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Which Route Do I Go To Try To Get 100%


tdak

Question

Hi,

I recently got awarded 60% disability, but have been out of work as per my doctor since Nov.2005. I am working with the VA and my rep told me to try for the TDIU before even asking for the convalescence temp of 100% because of the time frame I have to ask for it. I am surprised that they overlooked the fact that I am not working as per doctor's orders. In any case, my doctor wrote a letter for me and he was good and even put the direct connection to the military in the letter. But the last line was,” She remains unable to work because of her medical disability" he put in my diagnosis, all the dates, and the fact that I had surgery, what type and he also wrote” she continues to have disabling headache, neck and back pain which require ongoing medical supervision"

Do you think this will get me TDIU or should I try to ask for temp convalescence?

Can I ask for these at the same time?

Is there a form I need to fill out to get the temp or will they take that into account when they go over my TDIU form?

I stopped working 2 days before the surgery, but my hours went from 40 to approx. 15-20 per week prior to that.

I don't even go back to see the doctor for 3 months. They gave me meds to help with the pain and pressure of cerebellium fluid in the head, but I really only see a very slight change.

Edited by tdak (see edit history)
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I would apply for the TDIU but also for the Temp 100% due to hospitalization-

because -the doctor's statement does not seem to give a prognosis and the VA could well consider that you will be able to return to work-after convalescense and this way they would pay for the Temp Hosp-I am sure -and it would give you some money that could wait out the potential TDIU award.

Just write them a letter requesting the Temporary Total Disability Payment.

First though it might pay to check these regs- were you hospitalized for 21 days or more for SC disability? and what length of time did the doctor say you need for convalescence?

This is an excellent recent BVA decision showing what I mean-the Hospital award is different from a convalescent award and some veterans can get both.

http://www.va.gov/vetapp06/files2/0606166.txt

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I don't know much about about temp disability so someone else will have to answer that. I would apply for IU though. I would think you could do both at the same time but don't know.

It's hard to get a good rating from VA or SS or anyone else for that matter for the subjective complaints of damage to the brain. They are very skeptic without obvious signs such as paralisis. I had a 20% rating for years when undiagnosed. Once concrete proof was estabished, I finally got the 100% with the same symptoms.

I don't understand how they can question these problems. After all, the brain controls the body and health. If my car has an engine problem, it's not worth much no matter how good it 'looks'. It doesn't function normally. Same same for problems with our brain. (not saying I'm not worth much with a engine problem B) )

Anyway, I'm done ranting on your thread. Just think you deserve a better rating.

Time

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Berta....hi!

I was only in hospital for 6 days, but have been unable to work for a year so far, well actually plus 3 months til I go back. It goes case by case and each person is different in the recovery stages and they will not give me a time as to when or if I will go back to work. Most people are 6 months to a year. I have a hard time taking milk out of fridge, I can switch laundry, but I cannot lift a basket of clothes. I am in pain daily, constant tinnitus (pretty bad), and a fost of other things. I might was a few dishes then stop because I will drop them or I just cant stand there anymore. Some days are good and others are really bad. There are times I do not leave my for days, even to pick up my kids. My husband, bless his soul, has been a blessing to me. He will do it all on top of working 10 hour days.

So can I write them this letter without my rep at VA? or should I ask her to help me?

If I write this on my own, where do I send it?

She even said that the letter was not exactally what they would look for, but it was worth a try.

I applied for SSD and thats another hurry up and wait issue and I know if I get SSD to give my rep a copy to send to VA. I just hate the waiting process. It makes me want to get a job for the income, but I know dam well I can't work. I can barely function in my own home nonetheless trying to in the working world.

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If you have a medical statement from your doctor that this period of unemployment is convalescence- then -if I were you I would request a convalescence rating as well as apply for TDIU.

I will attach the form-

Under Remarks refer them to a separate page and tell them what side affect of your SC meds render you unable to work and also tell them that you have applied for SSA benefits due to your inability to work.

It sure would not hurt to attach a copy of any doctor's statement that supports this TDIU as well as even a short statement from your husband as to how your SC condition has impaired you to the TDIU form.

TDIU_form.pdf

Edited by Berta (see edit history)
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  • HadIt.com Elder

The temporary 100% evaluations are under §4.29 and §4.30, otherwise known as a paragraph 29 claim or paragraph 30 claim. In your case you would want to file a paragraph 30 claim due to the convalescent period after your surgery. There isn't any specific form, just write a letter to your RO requesting a temporary 100% evaluation in accordance with §4.30 and attach the hospital reports (surgery report and any bedside reports), discharge papers from the hospital, and statement from your physician stating how long you are expected to be recovering. These ratings generally go pretty quick.

"§4.30 Convalescent ratings.

A total disability rating (100 percent) will be assigned without regard to other provisions of the rating schedule when it is established by report at hospital discharge (regular discharge or release to non-bed care) or outpatient release that entitlement is warranted under paragraph (a)(1), (2), or (3) of this section effective the date of hospital admission or outpatient treatment and continuing for a period of 1, 2, or 3 months from the first day of the month following such hospital discharge or outpatient release. The termination of these total ratings will not be subject to §3.105(e) of this chapter. Such total rating will be followed by appropriate schedular evaluations. When the evidence is inadequate to assign a schedular evaluation, a physical examination will be scheduled and considered prior to the termination of a total rating under this section.

(a) Total ratings will be assigned under this section if treatment of a service-connected disability resulted in:

(1) Surgery necessitating at least one month of convalescence (Effective as to outpatient surgery March 1, 1989.)

(2) Surgery with severe postoperative residuals such as incompletely healed surgical wounds, stumps of recent amputations, therapeutic immobilization of one major joint or more, application of a body cast, or the necessity for house confinement, or the necessity for continued use of a wheelchair or crutches (regular weight-bearing prohibited). (Effective as to outpatient surgery March 1, 1989.)

(3) Immobilization by cast, without surgery, of one major joint or more. (Effective as to outpatient treatment March 10, 1976.)

A reduction in the total rating will not be subject to §3.105(e) of this chapter. The total rating will be followed by an open rating reflecting the appropriate schedular evaluation; where the evidence is inadequate to assign the schedular evaluation, a physical examination will be scheduled prior to the end of the total rating period.

(B) A total rating under this section will require full justification on the rating sheet and may be extended as follows:

(1) Extensions of 1, 2, or 3 months beyond the initial 3 months may be made under paragraph (a)(1), (2), or (3) of this section.

(2) Extensions of 1 or more months up to 6 months beyond the initial 6 months period may be made under paragraph (a)(2) or (3) of this section upon approval of the Veterans Service Center Manager.

[41 FR 34256, Aug. 13, 1976, as amended at 54 FR 4281, Jan. 30, 1989; 71 FR 28586, May 17, 2006]"

Vike 17

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My file is already being looked at for the TDIU and I was told I should know by the end of the month. I don't want to boggle them with too many things at one time, but it is stated in the letter that I have not worked since my surgery, Nov. 2005 and that it was all due to my sc disability and that I remain unable to work. I figured that I would wait for that answer before I applied for the Temp 100%, because in either case the rating would be the same, but the TDIU would hopefully be listed a total and permanent. I was going to write them a letter telling them what I have is a permanent condition and that I will never be back to what I once was, nowhere near it. I may end up having surgery again, because there is no cure for Chiari, there is only a surgical procedure that relieves some symptoms and not 100% relief, just enough to somewhat function daily. I would be in a wheelchair today if it wasnt for my neurosurgeons. I still have permanent loss of sensation on my entire left side of my body, but I can still get around on my own.

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