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anxiousinMD

TDIU Denied - What Next?

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So I waited the 7-10 days to call Peggy bc I still haven't received my BBE for my case that completed and closed Jan 4. The surprising thing was they were willing to fax it to me, I have an online fax number so it just goes to my account and I download it. That was a pleasant surprise, since I've read about folks waiting for months.

The bad news was that they denied TDIU and my dependency claim. They stated that I didn't complete the application for dependents so it was denied until I provide all of the information (nice to find out 6 months later). Thing is, I completed it online and filled out all the required portions to move on in the application. Thanks ebenefits. So is the dependency portion a matter of just sending in the requested information they said I left out or is that a separate NOD?

For the TDIU, my letter states:

Entitlement to Individual Unemployability has been denied because you have not been found unable to secure or follow a substantially gainful occupation as a result of service connected disabilities. (Is this standard language when IU is denied? It's unspecific...)

Information received from your employer revealed you were on short term disability leave and are now on long term disability leave. There is no ending date of employment. Based on this information, it appears you are considered employed, but on disability leave, such as FMLA.

********

There's no other reasoning listed, but it does show all of my evidence listed.

I'm so confused on the second part...yes I have been on disability leave since June 2015 and it transitioned to long term disability in Oct 2015. I sent them all of that FMLA paperwork that shows my short term and long term disability dates. I am still technically with my employer because they cover the LTD insurance, and they haven't fired me since I suppose they fear a lawsuit. But I haven't been working since June 2015 and I sent proof of how my disabilities were affecting my employment prior to going on disability leave as well. I can't go back to that job unless my doctors sign a return to work fitness form which they won't do, I'm pretty sure. My doc just submitted me for a consult for ECT which is reserved for severe, treatment resistant issues. Either way, I've heard of folks getting approved for TDIU while working because it was marginal, or being employed part time. Even if I am technically employed on paper, I obviously haven't worked! Do I file a NOD? Is this a CUE? I'm at a loss...

Note: all reference to disabilities are SC

 

Edited by anxiousinMD

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Can you afford an independent medical opinion?

Ellis Clinic, Oklahoma City, Ok.

Submit the favorable IMO(new and material evidence) along with your Notice of Disagreement.

Wait.

Hopefully the VARO will reconsider their unfavorable decision without having to wait to get to the next level decision maker.

 

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