieutenant colonel stated "those who talk the most about their PTSD tend to have the least PTSD." In all reality PTSD is a condition that evoles over time...it just does not happen. PTSD is the end result of PTS and if not treated in a timely manner and left unchecked it will develop into PTSD (d as in disorder) once PTS reaches the point of a disorder is when it becomes disabling due to the emotional damaging effect it plays in one's mental process. That is why there are many veterans of earlier conflicts that suffer from PTSD due to it not be detected when it was most treatable. Today with a new understanding of how PTS effects our veterans the condition is detected in it's early stages...most veterans will start out by having advanced aniexty sympoms as an early trigger sign for the doctors to diagnoses and hopefully get them into treatment as to how to cope with the horrors of what the veteran went through. Early intervention is the key to helping the veteran stay healthy. So I would say is someone is always talking that they have PTSD it would send up a red flag...due to many suffers do not discuss what happened to them due to avoidance or fear some even shame depending on the trigger. Like Berta said only a doctor that is trained in the field can make that determination. MT

Hello...you may want to read this artical as well as the ones Berta posted.. GAO Findings and Recommendations Regarding DOD and VA Disability Systems www.gao.gov/new.items/d07906r.pdf What You Need to Know About the Physical Disability Evaluation System Overview of the Department of the Army’s Physical Disability Evaluation System Each year the Army Physical Disability Evaluation System (PDES) separates thousands of Soldiers who are found unfit for continued military service. This guide answers a few general questions about the Department of the Army’s PDES. Overview of the Department of the Army’s Physical Disability Evaluation System. The Secretary of the Army is charged with assuring the fitness of Soldiers, and separating or retiring those who become unfit to continue military service because of physical disability. The law provides benefits for eligible Soldiers whose military service is cut short due to a service-related disability incurred in the line of duty. The United States Army Physical Disability Agency (USAPDA) manages the Army’s PDES and acts on behalf of the Secretary of the Army. USAPDA is a Field Operating Agency of the Army Human Resources Command (HRC) and is headquartered in Washington DC at Walter Reed Army Medical Center. In addition to the USAPDA HQ at Walter Reed, the agency has three Physical Evaluation Boards (PEBs), located at Walter Reed, Ft. Sam Houston, TX, and Ft. Lewis, WA. The PEBs are administrative boards that determine whether a Soldier’s disability prevents his/her continued performance in the Army. The PEB is comprised of two types of boards (Informal and Formal) that review medical and performance evidence to make determinations of fitness or unfitness to continue military service. It is important to understand that this is a performance-based system. Simply because a Soldier has a medical condition does not mean that the Soldier cannot continue to serve on active duty or in the Reserve Component. It is the impact of that medical condition upon the Soldier’s ability to perform duties appropriate to his/her rank and branch/MOS that is important. A Soldier with a serious medical condition can be found fit within the limits of his/her profile for continued service if the evidence supports that finding. If the PEB determines that a Soldier is unfit to continue military service, and finds that the Soldier is eligible for disability benefits, the PEB determines the percentage of the Soldier’s disability compensation using Department of Defense Directives (DoDD) and Instructions (DoDI), Army Regulations, and current Army policy in conjunction with the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD). Depending on the severity of the illness or injury, the Soldier receives either permanent or temporary disability retirement or disability severance pay. The Army only rates those medical conditions that result in the Soldier being determined unfit for continued military service. The Department of Veterans Affairs generally rates a Soldier for all conditions incurred in or aggravated by military service. Therefore, it is not uncommon for a former Soldier to receive a higher combined disability rating from the DVA than the PEB combined disability rating. The PEB makes determinations of: • Fitness or unfitness to continue military service; • Eligibility for disability compensation;• Disability codes and percentage rating;• Disposition of the case; • Whether or not the injury or illness is combat-related. When is a Soldier unfit to continue military service? A Soldier is unfit to continue in the Army when the preponderance of evidence demonstrates that one or more physical and/or mental condition(s) significantly interferes with the Soldier’s ability to perform the duties of his/her office, grade, or rank. The PEB makes the decision on fitness by balancing the extent of a Soldier’s condition, as shown through objective medical and performance evidence, against the requirements and duties that the Soldier may reasonably be expected to perform in his/her branch/MOS and grade. The mere fact that one or more medical conditions exist does NOT constitute an unfit determination. The inability to deploy CANNOT be the sole basis for determining unfitness per DoD Instruction. Typical medical evidence used by the PEB includes: • A narrative summary written by the Medical Evaluation Board (MEB). • History and treatment of the specific injury or illness. • Results of laboratory, x-ray, MRI, CAT scan, and other specialized tests. • Current Physical Profile • All referrals to physicians, specialists, and sick call (health record). • Type and frequency of medication. • Results of physical exam completed within past six months. Typical performance evidence includes: • Memorandum from the Soldier’s Commander addressing current ability to perform duties in MOS and unit.• Evaluation Reports• APFT• Approved Line of duty investigations. I’ve been seriously hurt; what happens next? The priority for a Soldier suffering an illness or injury is to ensure that he/she receives proper medical attention. If the Soldier’s condition improves to the point that he/she is able to return to full military duty, he/she is returned to his/her unit. However, if the treating physician believes that the Soldier is unable to perform full military duty or is unlikely to be able to do so within a reasonable period of time (normally 12 months), the Soldier is referred to a Medical Evaluation Board (MEB) at the Medical Treatment Facility (MTF) where treatment is being provided. Medical Evaluation Board (MEB) If the Soldier’s physical condition falls below medical retention standards, the attending physician refers the Soldier to the Physical Evaluation Board Liaison Officer (PEBLO) to start a MEB. The MEB is an informal process comprised of at least two physicians who compile, assess, and evaluate the medical history of a Soldier and determine how the injury/disease will respond to treatment. The MEB documents the extent of the injury or illness and decides if the Soldier’s medical condition is severe enough to question his/her ability to continue serving in a full duty capacity. The attending physician does this by relating the nature and degree of the medical impairment of the Soldier to retention standards and the duties that the Soldier may reasonably be expected to perform in his/her office, grade, or rank. If the physician believes the Soldier will be able to return to full military duties within a reasonable period of time, and the Soldier meets medical retention standards, then a MEB is not required. Referral to PEB The MEB normally contains all of the medical and nonmedical evidence described previously. The Soldier (or his/her next of kin if the Soldier is not deemed competent) is required to review and sign the MEB and is given an opportunity to comment, as desired, on the complete content of the MEB before it is referred to the PEB. How can I ensure the PEB has information necessary to render an accurate determination in my case? When a Soldier is informed by his/her medical care provider or a representative of the Medical Treatment Facility (MTF) that he/she is being referred to the PEB for a fitness determination, it is important for the Soldier to become familiar with how the disability evaluation system process works. The Soldier’s primary counselor and information resource is the PEBLO. The PEBLO is the Soldier’s advocate, counseling him/her on MEB/PEB findings and related rights and benefits. Note that the PEBLO works in the Patient Administration Division (PAD) of the MTF and NOT for the PEB. The Soldier will have an opportunity to review and comment on the medical and non-medical information referred to the PEB. A Soldier must ensure that all medical conditions are accurately and completely listed on the forms provided during the physical examination. The examining physician will address those additional conditions, document findings, and, if appropriate, refer the Soldier to additional specialists for further evaluation that MAY result in additional medically unacceptable conditions being referred to the PEB. To ensure timeliness in this processing through the PDES, it is in the best interest of the Soldier to: - Attend all appointments – contact counselor if you can’t make an appointment. (No shows will be reported to your Commander) - Provide copy of Leave and Earning Statement (LES), Enlisted/Officer Record Brief (ERB/ORB), last three evaluation reports (OER/NCOER) - Provide copies of approved retirement or separation orders - Provide copies of orders for recent promotions or demotions. A Soldier will be permitted to review the narrative summary (NARSUM) and any addenda regarding a medical condition that has been prepared for referral to the PEB. After completion of the MEB, the Soldier will review the findings and recommendations. If the Soldier disagrees with the MEB or feels there is information missing or not adequately addressed, he/she will have three working days to submit a rebuttal. The Soldier wants to remain in the Army, he/she can use this opportunity to provide documentation on their ability to continue to perform their duties despite their medical condition(s). The rebuttal is referred back to the original physician who will address the issues contained in the rebuttal and make changes as appropriate. The reviewing physician receives the rebuttal and can decide to let the MEB stand as written, send MEB back for further medical information, or forward to PEB with attachments or additional notes. The reviewing physician’s final disposition of the MEB can result in the following: - If the Soldier meets retention standards within the limits of his profile, he/she is returned to duty in his/her MOS. - If the Soldier does not meet retention standards, the case will be referred to the Physical Evaluation Board (PEB) for further disposition. - If the MEB is a MOS/Medical Retention Board (MMRB) directed MEB, the case is forwarded to the PEB regardless of the MEB findings/recommendation. The Army has three PEBs located at Walter Reed Army Medical Center in Washington DC; Ft. Sam Houston in San Antonio, TX; and Ft. Lewis, WA. Each of the MTFs that conduct MEBs is aligned with one of these three PEBs. This alignment determines which PEB will adjudicate the case. How is the PEB structured? The PEB is comprised of two types of boards, informal and formal. A board (Informal or Formal) is composed of a three-member panel trained on adjudication standards and procedures. The Presiding Officer will normally be a Colonel (sometimes a LTC); in addition each board has a Personnel Management Officer (normally a field grade officer or civilian equivalent) and a Medical Member (normally a DA civilian physician). Almost all of the civilian board members at the Army PEBs are retired military with significant experience. By law, all PEBs considering a Reserve Components (RC) Soldier will have an RC member. Informal PEB The MEB is initially reviewed by the Informal PEB. A Soldier does not appear before the Informal PEB. This board conducts a review of the medical and non-medical evidence of record contained in the MEB. The first determination made by the PEB is whether or not the Soldier is fit to continue to perform his/her primary military duties. If determined unfit, the PEB then decides whether or not the Soldier is eligible for disability benefits. If the Soldier is eligible for compensation, the PEB then determines a rating percentage for the Soldier and makes a recommendation as to whether or not the Soldier should be separated with severance pay, permanently retired, or placed on the Temporary Disability Retirement List (TDRL). Ratings are discussed later in this booklet. The findings of this board are forwarded to the PEBLO, who is required to deliver the PEB findings to the Soldier within three working days from receipt. For this reason, Soldiers should be available to PEBLOs and should avoid regular leave, TDY, or any duty that would make the Soldier unavailable for counseling by the PEBLO. The PEBLO will deliver the findings in person, if possible, but can satisfy the notification requirement through telephonic or other verifiable means. It is recommended that the Soldier’s AKO address be reflected on the MEB and any other frequently used e-mail address should also be noted. Soldiers should check both AKO and other e-mail inboxes frequently during the MEB/PEB process. The PEBLO will counsel the Soldier on the findings, assist in the completion of an election of options and notify the PEB of the Soldier’s decision on how to proceed. The Soldier must complete their election of options within a maximum of 10 calendar days. If found fit, the Soldier may either concur or nonconcur with the findings of the Informal PEB. If the Soldier nonconcurs, he/she may submit a written rebuttal that includes new medical information or performance data not previously available or considered by the Informal PEB. Other supporting material may also be presented. A Soldier found fit by an informal PEB does NOT have a legal right to a hearing; however, as an exception to policy he/she may request a formal PEB hearing from the PEB President. If a Soldier is found fit while on the TDRL, which is discussed later in this handbook, he/she is entitled to a formal hearing before the PEB. If found unfit, the Soldier has the right to accept the findings, or can nonconcur with the findings and submit a written rebuttal and/or demand a Formal PEB with or without personal appearance. All written rebuttals will be considered by the informal PEB, which may issue revised findings based on the information provided or may affirm their original findings. A Soldier does not give up his/her right to a formal hearing by submitting a rebuttal. Formal PEB As provided in law, no active duty or reserve Soldier found unfit by an Informal PEB may be retired or separated for physical disability without being given the right to a formal hearing. A Soldier who is found unfit by the Informal PEB and wishes to appeal can demand a formal hearing, with or without personal appearance. Army regulations require that unit commanders issue TDY orders to Soldiers to support travel to and from formal hearings. The Formal PEB is the Soldier’s opportunity, with the assistance of legal counsel, to present evidence, testimony and documents in support of his/her case. The Soldier may appear in person and present evidence pertinent to the case. The Soldier can be represented by an appointed Judge Advocate General Corps (JAGC) attorney, or counsel of their own choosing (a civilian attorney or a representative from a National Service Organization such as Disabled Americans Veterans). If the Soldier elects to have civilian counsel of his/her choosing, it will be at no expense to the government. I am going before a Formal PEB. What should I do? Counsel Once a Soldier is scheduled for a formal hearing, he/she will be contacted by a military attorney of the JAGC assigned to the garrison Staff Judge Advocate (SJA) office where the PEB is located. These officers are NOT assigned to the PEB; they serve as independent military counsel. Military counsel is normally appointed and made known to the Soldier prior to the scheduled formal hearing date. This occurs as soon after the Soldier elects a formal hearing as is practicable. Soldiers using military counsel normally meet their counsel for the first time, face-to-face, a day or so before the formal hearing. This is an opportunity to go over the Soldier’s case and discuss any last minute questions. Changing representation (counsel) prior to the formal hearing does not constitute an automatic reason for delaying or postponing a formal hearing. Informal VS Formal PEB At the moment the Formal Board convenes to consider a case, the Informal Board findings become null and void, and the Soldier CANNOT accept the Informal Board findings under any circumstance. Reporting to the Formal PEB On the day of the formal PEB, the Soldier reports, in the appropriate uniform of the day for the locale, to the Presiding Officer of the Formal PEB. The Formal PEB panel will inform the Soldier of his/her rights, including the right to make sworn or unsworn statements, rights under the Privacy Act and the right not to make any statements relating to the origin or aggravation of the injury. If the Soldier decides not to testify under oath, the Formal PEB panel will not question him/her. Recording testimony All Formal Board proceedings are electronically recorded, except during the general overview prior to convening and the deliberation phase. A copy of the recording is available upon request by the Soldier or their counsel. Documents to bring with you During the Formal PEB, Soldiers should anticipate questions relating to how and when their condition occurred, treatments received, medication, and work limitations that the condition imposes. The Soldier will be provided an opportunity to discuss his/her case in detail. At the Formal PEB, the panel will usually have the Soldier’s medical records, medical reports, administrative and performance records, and statements from the Soldier’s chain of command concerning current duty performance. To avoid undue delay and any detriment to his/her case, the Soldier should obtain, and arrive at the hearing with, their own personal copies of the above materials, especially those items that will be necessary in the presentation of his/her case. It is highly recommended that the Soldier submit any documentation not contained in his/her PEB packet to the members of the board at least 24 hours prior to the actual board date. The Formal PEB members use all of this information in the decision-making process. A chance to address board members Following questioning by the Board Members and the Soldier’s Counsel’s summation, the Soldier has one last opportunity to address the Board Members and has the option of making a brief statement. Once all evidence has been reviewed and testimony concluded the Soldier and Counsel will be excused for board deliberations. Only the voting Board Members are present during deliberations. Board members vote and provide recommendation The Formal PEB members will independently vote to determine if the Soldier is fit or unfit. If unfit, and found eligible for compensation, the PEB will also vote on the rating percentage and disposition. All findings are decided by majority vote. The Formal PEB then reconvenes and notifies the Soldier and his/her Counsel of their decision. A copy of the report of proceedings, which provides the PEB’s findings and recommended disposition, is provided to the Soldier before he/she departs from the PEB. The Soldier is again provided 10 calendar days to make an election as to whether he/she concurs or nonconcurs with the Formal PEB findings. If the decision of the board is not unanimous, the dissenting board member may choose to submit a minority report citing the rationale for disagreeing with the majority. The minority report will be made a part of the MEB/PEB record and will cause an automatic review by the Physical Disability Agency (PDA). Can I appeal the decisions of the Formal PEB? Soldiers who disagree with the Formal PEB findings can submit a rebuttal, which will be reviewed by the Formal PEB. The Formal PEB will either affirm their initial findings, or may issue revised findings (called a formal reconsideration). If the latter, the Soldier will again be given an opportunity to respond to those findings by submitting another rebuttal to the Formal PEB. Review by the Physical Disability Agency Final approval authority for all PEB findings and recommendations rests with the United States Army Physical Disability Agency (USAPDA). All cases completed by the PEB are forwarded to USAPDA. USAPDA HQ conducts an appellate review of every case where a Soldier disagreed with the final PEB findings (informal or formal), and also reviews approximately 20% of all other cases to ensure adjudicative consistency and accuracy. The Agency has the authority to issue revised findings or return a case to the PEB for reconsideration if they determine the evidence of record does not support the PEB findings and recommendations. If USAPDA does issue revised findings, the Soldier will once again be afforded an opportunity to agree or disagree with the revised findings, and submit a written rebuttal. If the Soldier has not yet had a formal hearing, he/she can request one at that time. If a Soldier has already had a formal hearing, his/her appeal will be forwarded to the Army Physical Disability Appeal Board for review at that level. After a Soldier has been separated or retired from the Army, he/she has the right to petition the Army Board for the Correction of Military Records (ABCMR) for relief if he/she believes the case was incorrect or subject to injustice or inequity. How does the PEB decide the percentage of disability? If the PEB finds that a Soldier is unfit, and the Soldier is eligible for disability benefits, the PEB rates the severity of the Soldier’s injuries using Department of Defense Directives (DoDD) and Instructions (DoDI), Army Regulations, and current Army command policy in conjunction with the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD). The VASRD lists hundreds of physical and mental disabilities and rates these disabilities using objective medical criteria. Depending on the severity of the illness or injury, the PEB rates a Soldier from zero to 100 % disability. Each condition receives a separate rating and these are combined (see page 15). Analogous Ratings While the VASRD lists hundreds of physical and mental disabilities, many conditions are not specifically identified and must be rated by analogy to a listed condition which is similar in function, anatomical localization, or symptomology. How does the PEB decide who receives disability retirement and who receives disability severance pay? How are these pays computed? The severity of the condition determines whether a Soldier, who is eligible for disability benefits, receives disability retirement or is separated with severance pay. Soldiers rated with a 0, 10 or 20 % disability who have less than 20 years of active service or 7200 points of combined service, will be separated with severance pay. To compute disability severance pay, multiply the Soldier’s basic pay for two months by the number of combined years (but not over 12) of active service and inactive duty points. NOTE: There is no difference between a 0%, 10%, or 20% rating in the calculation of the amount of severance pay that is received. The rating is NOT a factor in determining severance pay. Soldiers with 20 or more years of active military service or 7200 points of combined service, or possessing a disability rated at 30 % or more, receive disability retirement. Disability retirement is either temporary or permanent depending on the stability of the Soldier’s medical condition. Temporary disability retirement pay is computed in the following manner for service members with less than 20 years of active military service (or 7200 points of combined service): • 30%-50% disability rating = 50% of basic pay* • 50%-70% disability rating = that percentage of basic pay* • 80%-100% disability rating = 75% of basic pay* *Soldiers who entered active duty after 8 September 1980 will have their basic pay computed as the average of their high 36 months of basic pay. For those who are permanently retired for disability, disability retired pay is computed on the basis of the actual disability rating (i.e., 30% disability rating) or the length of service rating (2.5 x years of service) up to a maximum of 75%. The percentage is multiplied times the Soldier’s basic pay (or high 36-month average as described earlier). Disability retired and severance pay awarded to Soldiers who were not a member of the armed forces on September 24, 1975 is considered taxable by the Internal Revenue Service (IRS). An exception exists for a Soldier receiving separation or retired pay by reason of a combat-related injury. The PEB will make combat-related determinations on all cases considered. The Soldiers’ grade for purposes of computing disability severance pay or retirement pay is the higher of the Soldier’s current grade, highest grade satisfactorily held, or grade to which the Soldier was pending promotion. Enlisted Soldiers whose promotion eligibility date is after their separation date will be promoted on their last day of active duty. Officers pending promotion receive disability retirement or severance pay at the promotion list grade but, under officer promotion law, cannot be promoted ahead of their promotion eligibility date. What does a combined rating mean (PEB math)? Per instruction in the VASRD, the PEB combines ratings. The PEB arranges the rated conditions in the order of their severity, beginning with the greatest disability, and then rates each as a percentage of remaining efficiency. For example, a Soldier with a 60% disability is considered 40% efficient. If the Soldier also has a 30% disability, it is measured as 30% of the remaining 40%, leaving the Soldier as 28% efficient, or 72% disabled. The 72% is rounded to 70%, which is the Soldier’s combined rating. This system of combined ratings is complicated. If you receive a combined rating your PEBLO can explain how it was determined. What does placement on the Temporary Disability Retirement List (TDRL) mean? Soldiers who qualify for permanent disability retirement (rated at 30% or higher or with 20 or more years of active duty or 7200 points of combined service) are placed on the TDRL if the PEB determines that their condition is not stable for rating purposes. This happens if, in the opinion of the PEB, the Soldier’s condition can be expected to improve or worsen during the TDRL period. While on the TDRL the disability rating doesn’t change, regardless of any change in condition of the Soldier. Placement on the TDRL protects both the Soldier and the Army. Soldiers placed on the TDRL will receive a minimum of 50% of basic pay (or high 36-month average as described earlier) and also receive all other retirement benefits (ID cards, TRICARE eligibility, etc.) while on the TDRL. Soldiers on TDRL will receive a medical re-evaluation at least once every 18 months while on the TDRL, and this re-evaluation will be forwarded to a PEB for a new disability determination. As a result of the new PEB finding the Soldier may be found fit (and may be give the opportunity to return to military service if desired), separated with severance pay (if the rating is decreased under 30%), permanently retired, or retained on the TDRL and re-evaluated again within 18 months. Placement on the TDRL cannot be longer than five years. At the end of those five years Soldiers must be removed and given a final rating. If a Soldier does not keep USAPDA informed of their civilian address, or doesn’t report for scheduled TDRL re-evaluation, retirement pay and medical benefits for the Soldier (and dependents) may be stopped. I suffer from a condition listed in the VASRD. Does that mean I will be found unfit and rated by the PEB? Just because a Soldier has a condition that matches a description in the VASRD does not mean that the PEB will find him/her unfit to continue military service. Before a Soldier is eligible for a disability separation or retirement the Soldier’s case must show that he/she is unable to reasonably perform the duties of his/her office, grade, rank or rating and that this inability to perform is a direct result of a documented disability. I have more than one diagnosis. If the PEB finds me unfit as the result of one of my diagnoses, does that mean all of my diagnoses are unfitting and will be rated by the PEB? The PEB evaluates the evidence of each diagnosis, but only rates the conditions that prevent the Soldier from performing his/her military duties. For example, a Soldier, in a single accident, could suffer internal injuries that result in the loss of one kidney and a musculoskeletal injury that crushes two vertebrae damaging disks and impinging on nerves. The loss of a single kidney would not necessarily prevent the performance of military duties; however, the back injury may very likely result in the Soldier being unfit for continued military service. In this example the disability rating would likely be awarded for the back injury only. The PEB says my condition existed prior to service. How can this be? I never suffered from this condition before I came into the Army. Physical or mental disabilities that make a Soldier unfit may have existed prior to entering the service (EPTS). Causes of EPTS disabilities include hereditary or congenital defects or injuries with an inception before entering active service. There is a presumption that pre-existing conditions have been service-aggravated, but this presumption can be overcome if the PEB determines that the worsening of any condition followed the “natural progression” of the pre-existing injury or disease based on well-established medical principles. If a Soldier has less than eight years total active service (see eight-year rule on next page) he/she could be separated from the service without disability benefits. This would happen if the PEB deems a Soldier’s injuries EPTS and his/her condition has not been permanently aggravated by military service. By law, the Army only compensates for those conditions that were caused by, or permanently aggravated as a result of, military service. It is possible for a Soldier to possess a physical or mental disability and never experience a problem until he/she faces the stresses of military life. The physical and emotional stress of military training can cause a latent condition to appear or an old injury to worsen to the point that the Soldier is no longer able to perform his/her military duties. To appeal a finding of EPTS, a Soldier must present medical evidence that the condition did not exist prior to entering the service, or provide medical evidence documenting that military service permanently aggravated a pre-existing condition. Separation without Disability Benefits, A Soldier may be separated without disability benefits in the following situations: (a) The unfitting condition results from injury which is due to intentional misconduct or willful neglect. ( The disability was incurred during a period of unauthorized absence. © The disability was not incurred or aggravated as the proximate result of performing duty (for example, EPTS). What is the eight-year rule? By law, a Soldier with over eight years active federal service is eligible for disability compensation even if his/her condition existed prior to service (EPTS). The eight years of active service does NOT have to be continuous; however, the Soldier must be on active duty orders of over 30 days for this rule to apply. I’m a Reserve Component Soldier. Are there any differences in how my case will be processed through the PEB? There is no difference in PEB case processing for a Reserve Component (RC) Soldier serving on a period of active duty, from that of an Active Component Soldier. Each Soldier is entitled to the same determinations and disposition recommendations of the PEB. However, if an RC Soldier with twenty “good years” receives a rating from the PEB that would result in separation with severance pay, he/she is provided the option of waiving the separation pay and being placed in the retired reserve and drawing retired pay and benefits at age 60. Remember that the PDES is a military duty performance-based system. The PDES determines if the Soldier’s medical condition makes him/her fit or unfit to perform military duty. It does not assess the Soldier’s capacity to perform in his or her civilian position. RC Soldiers not on active duty who have conditions that were not incurred as a result of military service will be processed by the PEB for a fitness determination only. These Soldiers are not entitled to disability benefits. These cases are referred by the reserve activity Commanding Officer to the PEB for a determination of fitness for continued service only. The decision to submit a case as “duty-related” or “non-duty related” resides with the Soldier’s command. The PEB will not intervene or overturn this decision. Normally an MEB is not conducted by an MTF on these individuals, nor is care provided by the MTF for the condition. I am a Medical Holdover (MHO) Soldier. What special provisions apply to me? MHO is defined as a RC Soldier mobilized on 10 USC 12302 and who volunteers to remain on Active Duty for medical retention under 12301 (d) orders in support of contingency operations and diverted from his/her normal mobilization mission, demobilization processing, or medically evacuated from theater, who is in need of medical evaluation, treatment, and disposition including definitive health care for medical conditions identified, incurred, or aggravated while in an active duty status. The MHO program is designed to compassionately evaluate and treat the RC MHO Soldier with the primary goal of returning the Soldier back to duty within their respective RC. If a return to duty is not possible, the MHO Soldier will be processed through the PDES in the same manner as outlined in this booklet. It is important that the MHO Soldier reads the MHO Soldier’s Handbook that is distributed to all Soldiers who voluntarily request to participate in the Medical Retention Program since it contains useful MHO specific information. I am assigned to a Community Based Health Care Organization (CBHCO). How does that differ from being located at a military MTF? While the overall PDES processing is the same, there are some unique aspects to an MEB that is being conducted on a Soldier located away from an MTF. In many cases, the CBHCO Soldier is receiving his/her medical care from a non-military provider. It is necessary, therefore, that the Soldier’s CBHCO Clinical and Administrative Chain of Command closely monitor the Soldier’s medical progress to determine when referral to an MEB is appropriate. Once this medical determination is made, preliminary documentation is gathered by the CBHCO which will become the basis for referral to the supporting MTF for the MEB. In most cases it will be necessary for the Soldier to report to the designated MTF for completion of the MEB and, if appropriate, referral to the PEB. The Soldier will be at the MTF for about two weeks during which time he/she will undergo medical evaluation, MEB counseling, and all other aspects of the MEB process outlined in this booklet. At the conclusion of the MEB the Soldier will be returned to the control of the CBHCO where he/she will await the outcome of the board process. It is important to note that all documentation requirements, PEBLO Counseling, and appeal rights are exactly the same for Soldiers attached to a CBHCO as for a Soldier receiving care at a military MTF. CBHCO Soldiers are encouraged to remain in close contact with their CBHCO Case Managers who will monitor the Soldiers progress throughout the process. Moreover, upon arrival at the MTF Soldiers will have frequent contact with an assigned PEBLO who will become their advocate while the Soldier is at the MTF and who will remain responsible for the Soldier’s case even after the Soldier returns to the CBHCO. If I am found unfit, can I still remain on active duty or in the Reserve/National Guard? Certain Soldiers who are found unfit by the PEB may request to be Continued on Active Duty (COAD) or in Active Reserve (COAR) status as an exception to policy. Approval for COAD/COAR rests with Human Resources Command and the National Guard. The PEB does NOT approve or disapprove a COAD/COAR request. To be considered for COAD or COAR, you must have a condition that will not require undue loss of time from duty for medical treatment, must not pose a risk to the health and safety of yourself or other Soldiers, be physically capable of performing useful duty in an MOS for which currently qualified or potentially trainable, and meet one of the following criteria: - Have 15 but less than 20 years of active federal service (COAD) or qualifying service for nonregular retirement (COAR), or Be qualified in a critical skill or shortage MOS, or - Have a disability that resulted from combat operations or terrorism. Normally a COAD/COAR application is submitted by a Soldier when his/her MEB is completed. PEBLOs can provide more information on the COAD/COAR process. Shouldn’t I have my medical conditions evaluated by the PEB to support a disability claim I plan to submit to the Department of Veterans Affairs (DVA)? No. The DoD and DVA disability evaluation systems are independent of one another. As stated earlier, only those conditions that render the Soldier unfit for continued military duty will be rated by the PEB. However, the DVA could potentially rate and award disability compensation for any medical condition that affects a former Soldier’s quality of life whether or not that condition would impair their earning capacity. Although the Soldier’s medical record is used by the DVA to determine service connection, the former Soldier is given a complete medical examination by the DVA before a rating determination is made by a DVA rating specialist. Additional information on DVA benefits can be found at www.va.gov. In addition, DVA Benefits Counselors are available at most Army transition centers. Conclusion The above information is only an overview of the Department of the Army Physical Disability Evaluation System. It is not intended as a comprehensive review of the system. The PDES can be confusing. Soldiers going through the system should attempt to educate themselves with the help of their PEBLOs. The Secretary of the Army charges the PEBLO with the responsibility of counseling and educating Soldiers undergoing a medical board, on the entire MEB/PEB process. Disability Evaluation System (DES) As the result of career-ending illnesses and/or injuries, each year the Army separates thousands of Soldiers through the Physical Disability Evaluation System. This guide answers a few general questions about the Department of the Army’s Disability Evaluation System. • The Medical Evaluation Board (MEB) • The Informal Physical Evaluation Board • The Formal Physical Evaluation Board ~*the above information is from the http://www.vajoe.com/blog/category/veterans-benefits/ website....there are alot of good artical's at this website as well MT

soundweak....a few questions 1.) have you received the actual C/P so you can check it over to make sure that it is correct. 2.) Did the C/P evaluator have a copy of your original c/p? I know this may not make scence to you but the VA lumps all Mental Health issue's together so they do not pyamid disorders. you wrote that the VA granted you s/c of 30% for your anxiety disorder... did the VA ever send you a notice that they denied you s/c for PTSD? MT