diabetes Back Door Approval

[jsdwd]

I went yesterday to the VA outpatient clinic for a regular visit. In the course of discussion my primary caregiver was ordering a med (SSRI) and said, "This med won't cost you anything". I said, "Other than the $8, right?" and she says, "No your meds are now all free because you are 60% service connected." I says, "I am? First I've heard of it."

My claim has been before the rating board since May 15th, so I knew it was close, but I have not received any letter or any bump in my bank account. I had three claims. One was for bi-lateral hearing loss, one for Agent Orange/Diabetes and one for PTSD.

The primary printed out a "Patient Inquiry" and at the end it has listed:

------

Service Connection/Rated Disabilities:

SC Percent 60%

Inflamation of Popliteal Nerve 10% SC

Tinnitus 0% SC

Tinnitus 10% SC (yes it is repeated)

Diabetes Mellitus 20% SC

PTSD 30% SC

------

The nerve rating is for neuropathy associated with the diabetes (I think).

How reliable is this?

My PTSD C & P examiner said pretty plainly that I am unemployable due to ptsd. Quoting:

"The extent of Mr, D*******'s social and occupational impairment is reflected in his

Global Assessment of Functioning score above. From a practical standpoint, it

is fellt highly unlikely that Mr. D***** will be employed again- His lack of

return to competitive employment appears related to the combination of his

nedical and mental health problems; however, for the purposes of this

evaluation, his posttraumatic stress disorder with secondary depression,

anxiety, and alcohol dependence is considered sufficienl grounds for his

unemployability. "

Is it possible that I have not received a letter because the evaluation for IU is now being done, or that all done at once?

Finally, if, at some point, I achieve IU, is the retroactive amount paid for the SC portion only or for the entire amount?

Thanks.

[LarryJ]

If you receive TDIU, it's all goin to be service connected. And, you'll receive retro back to when you applied for TDIU. If you did not officially apply for TDIU, then, if the VA "infers" TDIU due to what your C&P examiner(s) have stated (that you can't and won't be employable), then it will be retro back to your C&P exam date (I think......therefore I am,,,,, or am not, or sumpthin lak dat)!

Sounds like something you've been hoping for, anyway!

;)

[john999]

Apply for the official TDIU. Don't wait for the VA to infer IU. That could take ten years or never. If you were going to get IU for the PTSD I bet you would have gotten a 70% rating and not 30%. As it is now you don't have percentages for IU according to VA thinking. Are you relying on just the C&P exam? Vets who get IU fastest are usually vets with their own private doctors writing an opinion that they are unemployable.

[jsdwd]

Apply for the official TDIU. Don't wait for the VA to infer IU. That could take ten years or never. If you were going to get IU for the PTSD I bet you would have gotten a 70% rating and not 30%. As it is now you don't have percentages for IU according to VA thinking. Are you relying on just the C&P exam? Vets who get IU fastest are usually vets with their own private doctors writing an opinion that they are unemployable.

I can't do anything until I actually get a letter right? So far all I have is that print-out from the medical person... sounds like the TDIU is determined separately. Maybe that's why I haven't got a letter yet??? Her statement is pretty clear. They'd have to ignore it to not give me TDIU. Also I already receive SSD so that means SS says I'm 100% permanent and total and unemployable.

Anyway, it all seems to be going in the right direction, but the low PTSD amount has me concerned. It doesn't make sense based on her report, the report of the VA psychologist and other records...

[sharon]

I can't do anything until I actually get a letter right? So far all I have is that print-out from the medical person... sounds like the TDIU is determined separately. Maybe that's why I haven't got a letter yet??? Her statement is pretty clear. They'd have to ignore it to not give me TDIU. Also I already receive SSD so that means SS says I'm 100% permanent and total and unemployable.

Anyway, it all seems to be going in the right direction, but the low PTSD amount has me concerned. It doesn't make sense based on her report, the report of the VA psychologist and other records...

Their information at the hospital is directly from the Regional Office. It is pulled from the health inquiry (HINQ) screen. Congratulation ;) :) :D

[jsdwd]

Their information at the hospital is directly from the Regional Office. It is pulled from the health inquiry (HINQ) screen. Congratulation ;) :) :D

Thanks. And thanks for answering my question about reliability. I'm reading CFR 38 and it seems to me to indicate that determining unemployability is done through a different process. Is that the case?

Also given the rating breakdown are these disabilities going to enable me to apply directly for TDIU? Isn't there a requirement that the lowest rated single disability be at least 40%? Or does a total of 60% allow me to apply directly (assuming I don't get it from the examiner's letter)?

[sharon]

Apply for the conditions secondary to diabetes ie., neuropathy, erectile dysfunction, incontenence, sleep apnea, hypertension or retinaopathy. Put in your claim for IU also. Should get you to seventy percent, thus IU.