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Ace C&p For Tdiu Results. Claim Was Denied? Waiting On Decision Letter.


jesusplay

Question

This is an evaluation of individual unemployability related to the veteran's
service-connected mental disorder. The veteran's VBMS/electronic medical
records were reviewed. The veteran was not individually re-examined as his last
C&P examination occurred within the last year.
The veteran is currently 70% service connected for Bipolar Disorder. The report
of the original C&P examination conducted by Dr. W in November,
2013
indicates that the veteran met full criteria for a diagnosis of Bipolar I
Disorder per DSM-IV diagnostic criteria at that time. That same report noted
the following: "Veteran is currently unemployed, and he is not attending any
school/university at this time. Veteran reported being terminated from his
position at a******** company 2months ago, due to not showing up for
work; veteran was only employed with the company for 2weeks. Veteran denied
having other work history since his discharge from the Airforce. Veteran
reported he has enrolled in school, most recently B******, and should have started
classes this month, however, he has had no motivation to go to class, and
veteran is unsure of his student status at this time."
Based on review of the available evidence, it is at least as likely as not that
the veteran's service-connected mental disorder could cause occupational
impairment during times of severe depression, due to lack of motivation. This
lack of motivation to attend work would likely be independent of work type
(e.g., equally possible to be amotivational for physical or sedentary
employment). The veteran has also previously been hospitalized for SI; given
his history of suicidality it is reasonable to anticipate that this may cause
occupational problems for him in the future. There is little evidence
demonstrating occupational or educational impairment in the past due to manic
features and it is therefore unclear whether these would be likely to cause
ocucpational impairment in the future, though within the realm of possibility.
It must be noted that the potentially salubrious features (e.g., a regular
routine) and effects (e.g., improved self-esteem) of employment may also serve
as a protective factor for individuals coping with Bipolar I Disorder or other
mental disorders, and it is within the realm of possibility that employment
could contribute to globally improved functioning.
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  • HadIt.com Elder

I hope they don't deny you.

These seem to me to be very speculative statements:

"There is little evidence
demonstrating occupational or educational impairment in the past due to manic
features and it is therefore unclear whether these would be likely to cause
ocucpational impairment in the future, though within the realm of possibility. "(Too speculative. A Mania phase can definitely cause occupational impairment)

"It must be noted that the potentially salubrious features (e.g., a regular
routine) and effects (e.g., improved self-esteem) of employment may also serve
as a protective factor for individuals coping with Bipolar I Disorder or other
mental disorders, and it is within the realm of possibility that employment
could contribute to globally improved functioning. ( I sure hope they dont pull that one on many future
MH vets requesting TDIU)"

"Realms of possibility" really do not equate to a valid medical rationale.

Have you applied for SSDI?

A very good friend of mine asked for my help with his BP claim. He had SSDI for many years solely for BP.

We found in his SMRs and 201 Personnel file enough evidence that he exhibited mania on board ship while in the Navy.

His VA MH doctor agreed. Finally after about ten years or more ,with no SC at all, the BVA awarded him 100% P & T for his Bipolar.

With almost a quarter of a million coming as retro , the VA proposed incompetence.

Luckily he was acceptable to his wife becoming his fiduciary.

I also hope, if the VA awards, they dont propose incompetence.

Was this a real doctor with a psychiatric or psychology background who did the C & P exam?

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  • HadIt.com Elder

If denied, maybe this case will help you :

"The VA examiner(s) is advised that the term as likely as not does not mean within the realm of possibility. Rather, it means that the weight of medical evidence both for and against a conclusion is so evenly divided that it is medically sound to find in favor of service incurrence, causation, or aggravation as against such matters. More likely and as likely support the contended relationship; less likely weighs against the claim. "

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp12/Files4/1223508.txt

Did this doctor use any of the terms VA is familiar with such as "as likely as not", or "less likely than not" ?????

If you are denied you might have a basis for them to CUE themselves, as the examiner, from what I see here, did not follow the proper C & P criteria.

BVA cases don't help veterans unless they contain a legal issue, as the one above does, via their remand. I have used BVA cases for legal issues myself.

The above vet was remanded for a C & P in compliance with VA C & P regulations.

I certainly feel that you might well get a TDIU award, but on the other hand I don't trust the VA and I think this C & P is deficient unless there is more to it that complies with the proper criteria. Is there more to it?

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Entitlement to individual umemployability,

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. The veteran is considered capable if gainful employment. {38 CFR 4.16}

The VA exminer opined that it is within the realm of possibility that employment could contribute to globally improved functioning. The examiner also noted that there us little evidence demonstrating occupational or educational imprairment.

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