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Question About Iu


CCC

Question

OK my husband was found 60% service connected on his heart, which was increased from 30%. From what I read, a 60% single condition SC rating qualifies one for IU. Would we have had to have requested that? He was found 60% SC in August of 2011. We requested IU but it was a separate claim from the one where he was found 60%. We are wondering about his back pay. The VA won't tell us anything.

Not trying to put the cart before the horse, but they admitted he was due back pay, and we have kind of struggled for a while.

After re-reading my post, I'm not sure if it makes perfect sense LOL. If not, please let me know how I can make my question more clear.

Thanks, y'all, in advance.

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If he can't work due solely to his SC condition he is entitled to TDIU. What you need is medical evidence that definitely says this. If he were to get the same from a Vocational Rehab specialist it might be enough, but usually you want a cardiologist to say it. When did you apply for TDIU? That would be the date used to figure TDIU even if he was just 30% at the time. I filed for TDIU when I was 30%. I was bumped up to 70% later and eventually granted TDIU. I think for the heart alone the only higher rating than 60% is 100% so I think he could be TDIU.

John

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"Back pay" or "Retroactive pay" will go back to what the VA calls the "effective date". This will be on your decision. Generally, the effective date is the LATER of the date you applied or the facts found (the date the doc said your husband can no longer work).

I dont know what date you put in for this. You will have to look at your records to see that. You can also look at your medical records and see if/when the Doc said your doc was "unable to maintain substantial gainful employment".

An "informal claim" for TDIU will be accepted as the date of claim.

Yes, you will get retro pay from whatever date the VA says is your effective date.

You start getting paid the first day of the month FOLLOWING your date of claim, as I stated above.

In other words if you put in for TDIU on July 14, 2007, your retro would begin on August 1, if the VA did not use a different date, such as the date the doc said you were unemployable.

There is much here on effective dates. Yes, if you dont like the decisions effective date, you can appeal just the effective date.

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If he can't work due solely to his SC condition he is entitled to TDIU. What you need is medical evidence that definitely says this. If he were to get the same from a Vocational Rehab specialist it might be enough, but usually you want a cardiologist to say it. When did you apply for TDIU? That would be the date used to figure TDIU even if he was just 30% at the time. I filed for TDIU when I was 30%. I was bumped up to 70% later and eventually granted TDIU. I think for the heart alone the only higher rating than 60% is 100% so I think he could be TDIU.

John

I'm sorry - I didn't realize I hadn't posted this. He was already approved for TDIU based on his heart. What's confusing is this -- we had an open claim. We opened the claim on August 29, 2011. They immediately increased his heart from 30% to 60%. However, we added on to the claim, not having realized that he had already been approved for his heart. Because we added on to the claim, it delayed the decision (and the pay) because the claim had been extended.

I found this information regarding TDIU at the VA website:

One service-connected disability ratable at 60 percent or more, OR

Two or more service-connected disabilities, at least one disability ratable at 40 percent or more with a combined rating of 70 percent or more.

He was found at 60% back in August of 2011, so would that not put him at TDIU then? Because he was at 60% for one disability (his heart)?

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"Back pay" or "Retroactive pay" will go back to what the VA calls the "effective date". This will be on your decision. Generally, the effective date is the LATER of the date you applied or the facts found (the date the doc said your husband can no longer work).

I dont know what date you put in for this. You will have to look at your records to see that. You can also look at your medical records and see if/when the Doc said your doc was "unable to maintain substantial gainful employment".

An "informal claim" for TDIU will be accepted as the date of claim.

Yes, you will get retro pay from whatever date the VA says is your effective date.

You start getting paid the first day of the month FOLLOWING your date of claim, as I stated above.

In other words if you put in for TDIU on July 14, 2007, your retro would begin on August 1, if the VA did not use a different date, such as the date the doc said you were unemployable.

There is much here on effective dates. Yes, if you dont like the decisions effective date, you can appeal just the effective date.

Thanks, Bronco. Take a look at what I posted to John. They are saying his effective date for TDIU is when the doctor saw him a second time, a year later, and bumped him up to 100% on his heart. But he was found 60% in August. If it only takes 60% on one disabling condition, would he not be considered TDIU back then? Because that's the guideline regarding TDIU that the VA had on their website - one service connected condition at 60%. He had that in August of 2011.

Thanks, y'all, by the way. This is confusing.

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CCC

60% DOES NOT mean he gets automatic IU. No. You have to meet the schedular criteria for IU AND be unable to maintain substantial gainfull employment. (But yes, you can seek "extra scheduar" consideration of IU also) So, just because he got 60% does not necessarily mean you get IU.

The effective date is the date of claim, or whenever the doc said you are unemployable WHICHEVER IS LATER.

You need to review your entire claim file and figure out:

1. When you put in for IU. (Date of claim)

2. When the doc said you were unemployable.

Being awarded 60% does not automatically mean your are unemployable!

The date of claim is the first time you told the VA you are out of work and seek benefits for unemployability. There are 3 criteria for an informal claim. They are:

1. You have to "show intent" to apply for one or more benefits. Going to the doc does not necessarily mean you are seeking benefits, you could also be seeking TREATMENT.

2. The claim needs to be IN WRITING.

3. You have to specify the benefit sought.

If you have all 3 of these, then this should qualify as an informal claim. It does not have to be on a particular form.

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OK thanks Bronco. The way I read the VA website, it was that if one was filing a claim for IU and had a 60% disabling condition, it was automatic.

I'll look into it more.

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OK thanks Bronco. The way I read the VA website, it was that if one was filing a claim for IU and had a 60% disabling condition, it was automatic.

I'll look into it more.

Not a chance. Even people rated at 90% have a hard time getting IU.

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There is a fast letter explaining that meeting certain schedular criteria does not mean the Veteran gets IU automatically.

http://www.individua....com/?page_id=9

There is one, however, which is supposed to be "automatic". Its SMC S. That is, if you have one disability at 100% and additional disabilities at 60%, you are "automatically" eligible for SMC S, you dont even need to file for it. (I would file anyway, because dont count on the VA to catch your "inferred" SMC claim). This does not have anything to do with automatic IU, but, it could be confused with that.

Please...I am not saying you are not eligible for IU. I say fight for it, and fight hard. But, do not use the "automatic" idea, because it will likely fail in the court system. OGC opinions and fast letters are binding on the VA, and the VA can not take a conflicting position to OGC opinions or Fast letters.

Since you apparently meet the schedular criteria, you need to show Part 2 of the IU criteria: You are unable to maintain substantial gainfull employment.

There are several ways to meet this standard. First you can show that you did not have a job since.....(date). You also need to show how your service connected disability prevented your employment. An example of this is to show that your boss fired you from frequent absences to go to the hospital for your PTSD or other SC condition. Likewise, if he fired you because your PTSD shows you have a violent temper which got you fired.

You may have to show you cant get ANY job, not just your old job. If your leg was amputated and you could no longer do your old job, you need to show that you can not do a sedentary job either. PTSD is easier. If you got fired as a construction worker because you got mad and tried to choke your boss, then it probably would not matter and, even if you were an accountant your boss would probably not take well to you trying to choke him, either.

Be careful of stating you are IU because of economic conditions, that is, you cant get a job. The VA is gonna say, ok, and the bad economy is the VA's fault, how?

Whenever you are seeking a particular rating, find out what the criteria is word for word. Look it up. Then, show the VA how you meet the criteria. They have to use that criteria, and if you meet it, they have to give it to you. They cannot turn you down for "non criteria", such as if you wear "spiked" hair. That isnt a criteria for IU.

Edited by broncovet (see edit history)
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