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Received My Denial On Iu, Mad Is Not The Word!


yoopergirl

Question

So, after almost 2 years of waiting I received that wonderful denial letter for IU. I was already rated at 50% for migraines and 30% for bipolar. I had asked for an increase and IU. Here is what the denial states:

DBQ Headaches Exam, Gainesville show the examiner opined that your migraine headaches should not preclude part-time light physical or sedentary employment.

WTF.....where are those jobs? And how exactly would they support me and my family? That is a joke, since the requirement straight from CFR is that 50% for migraines causes severe economic impact.

DBQ Mental disorders, Gainesville shows there is no objective evidence that you are unemployable due to mental disorder.

Really, tell that to my VA shrink who submitted a letter to the RO that he consideres me to be unemployable P and T. I guess that stupid girl that saw me at the C&P knows more about me than my shrink who sees me every month.

So, obviously they didn't increase my rating for bipolar because even though I fit their little rules to be rated at least at 50%, they don't want to do that cuz they would have to give me the IU more than likely.

I don't know where to go from here, I could really use some good advice. I am soooo mad at this point I could scream!

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  • HadIt.com Elder

Get your NOD ready and see if your psychiatrist can refer you to one of his pals for an IMO. I was rated 70% for a mental health condition and I was denied TDIU. I got me another IMO and went to the DRO. I got my TDIU in about 9 months. This is just a road block they throw in your way. Keep on fighting. This is almost SOP for the VA to pull this stunt.

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I had acutally thought that I would get approved for IU but was not sure if they would approve the permanent and total (which I need for my kids to have health insurance), foolish I know. I am going to see my psychiatrist on Monday and am going to ask what he thinks I should do. He has told me in the past that he thinks the va actually tries their damndest to deny mental health claims and it frustrates him as well. He has told me that it hurts me when I go to a C and P. What I really don't understand is how the VA thinks that I can find a job that is part-time, sedentary and will work around my migraine schedule or lack of schedule really. How does someone find a job that they can work part time when they feel okay and make enough money to pay their bills. I have yet to see that one advertised! I know I need to file the notice of disagreement but am wondering if I should also hire an attorney. I am not sure where to go from here........what are my choices? and how long do they take (I know that it varies). Thanks in advance for any advice!

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Sorry for your frustration, yoopergirl.

Many of us received our ratings in "chunks" over time.

Keep fighting and hopefully others will have more advice smile.png

Thanks Notorius Kelly, I appreciate the encouragement, I am pretty down about it today but know I have to fight on!wink.png
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Yoopergirl

Sorry to hear about this decision however do not give up even with a good economy I worked a high paying career field sick many years and now and am up this time of night with conditions worse as a result the private sector expects their employees to be able to handle the position they fill. Migraines and the conditions you state do not fulfill that and bipolar and mental problems I know you can get SSDI I remember reading about that while applying for my SSDI three and a half years ago. If you do not have SSDI better apply for it and once you get it submit the award as additional evidence on your claim (I wrote this not knowing if you already have this) Hope this helps

I will be praying for your family

Thanks For your service

Edited by ComputerGeek46 (see edit history)
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Many, if not most of us have been through similar denials. The VA does not want to make it easy..they want it to take 10 years to get your claim approved , small chunks at a time, and even then, they give you retro for a year so you have to appeal the effective date. Its the "VA way". As Berta pointed out if you dont have depression when you start, the VA will make sure you do when you get done because they want to frustrate you to insanity so you will be incompetent to file future claims.

Dont let them win. You have to hang in there, as Captain Contaminate says. Never give up. The VA is trying to get you to give up and abandon your claim.

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You need a Doctor's statement or IMO stating you cannot work and the reasons why. They seem to always overrule any C&P examiner. I did a lot of researchon the BVA and the BVA basically says the samething. C&P examiners are no more than PA and Nurse Practitioners...

I will say in my research that IMOs are the way to go. Go to a specialist that knows about your issues and see if he/she will write you an IMO.

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I concur with rpowell01 anytime you have a doctor write a letter or an IMO it almost always should weigh more that a CPO aka Physicians Assistant would try to ask your doctor if he can write a brief letter detailing diagnosis etc.

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You need to file a NOD and the first thing on it should be that a part time job is not gainful employment and the regulation is that IU is based on if a veteran can have that not a part time job that the examiner said. also that it is not if you are unemployable, it being gainfully employed as to what the regulation is. the rater failed to folloed the regs.

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when you file a NOD, be sure to ask for a DRO for review. I agree with many of the comments that you should obtain an IMO from your doc stating that you are not able to perform any types of work due to your service-connected disability. Good luck!

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Powell and computer geek are correct.

Apparently, you have what we call a "negative C and P" opinion. That is, the doc said you were EMPLOYABLE. There is a difference between Unemployed and unemployable.

Anyone can be unemployed. Your company downsizes and poof..you are unemployed. Can you find another job? Maybe. For the VA, YOUR DOC decides if you are just "unemployed" or if you can't get a job because of an illness or medical condition. If you have an illness or medical condition WHICH, the DOCTOR says prevents you from getting a job, that makes you unemployable.

Bottom line: If you want TDIU, you have to have the medical evidence which warrants it. Since you have a negative medical opinion, you can only refute that opinion with ANOTHER medical opinion. This usually means and IMO or IME. To have a good chance at winning an appeal, you will need another medical opinion to the effect that your illness or injury, which is service connected, prevents you from maintaining substantial gainfull employment.

If you obtain a favorable medical opinion, then you will likely prevail upon appeal, however, it is fruitless to try to use "lay statements" to refute a medical opinion. In other words, if my doc says I am employable, then 400 buddy letters from my non doc friends wont refute my docs statement as the "lay person" is not qualified to make such an opinion.

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  • HadIt.com Elder

The VA realizes that once they approve you for TDIU that you will never work again. Do you have SSD? I had SSD for SC condition and 70% from VA and they still turned me down the first time for TDIU. I got me the required IME/IMO and got my TDIU. Then I had to get another IMO to get P&T. They just fight all the way sometimes.

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I expect the same thing on mine. The NP I had put in two places I could work a sedentary position, then put I could not work either due to upper extremities PN. I think I will follow under the shadow of a doubt rule, but I do not know at this point. I have had some of my SC conditions for over 25 years, and every time I try for an increase on something the VA knows they can not touch the 25 yr SCs, so they just denie the newer increase requests. You need to get an IMO, and a strong one. Maybe one that says the other examiner was mistaken. And you have SSDI as well. I am using that as a back up on Monday. But I may get hammered by the 5 yr thing that Cpt Contaminate brought up. My last full time job was 2008. I have had two part time jobs only in 2010 and 2011, and did not make a lot of money. So, I will call SSA on Monday and get the scoop or lied to. You need to focus, find a solution, get help and assistance (and I do not mean a VSO), get a lawyer. FIGHT FIGHT and FIGHT some more. A little secret here and I may be shooting myself in the top of the foot. I was in LE for many years. I retired from it, and started working as a VSR at the Indpls RO. I lasted only 8 months, and returned to a small PD and worked for 5 yrs. The PN and DMII got pretty intense and I walked away. During that 8 months I saw some pretty cruel things, and heartless acts in order they PROTECT the COFFERS. You have an uphill climb, but it can be done. Best of luck to ya. Indyman. P.S. I hope nobody holds those horrible 8 months against me. You would not believe what I saw and heard.

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