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Tdiu Reasoning


cowgirl

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  • HadIt.com Elder

Okay, its Sunday and I was re'reading still trying to figure out why my claim was denied. I recieved a c&p for physical aspects and the va counselor notes were quoted. Denial reason was capable of sedentary employment.

So, on my 21-8940 in block 6, "what service connected disability prevents you from securing and following a substantial gainful occupation". I looked again, I put 'Mdd - major depressive disorder.

At the time of my application I was a patient of a psychologist and pyschiatrist (in treatment and recieiving prescriptions).

How does the va use a c&p physical to deny a mdd request for tdiu?

And no I did not recieve a psych c&p at all. Guess enough was in my va med files that could be used to answer my request for IU with.

Thanks, Just cg on Sunday,

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  • HadIt.com Elder

Are you still a psych patient, do you still see this psychologist and physician?

If so, go to them and get them, one or the other or both, to write a note, either in your medical records or on their stationery, simple stating that, due to your disability, you can no longer be gainfully employed.

Then you NOD the decision and send them this statement.

That is what it is going to take. What you have here is a rater practicing medicine.

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  • HadIt.com Elder

Thanks Larry'guy!

Yes, I see both, provider and a phd.

Reason I wonder, because I claimed mdd sc for 40% as the 'one sc disability that prevents me from securing or following any substantially gainful occupation'. (words are from the form).

Now I've nod'd the denial and attached my ssdi award, direct result increased sc disability of (<_< 60%. In fact that sc disability is much different than the (A) mdd @ 40%. Now, Ive done that, I cant figure how the raters determine what 'one sc disability prevents me from substantial gainful occupation'. I feel I have two.

The nod states, 'veteran disagrees with va decision on the issue as follows: Denial of individual enemployability 'attach" Social Security Record report.

(*Notice that I did not lock into just one disability or both, meaning I could have said veteran disagrees with 'Denial of individual employability due to mdd and ....". But I kept it simple, so both 40% and 60% could support the correct decision)

So meanwhile, I have drafted an additional letter to the va futha stating my concerns, but want to make sure I don't 'harm' the NOD or possible progress.

Generally (draft) letter describes the current 'two service connected disabilities that prevent me from securing of following any substantially gainful occupation'. I clarify I am under treatment for both, (read it MEDs!) from a va psych phd and other phd. The iu denial rating did not take into consideration psych phd clinical diagnosis and notes in veterans medical records in regards to mdd.(the very disability claimed). Now I have been deemed permanently disabled by ssa, due to sc disabilty (B). Please consider this additional information in your approval of my individual unemployability.(draft)

Any ideas? The nod is in, but I want to present additional truthful information soonest.

Is the additional letter, Good or not good?

Thanks y'all,

Cg'up2009!

p.s. Working on the letters, thats another story. Could happen soon, keep fingers crossed.

Edited by cowgirl
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cg - I am just guessing here but it looks like you did not have a statement from your P Doc at the time of your application.

Therefore, they used the progress notes on file and the C&P was conducted to determine if your physical disabilities prevented you from working.

The C&P doc determined that you could do a "sit down" type job so the claim was denied. They did or should have used the "total disability picture" (Phsyc/physical) to make the decision. My assumption is that the rater felt that with only a 40 percent Phsyc rating and the determination by the C&P doc that you could work you did not meet the requirements.

I am rambling, so to sum it up, Larry gave you excellent advice. As he said have you Phsyc doc, if he will, give you or indicate in your progress notes that you can not work due to your MDD and the reason he feels this to be true.

Ricky

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  • HadIt.com Elder

Ricky, okay, I am requesting the doc statement again, appointments are evry other month.

Its my thoughts, ha, the va would use a claimed condition originally placed on the iu form. I dont believe they did, my psych,phd name or notes wasnt used in the soc. I want to make sure the 40% condition (mdd) was properly considered for the IU claim. They gave me a physical c&p exam. No mdd exam, even so the soc cited a few 'selective' portions of my mdd clinic records with my counselor. So, in addition to the mdd, I believe the 60% condition (ssdi) should now be considered. Basically, I want the va to consider the facts I presented and also the new facts while the current nod is in processing.

Will see how it goes, thanks,

Cg'up2009!

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