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Tdiu Appeal Postive With Ellusive Retropayment

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tk3000

Question

I got my 100% IU appeal for what have had yet another (second) C&P exam in May of 2013. The good new in this case came along with not so good news: apparently the Detroit Regional office interpreted that the claim for IU that I filed about 3 years ago, and for what I filed a substantive appeal about 2 years ago, simply did not qualify for a retropayment going back to date of the original filing of the claim (3 years ago). My understanding is that the retroactive payment ordinarily goes to the date of original filing of a claim, and not to the date that the second C&P exam (for which the examiner posed a favorable opinion towards my claim) took place (May, 2013). The following is the VA's rational (via IRIS exchange):

Thank you for your advising that you received the notification letter.

An appeal for Individual Unemployability (IU) will go back to the date the evidence shows that you are unemployable.

Your letter indicates that you had an examination on May 16, 2013. The examiners summary is provided on page 3 of the reasons for decision section of your letter.

Your letter states the following:

The criteria for entitlement to individual unemployability benefits have been met. VA grants this benefit, effective May 16, 2013, the date on which the veteran met both the schedular and unemployability criteria under 38 CFR § 4.16, as per 38 CFR § 3.400.

The examiners's opinion bumped up one of my service connected conditions to 70%, and clearly stated that my conditions would affect employability. But the claim was originally filed about 3 years ago, so I did expect to receive payments retroactive to 3 years. .

Any insights would be greatly appreciated.

-tk3000

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You have been given good advice by some of the best. Your effective date is the later of the facts found, or the date of claim. Check your medical records over thoroughly and see when YOUR doctor said you were "unemployable (due to SC conditions). Did the decision use that date? If it did use the docs date, then you will likely need an IMO/IME to refute the doctor.

The date the doctor said you were unemployable is the "facts found".

Often times a fuzzy grey area is the date of the claim. Do you have a copy of your c file where you applied for IU prior to the effective date?? You need to make sure the VA has a copy of said described document..the VA has a proclivity of losing documents that may produce retroactive payments for Veterans.

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post-12899-0-48485100-1386825907_thumb.jMore appropriately, I have dealt with Vets who worked under the table and never amassed a sizable, lifetime SSI accrual. When they become disabled early in life, they fall into SSD-not SSI. That's a whole different ballgame. Some I've helped get the minimum but none has ever been skunked. Someone's talking through the top of their hat. Never ever, ever, ever take No for a final answer. If you go in to the local SSI office and sit down with a rep holding that TDIU paper, I guarantee you you'll get the minimum which is currently about $968.00 /month. After two years you'll get Medicare, too. SSD was designed with you in mind. You do not have to draw off the spouse's and besides, I doubt they'd let you if you were born in the US of A. More people get screwed out of entitlements based on the "I didn't know" or Billybob's uncle said I was screwed so I just never checked into it. Boy am I dumb." What will it cost you? Or, what will it cost you if you do not go in and find out I'm right.Nobody starves in America. Look at all those undocumented aliens and their kids sitting there in Section 8 housing with Food stamps and X-boxes. They're getting------guess what----- Social Security money. Go get 'em tk.

A sends

Edited by asknod
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"I did work (not in an optimum way by any means, but still...) few months in 2012 (from August to December) as a government contractor".

The VA will likely take this as evidence of employability. The short term nature can also be taken positively as you tried, but found that

things did not work out. Evidence that substantuates this would likely help, but might be hard to get.

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attachicon.gifMy favorite airline.jpgMore appropriately, I have dealt with Vets who worked under the table and never amassed a sizable, lifetime SSI accrual. When they become disabled early in life, they fall into SSD-not SSI. That's a whole different ballgame. Some I've helped get the minimum but none has ever been skunked. Someone's talking through the top of their hat. Never ever, ever, ever take No for a final answer. If you go in to the local SSI office and sit down with a rep holding that TDIU paper, I guarantee you you'll get the minimum which is currently about $968.00 /month. After two years you'll get Medicare, too. SSD was designed with you in mind. You do not have to draw off the spouse's and besides, I doubt they'd let you if you were born in the US of A. More people get screwed out of entitlements based on the "I didn't know" or Billybob's uncle said I was screwed so I just never checked into it. Boy am I dumb." What will it cost you? Or, what will it cost you if you do not go in and find out I'm right.Nobody starves in America. Look at all those undocumented aliens and their kids sitting there in Section 8 housing with Food stamps and X-boxes. They're getting------guess what----- Social Security money. Go get 'em tk.

A sends

arknod, thanks a lot for the great advise! I will contact a the SSA today!

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You have been given good advice by some of the best. Your effective date is the later of the facts found, or the date of claim. Check your medical records over thoroughly and see when YOUR doctor said you were "unemployable (due to SC conditions). Did the decision use that date? If it did use the docs date, then you will likely need an IMO/IME to refute the doctor.

The date the doctor said you were unemployable is the "facts found".

Often times a fuzzy grey area is the date of the claim. Do you have a copy of your c file where you applied for IU prior to the effective date?? You need to make sure the VA has a copy of said described document..the VA has a proclivity of losing documents that may produce retroactive payments for Veterans.

chuck75 & broncovet:

Yeah, I got some amazing thoughtful advices here!

I talked with my VA representative (the one who sends my paperwork, assist me, and gives me assurance), and he indicated that it is very common for the VA to give an earlier date matching an exam's date in such cases; also he indicated that normally he would appeal such decision and more often than not the veteran would get an earlier date. The mainstay in our case is to purport the time that I worked in 2012 as an attempt to work. Besides the C&P doctor used the time I did work in my favor: indicating that I could not hold the aforementioned job in function of my service connected issues. I have all the medical records and a copy of the documents I used to file the initial IU claim, and the subsequent appeal. Note that the first C&P examiner did not pose a favorable opinion towards my IU claim, so I am shooting at getting retropayment going back to my last day of work. And the second C&P examiner posed a positive diagnostic and prognostic opinion towards my case, but she did not specify any date -- it allusions to a date though, when it defines my temporary work as an attempt at working and subsequently indicates that I was unable to keep such job position due to my service connected disabilities. So, I simply appealed to an earlier date.

Edited by tk3000
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