tdiu Need Advice On Getting 100%

[jrodusmc523]

Hello everyone, this website has helped me so much in learning about how to file claims and what I am entitled to. I need help in finding out how to go about getting 100%

I am currently service connected for the following

50% Major Depressive Disorder

20% Lower Lumbar Strain/herniated disc

10% Right Ankle Strain

10% Shoulder Strain

10% Knee Strain

0% Sciatica

Total Service connection is rated at 70%.

I have also been diagnosed with Arthritis in my neck, backa, and ankle; have Sacroiliitis on my left side of my lower back, and have developed a strong chornic pain in my neck/cervical area, (all by the VA, but don't have a claim for it yet.)

I would like to start a claim to increase/or add the disabilities up top as secondary to my service connected disabilities. I have spent thousands of dollars hoping that my back pain would go away. I have had multiple injections, months of physical therapy, medication, ice pads, heating pads, you name it, I did it. It has been over 4 years now that I have my back pain and it is worse than when I first had it.

The VA gave me an injection in my back in December 2010 for the sacroiliitis, that was the 2nd one by the way. I called the doctor a week after getting the shot and told her that I do not feel any better and that I am still in a lot of pain. She said, "Well I don't know what to do next, call me in a month to see how you are feeling." Like how am I supposed to deal with that?? My doctor telling me that she doesn't know what to do next??

My wife gave birth to our daughter 5 months ago and I can only hold her for about 2 minutes before I start to develop a sharp pain in my lower back. I had to go to the emergency room last week because I couldn't take it, I was curled up in the fetal position crying because of the pain.

I have gained so much weight because it is hard to keep fit when you can't do exercises. I cannot do the things that I used to do, no roller coasters, no rides, running, wrestling, baseball, no activities that involve physical activity. I tried to shovel the snow this winter and couldn't. I get so depressed just thinking about not being able to do things and the fact that I can only hold my daughter for minutes at a time. It sucks.

I call out of work at least one a week because of the amount of pain that I am in. I have been trying to get an appointment to see the doctor at the VA again and I can never get through to her. I have a case manager that helps me make appointments and even she can't get through to her. I sit at a desk all day and it is the worst, I have to get up every 20 mins or so to stretch and ease the tension on my back and neck.

I really don't know what to do anymore, I feel like I am just stuck and need to get better.

Does anyone have any advice as to how I can go about getting an increase and possibly TDIU??

Thanks

Edited May 3, 2011 by jrodusmc523

[Hoppy]

When trying to obtain a high rating for a mental condition such as MDD it usually requires a paper trail that shows hospitalizations or extended periods whereby the MDD has prevented you from working. The VA rates mental conditions based on the severity of peak symptoms and considers the length of time between peak symptoms and recovery periods.

I recently assisted a 55 year old veteran who was rated at 50% for panic disorder with MDD get 70% plus TDIU. In this case the veteran had never been hospitalized. However, he had not sought work for three years due to his mental condition.

During the three year period he saw a primary care doctor a psychologist and a psychiatrist at the local VA hospital. The record clearly showed that the veteran had been living in his van for 10 years with his dog. The record clearly showed that he did not trust VA doctors and did not feel comfortable discussing his problems with them. Not one of these doctors asked him how he supported himself. Thus, the record was silent for any severe impairment on his employment.

All that it required was that I told him to have a statement that he wrote added to his treatment records that he has not sought work for three years due to the symptoms of depression and anxiety caused by his service connected mental condition. He took the statement to his primary care doctor and the doctor added it to the treatment records. He also filed a TDIU request and submitted the statement directly to the RO adding that the same statement was now part of the treatment records. I also had him supply the RO with a copy of his current social security income statement showing that he had no earnings in the last three years.

The VA sent him to a C&P exam whereby the C&P examiner agreed that his mental condition made the veteran unemployable. However, the C&P examiner said the unemployability was due to a personality disorder not the service connected Panic Disorder and MDD. Fortunately, I was able to point out that the supporting logic used by the C&P examiner was seriously flawed and the raters did not give any weight to the opinion that the personality disorder was causing the unemployability. Long story short there are people in the VA system that will try and make things difficult. The veteran’s service officer had only one approach which was for him to start talking to the VA doctors. The veteran became upset with the serviced officer because his dislike for VA doctors would not allow him to discuss his problems with them.

Each case is different. However, the bottom line is that your symptoms must be preventing you from working and the doctors and raters must know about it. The doctors rarely connect the dots for you to establish unemployability as an outpatient.

[john999]

Getting to 100% schedular is very hard unless you have one disability rated at 100%. For TDIU you have to be out of work due solely to your SC conditions. Do you have a disability retirement option at your job. Here is the big problem you face: While you are unemployable due to your SC conditions waiting for TDIU you are not getting any money. Can you handle that? It can take months if not a couple of years to get TDIU sometimes. Can you survive without a paycheck that long? If you become totally disabled you have no choice, but it is an awful experience to be broke with a young daughter to support. If you have insurance you can shop around for a private doctor who might be better than the VA. Has the VA doctor considered surgery? If you have herniated disc that may be the only answer.

[jrodusmc523]

Getting to 100% schedular is very hard unless you have one disability rated at 100%. For TDIU you have to be out of work due solely to your SC conditions. Do you have a disability retirement option at your job. Here is the big problem you face: While you are unemployable due to your SC conditions waiting for TDIU you are not getting any money. Can you handle that? It can take months if not a couple of years to get TDIU sometimes. Can you survive without a paycheck that long? If you become totally disabled you have no choice, but it is an awful experience to be broke with a young daughter to support. If you have insurance you can shop around for a private doctor who might be better than the VA. Has the VA doctor considered surgery? If you have herniated disc that may be the only answer.

I was going to see if I can get an increase for my back. I know that I wont get an increase for the MDD. I know it will be hard also to get TDIU so I haven't even tried. I am just going to see if I can meet with at private doctor to get some answers. I was told by the Hospital for Special Surgery in NYC that I needed surgery but the VA said that they don't recommend it. So I don't know what to do.

[Guest terrysturgis]

523, if you can not work or if you have not been working I believe you should file for TDIU and SSD. Let the VA tell you if you don't qualify for TDIU. In their decision they will tell why if you get denied. Also talk to an SSD attorney to see if you qualify. If the attorney will not take your case it could be because they feel your case is not winnable which means they won't get paid.

Now having said all this, you cannot be working and earning above the federal guide lines for poverty which is a little over $12,000.00 per year.

[Hoppy]

Getting the back upgraded can be tricky. I am not confident a private doctor will know how to write the reports.

Wait until you learn more about how backs are rated before you start spending money on private doctors.

Establishing medical evidence of neuropathy or nerve function loss is one way. However if they do not think you

are a candidate for surgery this does not sound like an issue to me that will get a high rating.

Check the rating schedule to see what the specifiic requirements are.

Another way to deal with this is to show that excurbations result in you needing six weeks or more per year of

"bed rest". You must have a treating doctor prescribe the bed rest. The raters like to attack the defination of bed rest.

I read a case where the veteran kept a journal of days missed from work and off work days wereby he needed bed rest to

deal with excurbations of pain. A doctor provided a prescription for bed rest covering the days in the veterans journal

the veteran claimed bed rest was required.

The prescription is best if it is current and ongoing. One veteran I knew had been treated by a doctor for the two previous years. During the two year period he prescribed pain killers. However, since he was a private doctor he did not know the advantage for rating had he prescribed bed rest. The DRO would not accept a retrospective statement from the doctor saying the veteran required bed rest in excess of six weeks during the last year. However, I would try this approach again. What is there to lose? Then start keeping records of ongoing bed rest prescriptions from this date forward.

Six weeks of bed rest will get you 60% for your back. From there you can file for TDIU.

Also look into the possibility that the combination of your ratings makes you eligible to get TDIU based on how you are rated right now. I will need to find the rating info. Hopefully some else will have this and can post it. I will not be able to get back to a computer until this weekend. I am not sure if you need one condition rated at 50% or 60% with a total of 70% to be considered for TDIU.

Edited May 4, 2011 by Hoppy

[john999]

Do you want to try and keep working or are you looking for total disability? You are rated at 70% so you could file for TDIU, but you have to out of work while you wait for the VA to adjudicate your claim. As far as the back I would get another opinion from the best back doctor in the area. If you are on TDIU, or working, your back is going to hurt like hell. I know it is hard to decide these things. Even if the doctors operate on your back it may not cure the pain. It could make it worse. The same goes for the neck. I would get as many second opinions as I could get to feel comfortable about taking one course of action or another. Don't rush into any surgery.