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TDIU RE-Evals

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Ddsr

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Out of curiosity, has anyone on Hadit, been re=evaluated after being awarded TDIU Total and Perminant? I am told my cfile at some point will show a future re eval date. Regional locally tells me my cfile still shows no future exams shown.

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  • HadIt.com Elder

 Within the first 5 years,If the rescheduled exam was before the Diaries DATE they usually cancel it.

look in your C-FILE for this very CLOSE

I'll recheck my C file  I'm not sure it said before or after the Diaries date.?

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  • HadIt.com Elder

This may help  if you can understand it? its kinda long read.

III.iv.3.B.2.d.  When Not to Schedule Review Examinations

Do not establish a future examination control in cases when

the disability is static, without material improvement over five years

the disability is permanent in character and of such nature that there is no likelihood of improvement

the Veteran is over 55 years of age (except under unusual circumstances or where required by regulation)

the evaluation is the prescribed schedular minimum within its DC

the evaluation is 10 percent or less, or

the combined evaluation would not change even if the reexamination resulted in a reduced evaluation for one or more disabilities.

Important: 

When deciding if a disability is static or not, only order a future examination if there is objective evidence stating clearly a disability is likely to improve.

The principles expressed in this block apply equally to (1) initial routine future examinations and (2) reexaminations requested in the interest of substantiating sustained improvement.  Therefore, where one or more of the above criteria are applicable, and the evidentiary record includes a single examination report (or alternative form of medical evidence) portraying improvement in a disability that has persisted at its assigned level of evaluation for five years or longer, do not proceed with scheduling an additional reexamination unless doing so is

required by regulation, or

warranted in light of unusual circumstances, such as in cases of Veterans over age 55.

References:  For more information on

when not to schedule reexaminations, see 38 CFR 3.327(b), and

considering a Veteran’s age in connection with review examinations, seeM21-1, Part III, Subpart iv, 3.B.2.e.

III.iv.3.B.2.e. Considering a Veteran’s Age in Connection With Review Examinations 

As is discussed in M21-1, Part III, Subpart iv, 3.B.2.d, and with only a few rare exceptions, Veterans over the age of 55 must not be routinely recalled for reexamination.

 

In determining whether a Veteran meets the criteria for exemption from reexamination by reason of age, do not limit consideration to his/her age at the time of the rating decision’s preparation.  Instead, consider what age the Veteran will have attained by the time the future review examination is actually conducted. 

 

Use the table below to determine the impact of the Veteran’s age on future reexamination efforts and planning. 

 

If ...

Then ...

the Veteran will have reached or surpassed age 55 by the time the reexamination is conducted

do not schedule the reexamination unless

required to do so by specific regulation, or

compelled to do so based on unusual circumstances.

the expiration of a future examination control (i.e. local diary, 810 series work item, etc.) results in referral to the rating activity, and

review of the case indicates that the Veteran is currently age 55 or older

cancel any examination not

required by regulation, or

warranted in light of unusual circumstances, and

follow guidance as it appears in M21-1, Part III, Subpart iv, 3.B.2.l.

review in connection with an unrelated claim or issue reveals a future examination control for a Veteran who

is currently age 55 or older, or

will have reached or surpassed age 55 by the time the reexamination is conducted

delete or cancel the existing examination control provided it is not

required by regulation, or

warranted in light of unusual circumstances, and

follow guidance as it appears in M21-1, Part III, Subpart iv, 3.B.2.j.

Note:  Whether a case is found to involve the “unusual circumstances” described above and in 38 CFR 3.327(b)(2)(iv) is an individual, fact-specific determination left to the discretion of the rating activity.  If, however, a future review examination is deemed warranted in light of unusual circumstances, the claims processor must identify and document the nature of the unusual facts found in the form of a

remark in the SPECIAL NOTATION field on the PROFILE screen in the Veterans Benefits Management System (VBMS) – Rating, or

permanent VBMS note, if no rating decision is being simultaneously prepared.

III.iv.3.B.2.f. Example of Considering a Veteran’s Age 

Scenario:  A Veteran born on March 7, 1963, claims an increase in his SC posttraumatic stress disorder, currently evaluated as 50-percent disabling.  Medical evidence amassed in connection with the claim supports an increased evaluation of 70 percent, but also indicates that the Veteran recently began attending weekly counseling sessions with a therapist, and that the prognosis for progress is hopeful and the potential for improvement likely.  The claim is forwarded to the rating activity for a decision in February 2017.

 

Result:  The increased evaluation of 70 percent must be awarded and deemed static, with no future review examination scheduled.

 

Rationale:  If pursued, a routine future examination would be scheduled for performance in February 2020, three years following the rating decision’s preparation.  The Veteran, though only 54 years old at the time of the claim’s referral to the rating activity, will have surpassed age 55 by the time the examination is conducted. 

III.iv.3.B.2.g.  When Review Examination Shows Improvement of a Stabilized Disability

When the results of a review examination show improvement of a stabilized disability, consider the following prior to taking any rating action to reduce the assigned evaluation:

universal evidentiary standards for reduction, as discussed in M21-1, Part III, Subpart iv, 8.D.1.b, and

longevity of the assigned evaluation and any consequent need for a showing of sustained improvement, as discussed in M21-1, Part III, Subpart iv, 8.D.2.b.

If an additional reexamination is deemed necessary to demonstrate sustained improvement over time and situation, or to resolve any element of doubt concerning the extent of the disability’s improvement, schedule such examination to occur 18, 24, or 30 months from the date of the current rating decision’s preparation, as discussed in M21-1, Part III, Subpart iv, 3.B.2.c.

References:  For more information on

stabilization of disability evaluations, see 38 CFR 3.344, and

reduction in evaluation of a stabilized disability, see M21-1, Part III, Subpart iv, 8.D.2.

III.iv.3.B.2.h.  Reexaminations in Pension Cases

Do not routinely request reexamination in disability pension cases.

Note:  If a reexamination is scheduled, fully explain the reason for reexamination in the decision narrative.

References:  For more information on

reexaminations, see 38 CFR 3.327, and

circumstances in which a review examination may be requested in a pension case, see M21-1, Part V, Subpart ii, 1.B.6.b.

III.iv.3.B.2.i.  Handling Routine Future Examinations Previously Scheduled at Five-Year Intervals 

Incidental and unrelated review of a claims folder may reveal that an outstanding routine future examination was previously scheduled for performance five yearsafter the associated rating decision’s preparation.

 

In such instances,

determine whether the routine future examination was actually warranted in the context of M21-1, Part III, Subpart iv, 3.B.2.a and b

delete or cancel the existing five-year routine future examination control, and

re-establish review examination control, as appropriate,

at an interval three years from the date of the previous rating’s preparation, or

for immediate performance, if the previous rating decision was prepared more than three years prior to the date of review.

References:  For more information on

documenting the cancellation of review examinations, see M21-1, Part III, Subpart iv, 3.B.2.j, and

types and management of future examination controls, see M21-1, Part III, Subpart iv, 3.C.2.a-c.

III.iv.3.B.2.j.  Documenting the Cancellation of Review Examinations

If a future examination control, such as an 810 series work item, 631A Future Physical Examination diary, or automatically established end product (EP) 310 is canceled, place a note in VBMS as to the reason for cancellation.

References:  For more information on

action when the control period for the future examination matures, seeM21-1, Part III, Subpart iv, 3.C.2.d, and

rating action after a future examination is canceled, see M21-1, Part III, Subpart iv, 3.B.2.l.

III.iv.3.B.2.k.  Failure to Report for a Review Examination

For more information on what to do when the claimant fails to report for a review examination, see M21-1, Part III, Subpart iv, 8.E.1.

Important:  According to VAOPGCPREC 4-1991, a Veteran’s refusal to participate in an examination without the presence of an attorney or a recording device will be considered a failure to report for examination under 38 CFR 3.655.

III.iv.3.B.2.l.  Rating Action to Take if a Review Examination Is Canceled

Use the following table to determine the rating action to take if the expiration of a future examination control results in review and the conclusion that the examination is not warranted and should be canceled.

If it is determined that a future examination should be canceled, and the Veteran’s combined evaluation ...

Then prepare a rating decision establishing permanence by ...

reflects total disability, either by reason of 

a 100-percent schedular evaluation, or

entitlement to individual unemployability

awarding basic eligibility to Dependents’ Educational Assistance (DEA).

References:  For more information on

preparing a rating decision for DEA, seeM21-1, Part IX, Subpart ii, 2.1

establishing an effective date of permanency, see M21-1, Part IX, Subpart ii, 2.1.m and n, and

taking action to provide notice of entitlement to DEA, see M21-1, Part III, Subpart iii, 6.C.

does not reflect total disability

confirming and continuing the existing evaluation of any disability for which review examination was originally scheduled, and

identifying the disability(ies) as static, warranting no additional or future examination.

References:  For more information on

EP control following cancellation of a review examination, see M21-1, Part III, Subpart iv, 3.C.2.d, and

when not to schedule review examinations, see

M21-1, Part III, Subpart iv, 3.B.2.c, and

38 CFR 3.327.

 

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  • HadIt.com Elder

Future Diaries
Dates Reason Remarks
02/01/2017 100% Unemployable Review
Review Messages
1. This Award was System-Generated From 12/01/2007. If Converted Award Lines Existed Before That Date, They Were
Protected From Change
Remarks
100% with SMC S & K

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4 hours ago, Buck52 said:

Future Diaries
Dates Reason Remarks
02/01/2017 100% Unemployable Review
Review Messages
1. This Award was System-Generated From 12/01/2007. If Converted Award Lines Existed Before That Date, They Were
Protected From Change
Remarks
100% with SMC S & K

I understand all of what you are sending me Buck. Thanks. I am just wondering when if at all a re- evaluation will come up. I am still showing in my C-File no future re-exams and my VSO again tells me I will not be re-evaluated. Still some tell me otherwise that there will be a date put in my cfile in the future. Ok well I guess I continue checking on that. 

Edited by Ddsr
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  • HadIt.com Elder

I believe if you have a Diaries Date set it should show as a''Unemployable Review and then Review messages

Like mine it was 12-1-17  and was converted  before the Feb -12- 1-2017 date

My Award date is 2002., Since I never got a exam notice in 2017 on or around 12-1--17  I am thinking they converted it from the system generated because the Award lines was before that date

Now this is what it says

1. This Award was System--Generated From 12/01/2007. If Converted Award Lines Existed Before That Date, They Were
Protected From Change
Remarks ( IT WAS LEFT BLANK) this is where they would put the diaries date if I had one.

 Please Note: I am not sure I understand all of this!!!

In my Award letter it says no future exams scheduled and my disability is of nature and  chronic not  expected to improve in my life time.

Now with all this said I was over age 55 in 2017  and maybe that is what saved me?  2007 is when I turn 55  

If you have a Diaries date scheduled it should show.

you can call the 1-800-827-1000 They can or should open up the VBMS and look and let you know , other wise if you use a VSR he/she has excess to the VBMS Ask the VSR to check on this for ya. (won't hurt)

 

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6 minutes ago, Buck52 said:

I believe if you have a Diaries Date set it should show as a''Unemployable Review and then Review messages

Like mine it was 12-1-17  and was converted  before the Feb -12- 1-2017 date

My Award date is 2002., Since I never got a exam notice in 2017 on or around 12-1--17  I am thinking they converted it from the system generated because the Award lines was before that date

Now this is what it says

1. This Award was System--Generated From 12/01/2007. If Converted Award Lines Existed Before That Date, They Were
Protected From Change
Remarks ( IT WAS LEFT BLANK) this is where they would put the diaries date if I had one.

 Please Note: I am not sure I understand all of this!!!

In my Award letter it says no future exams scheduled and my disability is of nature and  chronic not  expected to improve in my life time.

Now with all this said I was over age 55 in 2017  and maybe that is what saved me?  2007 is when I turn 55  

If you have a Diaries date scheduled it should show.

you can call the 1-800-827-1000 They can or should open up the VBMS and look and let you know ,other wise if you use a VSR he/she has excess to the VBMS Ask the VSR to check on this for ya. (won't hurt)

 

Thanks Buck. Yeah I am getting the information from Regional Office locally. The person telling me I have no scheduled re-exams showing is a very longtime high in the chain of command. He looked it up and stated no future re-exams. Now...This is what I understand I think. What I am understanding is that there could be shceduled future exams put in my file down the road. IS THIS CORRECT?? Again the Regional Office guy looking tells me I will not have future re-exams.

 

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