Ssdi Reevaluation?

[StreetWalker]

If you're receiving SSDI are you on a schedule to be reevaluated?

[Philip Rogers]

The VA can't use that fact to deny you TDIU, as TDIU can be awarded temporarily. There's a chance SSDI will waive that re-evaluation at 5-7 yrs. You need to appeal the VA's decision denying you TDIU. I suggest reviewing M-21 for how the VA should handle claims for TDIU. If your SSDI is for the same disabilities that you are SC for the TDIU should be awarded. jmo

pr

My paperwork tells me I'm scheduled for reevaluation in 5-7 years.

The VA used the fact that I'm scheduled for a reevaluation as one of the reasons to deny my TDIU claim.

[StreetWalker]

I'm going to appeal it. I have an appointment for a IMO next week. Going to lay a DBQ on the VA.

My SSDI is based solely on my service connected back. The only medical records they reviewed were my VA medical records.

The VA contract doctor that did my C&P did not to a complete exam, that exam contradicted every exam I've had over the past 10 years. She filled out the DBQ like she had done the complete exam then said I could do sedentary work in which does not involve lifting, squatting, bending or frequent twisting movements. She totally glossed over the fact that I can't sit in a normal chair for more than 15-20 minutes.

Here's the wording from the denial about SSDI.

Although your records from the Social Security Administration (SSA) indicate you are currently receiving social security disability for your back and other osteoarthritic conditions, the SSA records note your disabilities are subject to reevaluation and as such are not considered permanent in nature.

That leads me to try and figure out how to word my NOD. How do I tactfully point out that the decision is moronic.

[Berta]

"The VA used the fact that I'm scheduled for a reevaluation as one of the reasons to deny my TDIU claim." Geez I said WTF out loud when I read that. PR is right.

I think they committed a CUE by using that statement.

I would think many if not most SSA disabilities are re evaluated and not considered as permanent.

For example

I had an Army husband hospitalized for 2 years due to removal of a brain tumor.

SSA would check with the hospital every 2 months to see if he had improved. Much of the time he was in a coma or hooked up to Intensive care machines.

When he died I called SSA within an hour to tell them but they already knew because, as the woman told me, they had checked that same day to see if he was still disabled and hospitalized and was told he had expired.

I am dumbfounded by the statement the VA made regarding your SSDI.

What medical rationale did the VA state, (if any) to suggest that your SC is not "permanent in nature" and what the hell has that to do with TDIU?

You also said:

"The VA used the fact that I'm scheduled for a reevaluation as one of the reasons to deny my TDIU claim."

One reason...what were the other reasons?

PR is right and made a great point....M21-1MR has all the info available as to how the VA is supposed to decide all types of claims.

I have used print outs from M21-1MR and sent them to VA with some of my claims issues, to show them how they are supposed to do this stuff.

I sent M21 printouts with my pending 1151 claim as well as my Oct request that they CUE themselves.

38 CFR contains the regulations.

38 USC is the laws in the United States Code

M21-1MR is the enormous VA handbook ,updated from time to time when regs change, as to how these regs and laws are supposed to be applied by the VA.

If they interpret M21- MR wrong, to a claimant;s detriment, the VA has committed a CUE.

But we need to see the other reasons for the denial.

Edited March 10, 2013 by Berta

[StreetWalker]

The other thing used was the opinion of a contract C&P examiner that never completed my lumbar exam, yet she completed the DBQ to show that she had. Her finding go completely against every other exam I've had in the past 20 years. I've had this same examiner in the past and she missed things on that exam too. However in that case the rated used my medical record and the C&P didn't count for much.

My PCP wrote a letter back in August stating I was unemployable. I had SSA say I was unemployable. But one bad C&P exam counted more than those.

Here's the complete paragraph. I finally got it scanned in and OCR'ed.

10. Entitlement to individual unemployability.

Entitlement to individual unemployability is denied because the claimant has not been found unable to secure or follow a substantially gainful occupation as a result of service connected disabilities.

Although your records from the Social Security Administration (SSA) indicate you are currently receiving social security disability for yotu back and other osteoarthritic conditions, the SSA records note your disabilities are subject to reevaluation and as such considered not permanent in nature. Based on the evidence received from your VA examinations, the examiner opined that you are capable of sustaining and gaining employment in a sedentary environment that does not involve lifting, squatting, bending or frequent twisting movements.

Totally ignored in that finding was that I'm unable to sit more than 15-20 minutes in a normal chair. After that my back starts to lock up and my legs hurt even more. After about 30-40 minutes in a normal chair I'm pretty much screwed for the rest of the day. Of course the examiner never asked me about that.

Any help you could give me with filing my NOD would be greatly appreciated.

There was no medical rational used to explain why my degenerative disc disease and radiculopathy are not "permanent in nature".

I've got my whole award letter scanned to a .txt file but haven't gotten it cleaned up yet. I can send it to you if you want.

Edited March 10, 2013 by StreetWalker

[StreetWalker]

Here's where I stand so far.

I have obtained a copy of my SSA-831-C3 which is the Disability determination at transmittal.

In section 17 I have the following codes. Diary type - MRP, mo/yr - 07/2019, reason 7.

According to https://secure.ssa.gov/poms.nsf/lnx/0426510020 these codes show that I'm "Medical Improvement Not Expected".

This directly conflicts the wording in my TDIU denial. Does this make the cut for a CUE?

[Skipdawg]

My first time was 2 years, 2ed 3 years and last time 5 years.