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Need advice applying for TDIU

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smith22

Question

Last month I went in for an increase for my back & Knees and new claim for tinnitus and PTSD.  My overall rating went from 30% to 90%   Breakdown as follows:

70% PTSD

40% DDD & radiculaphy of lumbar

10 % L Knee

10% R KNee (stayed the same)

10% Tinnitus  (stayed the same)

My effective Date is JUne 2016 for the above and received my letter in May 17 that I was rated 90%.   I am not sure what I should do?  I embarrassed to say but I am unemployed and have been for several years.  I will stick to facts and not life story.  We all have our demons! 

My questions:

1.  Should I just file the form 8940 thru my VSO and see if they award the TDIU?  Or should I file a NOD and file form?  Not sure what to do ?  I have called the VSO but they wont pick up their phone.  I am planning a trip there this week to talk her. 

2. I have not entered into treatment for my PTSD but plan to when I go to my next DR. appointment with VA.  (I am not sure if this will be a negative on my case).  I do not like doctors... I do not like talking to people in general....   Especially about my feelings.   Additionally, I have a personal belief of not taking medication because that is how my father died from opioid abuse.  So, I just wont take meds.....   I know everyone on here says you must show medical proof by seeing the doctor and meds you are on etc..  I just am not sure I can deal with a psych doctor..  NOt sure what to do here....  

3.  I have not filed for SSDI because it is hard for me to admit that I am disabled.  I am not sure that my rating would even qualify for SSDI (I am 45).   Criminal justice degree.   My lower back is really jacked up and recently broke my tailbone when knee gave out.  At the C & P exam the Dr did not have my records and MRI results showing Bulging disc, stenosis.  She awarded off of range of motion.  My questions should I file for SSDI ?   The combination of physical and mental has taken a toll on my me. 

4. I would like to know if anyone else has had similar case as mine and what they recommend I do.     Also have two young kids and would like to ensure my family is taken care of with benefits. 

I appreciate everyone's service and your willingness to support each other in this forum.   My only friends are buddies I have served with!   

 

thanks again

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smith22

You can't be working and get the extra scheduler IU.

 when they gave you the increase if you let them know you were not able to work b/c of your S.C. Condition or conditions  they should have sent you the IU Form  21-8940 or gave you the IU at the time you was approved to 90% But now if your working that changes the whole picture for IU.

  if they don't know you can't work they will not ask....you have to let them know your not working  b/c of your S.C. Condition & have not worked in over or year or what ever your case maybe? It will ask you on the 8940  IU form the last 5 years you were employed  so don't confuse that with the last 5 years you have worked

  Most Veterans seek Voc-Rehab to see if they can help you find anything you can do?  if not then they ''usually'' write you a letter explaining your not feasible to retrain at this time b/c of your S.C. Disability's  (this is the golden ticket to IU)

However since you are working  I doubt seriously you will be approved for IU.

You can file for SSDI but even with them your working  so they will probably deny , you unless you can get some type of  Temp supplemental income disability and be declared by a medical Dr that your not able to work period...but you can still file for SSDI and see what they say....your working is a no no when it comes to applying for disability.

jmo

Edited by Buck52
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1.  Yes, file the form 8940 "if" your doctor has stated you are unable to maintain substantial Gainful employment due to SC conditions.   File it even if your doct did not so state, but you will also need to obtain this statement probably from an IMO/IME or Voc Rehab Assessment.  

2.  You have to be "in treatment" to get benefits, not necessarily taking pills.  Going to therapy is treatment.  If you are not in any kind of treatment, then VA assumes that is because you have no symptoms so they deny you.  You do get somewhat of a choice, however, on your own treatment.  You at least have a say.  There is no regulation which requires you to take so many miligrams of "x" pill to get benefits.  

3.  If you are not sure, well, read what your doctors say about you.   It sounds like you have 70 percent for PTSD, and this implies strongly that you have some judgement issues.  So, simply rely on what your doctors say, in this case.  Do the doctors say you are disabled and unable to work?  If they do, trust them and submit that evidence to SSDI.  If they do not state you are disabled and unable to work, then you have 2 choices:

a.  Accept this diagnosis and not apply as it will be fruitless unless a doc says you are disabled.  

b.  Reject this and seek another doctor if you think his or her opinion is totally out of line.  

4.  I beleive what you should do "turns" on whether or not you can work.  If you really think you can or should work, then do so.  Along with your 90 percent, you should be able to support your familty.  

While its likely you can not work forever, you should work as long as you can.  Only then, should you seek TDIU from VA and or SSD.    Dont ever "fake" anything, but do get all the benefits you deserve.  Only you really know what is going on well enough to know if you can work, I dont know whether this is practical or possible or not in your case.  

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Buck,

Really Appreciate all the information.  I am processing what you have written.  I have not signed up with a doctor yet for PTSD.  I have my annual physical Friday and I planned on going to the mental health clinic and getting signed up to see what I need to do.  I live  an hour from there so it is difficult to get there so I hope it is not a regular therapy program....

Below is my C & P explanation that was sent from VA:

We have assigned 70% evaluation for you post-traumatic stress disorder based on: difficulty in adapting to stressful circumstances- suspiciousness- Depressed mood- Suicidal ideation- Impairment of short- long-term memory- distrubances of motivation and mood- anxiety- Occupational and social impairment with occasional decrease in work efficiency (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal) - Difficulty in establishing and maintaining effective work and social relationships - chronic sleep impairment- panic attacks more than once a week.   the overall evidentiary evidence shows that the severity of you disability most closely approximates the 70% evaluation.  

Buck, during my C & P I was out of state visiting a fellow vet in Maryland and did not have my record with me.  So the C & P Examiner did not have my recent MRI for my back and Knees.   She had the ones from back in 2006.   My recent back MRI result went from mild DDD to SEVERE DDD L4-S1 L2-L3.    Not sure that would help any raise my rating but I sure with it was there when she was checking me out.  I understand the back is just on range of motion????  so maybe the MRI results might not of helped. 

I am not sure if my C & P results are enough to file for SSDI or should I wait and get enrolled in treatment?   I want to file for IU but again do not know if I should wait until I get enrolled with mental health and get vocational rehab results?  Also I was wondering if I should file a NOD to get the Date of June 16 as the Date for IU since that was the date for PTSD claim award and I was unemployed at that time and I still am. 

 

 

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