ptsd Extraschedular

[Berta]

The VA never acknowledged receipt of my husband's TDIU form.

They awarded from 30% SC for PTSD in his lifetime to-posthumous award to 100% SC for PTSD. They used his PTSD SSA award date for the VA EED.

If this had been an extraschedular award wouldn't the decision have said that?

The claim as far as I know certainly never went to VACO for any extraschedular review.It never left the VARO as far as I know.I continually supplied evidence to them after he died.

This is why I often get confused as to extraschedular awards.

I had the following rating criteria for 100% SC for PTSD when I re-opened his PTSD claim and I focused solely on the documented evidence that put him into that criteria.

This insert from a BVA decision gives all the PTSD ratings.

The veteran's service-connected PTSD has been rated 30 percent disabling from October 1, 1999 to June 30, 2002 under the provisions of 38 C.F.R. § 4.130, Diagnostic Code 9411, exclusive of a temporary total hospitalization rating from May 20, 2002 to June 30, 2002. Under this diagnostic code, a 30 rating is assigned for 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). A 50 percent rating is assigned for 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 effective work and social relationships. 38 C.F.R. § 4.130, Diagnostic Code 9411. A 70 percent rating is assigned for 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 work-like setting); inability to establish and maintain effective relationships. Id. A 100 percent rating is assigned for 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 or minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. Id. Rod was meticulous in his personal care and never had a suicidal ideation but I had documented evidence of everything else in the 100% regs.

[halos2]

From reading your post this is what I gather;

Rod was 30% PTSD from Oct 1, 1999 to June 30, 2002...his amount changed to 100% PTSD exclusive of a temporary total hospitalization during May 20, 2002 to June 30, 2002 (his hospitalization time because of period over 30 days he was rated/payed at the 100% level for 41days(5/20/02-6/30/02)) Is this when he passed away?

So my question is do they temporarly call it extra-schedular awardance past the 30 day hospitalization period? Then if someone goes home revert back to the % they were prior to their hospitalization?

I know when rated 100% when you do not have 100% disabilities, and you don't meet the criteria for 70% with one at least 60% like with TDIU they can change your rating to 100% due to unemployability and it is extraschedular.

So is this what happened here during this time period?

I know if I attended an impatient program for 30 days or more I would be paid at the 100% rate...so it would look like 100% PTSD...so is that what occurred to Rod here? They would not refer to it as TDIU because that was not the award but perhaps they call it just 100% PTSD as schedular temporarily,(for accounting purposes?) yet just list it as 100% PTSD and not schedular.

[Berta]

halos I guess I stated this wrong- he never got temp hosp comp except for the month he was in the PTSD inhouse program

He was granted 100% PTSD P & T SC from Nov 1991 to Oct 1994 when he died. The award was 3 years later posthumous award so it didnt do him any good.He had been 30% SC PTSD since 1983 until 1991 100% EED.

I just thought maybe he had been granted extraschedular but now I realize he was 100% SC PTSD -no extraschedular rating was needed.I finally found the decision.

I think only if the medical evidence does not raise to 100% rating- then- in some cases they might consider extraschedular-??? any comments ??? I really dont understand extraschedular ratings.

But Rod raised to the 100% SC level.

[Philip Rogers]

Berta & halos2 - when someone is hospitalized for 22 days or more they are awarded the 100% rating, for the period they are hospitalized, as w/ptsd programs. Also, back prior to 11/96, a person rated 70%, solely for PTSD, and unable to work was automatically raised to the 100% rate, thereby not needing 4.16a. I believe this changed on or about 11/8/96 and 4.16c was dropped. I believe the extra-schedular rating (4.16b), at least for PTSD, came about around then. Extra-schedular ratings are determined by the Central Office (CO), generally at the recommendation of the RO. Hope this helps. My claim was pending during the 11/96 change and therefore, whichever regulation, was more favorable to me, was used.

pr

Edited November 22, 2009 by Philip Rogers

[Ricky]

An extra-schedular rating is a rating percentage that is awarded to a vet that is above and beyond the maxium level listed for a particular disability.

As an example - if a vet suffers from and is service connected for a (example) lung disease - if the max rating percentage for that disease listed in 38 CFR is 40 percent however, the rating authority for some reason truly believes this disease has caused the vet to really be 70 percent disabled then he or she can recommend that the vet receive the 70 percnet level even though the rating schedule only lists and allows a 40 percent max. Hence the term extra-schedular - a rating for a disability that is above and beyoned the maxium percentage level allowed by 38 CFR.

If the max rating percentage for a disability is 70 percent and the vet's medical evidence truly shows a disability of 50 percent, however, the rater rates him or her at 60 percent that is not extra-schedular. It is simply a judgement call on the raters part that the vet, in the raters opinion/eyes, meets the requirement for the higher rating level.

Both of the situations above are very rare. In the first case my guess would be that it may happen in about 0.5 percent of rating decisions and maybe 0.001 percent of those request are approved.

In the second situation when was the last time you applied for a 30 percent rating for PTSD and the rater came back and said, "nope I disagree with you - I think you are 50 percent disabled from your PTSD - maybe in 0.001 percent of the ratings?

So when you see, hear or think of extra-schedular which, is approved only by Washington, think - a rating percentage that EXCEEDS the max/highest rating percentage for a certain disability category. If the max allowable is 0-60, and you and your evidence think you meet the 30 percent level until you get your rating back and you were awarded 50 percent - sit back and thank your maker and lucky stars cause all you got was lucky not extra-schedular.

I hope I wrote this in an understandable way. Heck sometimes I even confuse myself.

Edited November 22, 2009 by Clown Man

[halos2]

Thanks rickey and philip rogers too for explaning and clarifications too B)

[Philip Rogers]

Thanks, Ricky, I forgot that part.

An extra-schedular rating is a rating percentage that is awarded to a vet that is above and beyond the maxium level listed for a particular disability.

As an example - if a vet suffers from and is service connected for a (example) lung disease - if the max rating percentage for that disease listed in 38 CFR is 40 percent however, the rating authority for some reason truly believes this disease has caused the vet to really be 70 percent disabled then he or she can recommend that the vet receive the 70 percnet level even though the rating schedule only lists and allows a 40 percent max. Hence the term extra-schedular - a rating for a disability that is above and beyoned the maxium percentage level allowed by 38 CFR.

If the max rating percentage for a disability is 70 percent and the vet's medical evidence truly shows a disability of 50 percent, however, the rater rates him or her at 60 percent that is not extra-schedular. It is simply a judgement call on the raters part that the vet, in the raters opinion/eyes, meets the requirement for the higher rating level.

Both of the situations above are very rare. In the first case my guess would be that it may happen in about 0.5 percent of rating decisions and maybe 0.001 percent of those request are approved.

In the second situation when was the last time you applied for a 30 percent rating for PTSD and the rater came back and said, "nope I disagree with you - I think you are 50 percent disabled from your PTSD - maybe in 0.001 percent of the ratings?

So when you see, hear or think of extra-schedular which, is approved only by Washington, think - a rating percentage that EXCEEDS the max/highest rating percentage for a certain disability category. If the max allowable is 0-60, and you and your evidence think you meet the 30 percent level until you get your rating back and you were awarded 50 percent - sit back and thank your maker and lucky stars cause all you got was lucky not extra-schedular.

I hope I wrote this in an understandable way. Heck sometimes I even confuse myself.