lumbosacral SMC S, schedular 100, tdiu, P&T and working

[zat954]

Hello All,

 

I apologize anything redundant, i see this  topic is overrun with similar cases but none ive found like mine exactly and Im hoping someone can help or provide some direction.  Ive researched endlessly for an answer to my question. Im a medically retired fmf corpsman. Upon retirement in 2010 i was initially rated 80% (84) and ha a claim for tdiu as well as other increases. In 2013 after a c&p for psych and back injuries, I was upped to the following:

70% mood disorder (up from 30)

50% sleep apnea     (up from 30)

40% lumbar              (up from 20)

20% sternal injury

20% pectoral shoulder tear

10% cervical strain

total 100% (95) P&T

 

Interestingly my ebenefits lists these all accurately but still shows the previous rating for mood disorder (then diagnosed as MDD for 30%. I dont know why it still shows. the back increase was alone as was the sleep apnea (previously 20% and 30% respectively). So why MDD is still showing leads me to believe its probably a typo. 

 

Moving on. I am schedular 100% p&t. but i believe, because of the following explanation under my additional benefits section I am a Bradley vs Peake candidate: 

                  "Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (s) and 38 CFR 3.350(i) on account of mood disorder (previously rated as major depressive disorder with anxiety disorder and body dysmorphic disorder (also claimed as involutional melancholia, severe insomnia due to pain, and adjustment disorder with anxious mood)) a single disability upon which a total individual unemployability rating is based and additional service-connected disabilities of lumbosacral strain claimed as lumbago pain and spasm , independently ratable at 60 percent or more from 09/09/2011.

Rating Date : 11/20/2013"

 

Now i dont understand bc my back injury is rated at 40% NOT 60% But im not complaining. My concern and desires are this; Im in Voc rehab now, and when i graduate will use my remaining 8 months of GI bill to pursue veterinary or physicians assistant school. So, Can I work freely due to being 100% schedular and P&T? In other words does that trump or in any way effect my SMC for TDIU B vs P? I do not fill out the 21-4140. The only feedback ive gotten anywhere is a moderator on YUKU who seems as educated in this as you are. His response was this:

 

                         "your disabilities combine to 95%.  So, in the eyes of the VA, you are schedular 100%.  That's why you don't get the annual employment verification form.  However, because you were (or could have been) IU based upon a single disability,you are eligible for SMC S (see “Bradley vs Peak” for reference. I know it's confusing.)  I think of it as a loop hole that allows for an additional benefit that you would not qualify for otherwise. Maybe that will help.In any event, you are not IU.  As long as your current ratings remain in force, you can work all you want without affecting your benefits for dependents - ChampVA and Chap 35."

 

So needless to say im confused. The overall goal is to get back into a career and maintain my 100% Schedular P&T, as ive earned it. Now i know there is no crystal ball that can see if ill be called for a C&P in the future, but would going back to work prompt this? Should i request the smc removed as well as tdiu or ask for forgiveness in the future not permission? If this moderator, who is extremely resourceful from what ive seen, is correct the tdiu is secondary and ive earned the smc s according to guidelines, regardless of actual employment ability and my employment should not prompt an evaluation, particularly because I dont fill out a 21-4140.

 

So if and when anyone has time id love your opinion on this, as I do WANT to work, but i want to play this game of chess with the VA very carefully. Im happy to give up smc, and tdiu, but not 100% schedular PT or the benefits educationally my wife gets. Please let me know your thoughts. Work is still a minimum of 14 months away. Thank you.

 

V/R

 

Zat954 HM3 retired

 

[Buck52]

To the VA it don't matter what rating you are  some say 100% plus an additional 60%  is 160% rating...its not, actually altho you will be infreed to the SMC Level,, your still only consider 100% rating by the VA.

 Were fortunate to have the SMC  It helps paying for a caregiver if you need them and other Bills that come up due to your sc disabilities.

Usually when a veteran is inferred SMC he/she is unable to work.

jmo

...............Buck

[justrluk]

In several ways, I'm in the same boat. I was medically retired, but see no retirement income. The offset of VA comp takes care of that. I'm still repaying my disability severance received from the AF, which if I knew it would only be a loan, I would have hired a lawyer to help keep me in the service as long as possible. Water under the bridge at this point. In the process, I went bankrupt paying medical bills until the VA started taking care of the biggest medical issues. I paid all creditors and got to keep my 11-year-old vehicle. Most of the compensation I got from the VA covered housing and food and clothing. My pay- 3/4 of it - went to pay creditors. After several years of paying things off, several conditions got worse and I was increased to 100% schedular. I was working for the government as a disabled vet, so at least I had some health insurance, dental, etc. Never had any dental or family benefits from the VA until recently. Then, after an eight-year (or so) appeal, I was awarded P&T. At least now my kids can get an education and my wife has something more than a bare-bones insurance payout if I pass. Even while working, I spent most of last year in the hospital with several surgeries. I could not have planned for this, but at least with the VA I was covered. I took leave without pay and lost a lot of income and am paying back insurance, etc. just to keep up.

My point is this: we all have our own circumstances, how we got where we are and what our lives mean to us. I agree: I'd rather at least try to work as long as I am able than not. However, I learned in the last year that things don't always work out the way you think they will. While sitting in the hospital, the only real comfort in all of it was knowing my kids would get an education and my wife would be able to survive on the death benefits. The way I see it, at least I didn't loose my family over all this mess. I've been real close to death a few too many times in the last year to don't take any of this for granted. I'll tell you what I was told when I first entered the VA system (by my PC doc): are you prepared for the day you can no longer work? John and many others here have had to face that issue and I'm sure would choose to work as much as they could. Just my thoughts - I think working is great but I've had to come to grips with not being able to work - it wasn't pretty. You may have touched that 'third rail' without knowing it.

Last thoughts: be prepared for the day you can no longer work. It wasn't a goal for me, but a brick wall I hit most of last year. I was prepared financially (only because of VA benefits), but not emotionally.

[zat954]

Thank you for all of the advice and responses. I appreciate it. I agree there is a lot at stake and some major decisions to be made in the future.  I will definitely tread cautiously into the future. Thanks again

[john999]

Zat954

 

                    I  probably overacted to your post.  You must realize that when dealing with the VA  you are dealing with fire.   These people are unethical, immoral and criminal at times.  If I was 37 I would not want to be consigned to the junk pile either.   However,  since you are P&T this means your wife and kids can get help with schooling. Does your wife get a caretaker stipend?    If you keep your 100% rating for ten years your wife will be eligible for DIC if you die before her.  Most of your rating is for a mood disorder.   Working would indicate an improvement in this disorder.  I, too, have a mood disorder and other MH disorders.  I get SMC  "S".  It is about $300 a month.  The most important thing you have going is the P&T and Chapter 35 benefits.  I assume the main problem that has kept you out of work and led to your retirement is the mood disorder.   Vets whose 100% or TDIU is based on a mental health disorder come under a special consideration.   Working is the main factor that separates a 70% vet with a mood disorder and a TDIU or 100% vet with a mood disorder.  If the VA were to learn that you had completed voc rehab and were working I bet they would haul you in for another evaluation on that mood disorder and reduce it to 30% if you are lucky.   How would that affect your overall P&T compensation or even TDIU?  I think it would kill it.   If I were you I would take every penny I could get, but I would think long and hard about every mentioning the word "Work" to the VA much less actually working.    They love to slam/dunk vets they think have improved and working would show a vast improvement in at least your mental health situation.  Just because the regs. say this or that does not mean the VA will not wreck your home and family fighting you.   They are immortal as an institution.  You are not and they have decades to screw you around while you go broke and your kids grow up and you and your wife get older.  I imagine it took years to get P&T.   It could take years to get it back.

[zat954]

John999.... No worries about the misunderstanding were all here dealing with the sleeping dragon that is the VA so I get the reaction. I appreciate the response and totally agree. They terrify me and I did fight hard to get here. I'm hoping that the p&t schedular rating takes precedence during school/voc rehab. Those are technically not working and I miss many days for my injuries or appointments. God willing if the day comes I feel I'm ready and capable to work it will be doing something I take pride in and is lucrative enough to not rely on them. I.e. Being a pa or substance abuse counselor working with vets like us for the government. Then if I get dropped to 90% total at least that's just gravy income and my gs years are added to my active duty years for pension. Again it's a long way off, it's all speculation right now, and nobody can predict anything. Hell I don't trust one day they tell all of us veterans they are broke and we're all out of a paycheck. That's actually one of my biggest motivations for getting better and working. But you're right I need to be very smart and careful. Thank you 

[zat954]

3 hours ago, justrluk said:

In several ways, I'm in the same boat. I was medically retired, but see no retirement income. The offset of VA comp takes care of that. I'm still repaying my disability severance received from the AF, which if I knew it would only be a loan, I would have hired a lawyer to help keep me in the service as long as possible. Water under the bridge at this point. In the process, I went bankrupt paying medical bills until the VA started taking care of the biggest medical issues. I paid all creditors and got to keep my 11-year-old vehicle. Most of the compensation I got from the VA covered housing and food and clothing. My pay- 3/4 of it - went to pay creditors. After several years of paying things off, several conditions got worse and I was increased to 100% schedular. I was working for the government as a disabled vet, so at least I had some health insurance, dental, etc. Never had any dental or family benefits from the VA until recently. Then, after an eight-year (or so) appeal, I was awarded P&T. At least now my kids can get an education and my wife has something more than a bare-bones insurance payout if I pass. Even while working, I spent most of last year in the hospital with several surgeries. I could not have planned for this, but at least with the VA I was covered. I took leave without pay and lost a lot of income and am paying back insurance, etc. just to keep up.

My point is this: we all have our own circumstances, how we got where we are and what our lives mean to us. I agree: I'd rather at least try to work as long as I am able than not. However, I learned in the last year that things don't always work out the way you think they will. While sitting in the hospital, the only real comfort in all of it was knowing my kids would get an education and my wife would be able to survive on the death benefits. The way I see it, at least I didn't loose my family over all this mess. I've been real close to death a few too many times in the last year to don't take any of this for granted. I'll tell you what I was told when I first entered the VA system (by my PC doc): are you prepared for the day you can no longer work? John and many others here have had to face that issue and I'm sure would choose to work as much as they could. Just my thoughts - I think working is great but I've had to come to grips with not being able to work - it wasn't pretty. You may have touched that 'third rail' without knowing it.

Last thoughts: be prepared for the day you can no longer work. It wasn't a goal for me, but a brick wall I hit most of last year. I was prepared financially (only because of VA benefits), but not emotionally.

I'm sorry to hear you went through that. Criminal. So when they separated you I'm assuming they did so at under 30% dod? Hence the severance and lack of Tricare. That's gross. I was lucky. My actual retirement was based on back and sternum injuries only PDRL at 40% and I was pilot program so the va had my 80% ready upon retirement. You guys who had to do it all on your own after separation we're screwed so badly. The recent transparency is helping fix this slowly but they are still thousands of cases behind and vets are dying at the abg 22 a day I think still. That's 4 years that number is going. Fighting them is tough. And its counterintuitive Bc the medical professionals at the va are amazing. It's the admin side of everything that is awful.