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brokensoldier244th
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Posts posted by brokensoldier244th
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No, they are in congruence with each other. Wade posted a broad definition example of marginal employment. I posted the regulation. Wade's example would fall under VIII.iv.3.A.2.c, bullet 2, under 'facts found' basis. Just be aware that even the Dept of Labor defines "Marginal employment' on a facts-found basis, case by case.
Sheltered employment is something that is rarely done anymore, except for places like "Goodwill" which hire developmentally disabled people and are allowed to pay them less than minimum wage under 'sheltered employment'. If you have so many accommodations that you can't work other than 1 place, unless another employer fulfilled the same accommodations, that could be considered marginal employment under a 'facts found' basis. I am not a rater, however, so I don't make those kinds of determinations- they have a lot more training in that area than I do.
I can say that I work from home, full time, as an accommodation. If I didn't have that (along with some others) I would not be able to gainfully work with my combination of issues. Still, I am 100% P&T and I can type, and shovel my brain around, so as long as that holds up Ill keep working where I work. For me, there is no point in applying for TDIU, but as an example my workplace supplied me an ergo chair, keyboard, standing desk, and extra monitors for my computer of certain resolutions, and I have a more lenient break policy so long as I get my work done. I work from home, also, and that 'rider' will follow me throughout my employment here even if I change departments or Regional Offices.
If I didn't have the above and wasn't 100%, I could not gainfully work, ergo, I would be a candidate for IU (and I have been before my 100% rating was finalized 8 yrs ago).
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Yup- if its an issue that is intertwined with the claimed contention, or, say, a TBI that we find evidence of, we can add stuff like that, usually at the RVSR level- I can't unless I ask someone higher up about it. Sometimes, though, the wording on the claim 526 itself is loose enough that I can infer or at least be on the lookout for other related contentions and if nothing else add the symptoms and whatnot to my notes before I request the exam.
You can always tell us not to pursue an issue via phone or 21-4138, or even a letter- there is no prescribed form for that. -
No, unless you work for the VA (or possibly other fed agencies). If you are a new employee and are listed as a disabled vet you get 104 hrs chargeable to your leave account for 'free' (you don't earn them based on how long you work) that you can use for VA or private appts that are because of something related to your SC conditions. Its use it or lose it, though- you only get it for the first year you work. On your anniversary whatever is left falls off.
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LOL. I understand. He wasn't advocating a blanket approval of every claim, but the context was that even if, say, a PACT doesn't apply due to no foreign service or some other thing, we can still award based on Direct basis, or secondary- basically, if we do a search on a veteran for exposure pathways/locations for PACT and don't find anything, just because the veteran submitted under PACT - don't consider it a done deal (this was for both development VSRs, and RVSRs) and deny, or in my case, stop developing, just because 1 thing was found unlikely. There are other pathways to service connection. It was a strong reminder to everyone to maintain situational awareness of other theories that could be explored, at least through an exam, or through a different and varied review of the existing evidence.
I got one yesterday where the veteran has been denied multiple times because RMC lost their STRs sometime in the 90s. I have about 8 pages of STR, however what I DO have shows - enlisted sound, a year later suddenly deteriorates, goes to Portsmouth mult times over a 4 month prd, and then is PEB'd as unfit. Denial was based on no MH/BH markers in STRs....which don't exist. However, unexplained multiple sick-calls in a short period of time that corresponds with a claimed MST incident- that is a marker all by itself, and wasn't addressed by the rater. Veteran also has a pos VAMC medical opinion.
Veteran submitted a request to withdraw claim- they just don't want to deal with it anymore- that's why I got it. They submit withdraw request, wait 30 days, withdraw claim unless they change their mind- that's the regulation.
After reviewing all the above, I think that I can get it in front of a rater to review and possibly grant without an exam (veteran is on SSA for MH, also) and without an exam or further trauma/stress to the veteran. So, I'm sending it to a rater anyway. If its granted AWESOME. If its not, the claim is withdrawn anyway based on veteran's wishes. I have a 30 day window right now to operate within, so I'm going to use it.
- Vync and blahsaysme2u
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...and give out as much/many benefits as possible. This was by the training leader who used to work in Office of Field Operations.
While it seems sometimes that the VA is an antagonistic agency, there are those of us within it that do believe in what we do and TRY in our own small ways to get things moving, or out to the veteran. This meeting/training yesterday was a multi-RO level collaborative and continuing training/update for PACT Act and MST. We have it about every month or 2 to keep track of internal or external guidance changes for (mostly) PACT claims review and rating. This call had everyone from Asst directors (RO level), coaches, RVSRs, Authorizers, and peons like me on it.
The mentality of the VA is not completely against veterans, although in individual decisions at a micro level it can seem that way, especially when magnified by the internet. Negative decisions for veterans, or VA f*ck ups from years ago are constantly brought to the foreground via forum searches or internet searches, and unless someone is prepared to do some digging and cross-referencing, at the top-level everything reads as 'current' information.
Many times it isn't, or prior negative decisions were based on older regulations since changed, and/or VA screwups (exam scheduling, documents shredding) are brought up from years ago, and made seemingly current.
Am I blanket apologizing? Hell no, I know the VA screws up- its the basis of my job for the last several months to review specific claims that were denied 2,3,4 times from years ago, and I'm still finding claims that I get overturned. But still, I guess I posted this so that you all can see that there are pockets within the VA where people are trying to do right by veterans. Its part of why I applied to work there 3 yrs ago- I could get as much or more done 'inside' than from just helping people prepare claims on the 'outside'.
- Vync, ShrekTheTank, Sgt. Wilky and 1 other
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On 7/17/2019 at 11:23 AM, Richard1954 said:
There is a lot of research on the internet that indicates so-clean ozone breaks down the rubber seals in the machines...
that’s because it does.
here’s how to order resupply—
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It's normal for claims that are submitted after the initial claim is opened to be summed to 1 claim as long as no decision had been made yet on the initiating claim. Claims can have partial decisions made on them while other issues are pending.
Switching back to initial review is normal because you added something to it, meaning new subtasks are now required for the new contentions. The state of the claim is overall, not by contention.
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VIII.iv.3.A.2.c. Definition: Marginal Employment
Marginal employment exists-
when a Veteran’s earned annual income does not exceed the amount established by the U.S. Department of Commerce, U.S. Census Bureau, as the poverty threshold for one person, or
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on a facts-found basis, and includes, but is not limited to, employment in a protected environment, such as a family business or sheltered workshop, when earned annual income exceeds the poverty threshold.
Important:-
Marginal employment is by definition not substantially gainful employment.
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Do not consider amounts received from participation in the Veterans Health Administration’s Compensated Work Therapy Program as income for IU purposes.
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Yeah, im not gonna comment much, as I may need one someday for my right (dominant) and it scares me. I play guitar and I'm blessed with weak rotators. My mom had it done (20 yrs ago) and it was a long recovery and she never quite had it back. Now, its probably a lot better now, but when your doctor says "immobilize......" or "no more than 5 lbs..." don't F around and F out. (FAFO)
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Send a request for 100% Temp disability along with copies of the admission report, the surgical reports, and the prognosis/rehab stuff. You can always update or extend it later if your rehab is being less than successful but initially they will usually go off of what your doc says first, i.e. "patient prognosis 6 months to full activity..." or whatever they put in there- or just have your surgeon or your followup doctor write you up something short and sweet with your expected recovery time. Still submit the other stuff but its nice when the doc puts it all on 1 page.
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Both tiers are being worked. I don't see real time numbers, though
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You have to request them, usually, from the vendors . A VSO has access to VBMS, also, so they can do it if you know what date range you are looking for.
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That it is
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VA math, like insurance or other actuary/disability math, starts at 100% 'whole' and every rating percentage you get takes away from that, but what that means is that every subsequent rating is a percentage of less than 100%, i.e. whatever was left over after the last rating. So, as you get towards 100% into the 80 and 90 percent range it takes something like a 50%, or a combination thereof to get to 100%.
100%-50%= 50% rating and 50% remaining
Next rating 10%
10% of 50% (the remaining from the last rating)= 5%, so, now you are 55%
20% of 45% (the remaining "whole") =9% so now you are 65%
20% of 35%=7 so now you are 65+7=72, which rounds down to 70.
Etc, etc. The ratings table is online and you can learn to do the calculation yourself, or, punch numbers into one of the many calculators available online, though they don't SHOW you how the math works so you have to trust them. The ratings tables are what the RVSRs still use since its still part of the CFR.
https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-A/section-4.25
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It would be difficult, depending on the job. I have accommodations for most of the above including an accomodations to work from home always as long I'm within federal employment. I'm not tdiu, though.
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Exactly. The phone people know enough to read some of the notes we leave, and that's it. There are no auto c&P's. They still all have to be reviewed and approved.
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IMO or not you may just have to go. The standards and tests for a VA audiologist to prescribe hearing aids are different than hearing loss standards for a rating based on the CFR. I have tinnitus and HF hearing loss and I'm only rated for tinnitus. My VA audiologists exam is not the same as a C&p exam, and hearing loss is not enough to trigger the thresholds for HL.
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On 3/28/2023 at 8:42 AM, broncovet said:
You posted:
Unfortunaly, if this is the doctors opinion, VA does not like this. The voc rehab specialist can opine if you are able to be retrained or not, but the doctor normally does not do voc rehabilition, and the voc rehab guys dont practice medicine. I hope it works for you, and it may.
Medical opinions from private doctors that aren't occupational therapists are supposed to focus on the disabilties' affect on ADL (activities of daily living) and on how they would affect a veteran in an occupational environment, but not making a direct opinion on employability. They can say what activities the veteran can or cannot do, and with what level of difficulty physically or cognitively, but they can't make a direct opinion unless they have something in their CV or practice that makes they qualified to make an occupational opinion.
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In some cases, a bilateral factor actually makes it harder to get a higher rating, primarily due to rounding issues. If you do a bilateral factor you only get 1 number to round up. If you don't combine them it can result in 2 numbers being rounded up, resulting in a higher rating.
Effective 16APR23 38CRF 4.26 is being revised to say "except as provided in para (d) of this section when a partial disability results from disease or injury of both arms........" etc. Para D is being revised to say "Exception- in cases where the combined evaluation is lower than what could be achieved by not including one or more bilateral disabilities in the bilateral factor calculation, those bilateral disabilities will be removed from the bilateral factor calculations and combined separately, to achieve the combined evaluation most favorable to the veteran".
In claims adjudicated prior to 16APR23 where the veteran was rated 90% instead of 100% VA will readjudicate those claims. Compensation Services and Office of Field Ops has estimated some 3000 veterans' claims will be reviewed.
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If there is a record of the request, like an 0820 record of the phone call in his Efolder he could contest it on the basis of he requested a reschedule and it wasn't done.
Requesting reschedule isn't always automatically granted but 'reasons and basis' is pretty liberal, too. The system doesn't generate a C&P- they are created by VSRs based on a lookup by zip code that scans available locations daily. The zip that comes up closest available AND able to do the exam (not all locations may have an audiologist or something, or, during Covid a lot of locations' ability to do exams of many types was compromised) is the one that gets put in.
I wouldn't think a C&P would have been necessary, though, since he already had exams, and hearing aids, and I'm assuming that it was within the year prior of him claiming HL/TInnitus?
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VA has changed there rating table for tinnitus. That was proposed, still being discussed, but not finished or finalized.
Doordash and TDIU
in TDIU Unemployability Claims
Posted
Don't say that. It's a murky part of VA regs and also Employment law and policy for everybody. It confounds most people because of the case-by-case basis. You can't just point to 1 part and say "yup, there's the rule" and neither can the adjudicators for DOL, VA, or SSA. It really comes down to the individual person's set of circumstances.