Pursuing 100% Scheduler Over Keeping IU

[MarineLCpl]

I’ve been receiving IU for 10 years now for PTSD/Anxiety/Major Depressive Disorder. It was initially diagnosed as major depressive and anxiety, but that was dropped in favor of PTSD at my last 5-year evaluation. My condition has worsened with time with no signs of getting better. I’ve tried therapy, medication, etc. I’m still getting scheduled for C&P exams, but nothing changes with my benefits. 

What bothers me is the lack of security in the long term. If I understand correctly, I have ZERO protections on IU, no matter how much time has passed, this benefit can be taken at any time. If I understand correctly, at least being scheduler has protection once certain time milestones have been reached. And you can try to work on it without fear of losing benefits, correct?

I have postponed the idea of starting a family because of this lack of security. I don’t even have the courage to pursue a meaningful relationship due to being embarrassed about not working. In a perfect world, I could at least TRY to work without having to worry about losing benefits. I don’t have much faith in being able to hold down a job, and because the VA would likely try to reduce me for even trying, I just don’t. Why? Say I do good at a job for a few years, but eventually get fired for having a mental breakdown. I’d be in the same position I am now, minus the benefits. What then? File again? Just sounds so backwards. 

What are my options at this point?

Going back to my last c&p exam, note they dropped one 70% rating in favor of another 70% rating. I feel like they did this to prevent a scheduler status. I still have depressive/anxiety symptoms out the wazzoo, but they just seemed to lump it all up nice and tidy being labeled ‘ptsd.’ Not sure what to think about that. 

I can’t even contribute to an IRA with VA income. Being able to attempt to work affords me an opportunity to at least earn SOME income that would allow me to plan better for retirement. I just want a little normalcy, or at least the illusion of it so I’m not constantly thinking my life is already over. I’m getting close to the breaking point...Hoping someone can chime in here. Thanks everyone 

 

MarineLCpl

 

Edited May 23, 2019 by MarineLCpl

[broncovet]

Its not EXACTLY true that if you are 100 percent schedular (for mental disorders), you can get a full time job and earn all you want.  

You take a similar risk of reduction with 100 percent schedular for mental disorders as you do with TDIU.  This is the criteria for mental disorders:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.	100
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.	70
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.	50
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).	30
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.	10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.	0

If you are working full time, then you are not "totally occupationally impaired".  

For me, I would not go down that rabbit hole, its my opinion it wont accomplish your desired result.  

Instead, you can go ahead and persue employment on tdiu.  You have at least 12 months to see if you can actually work full time.  (You have to report your earned income each year).  

So, you have a 12 month trial period.  If you can work, yes you could be reduced back to your original rating without tdiu.  However, if you are 70 percent, get an increase to 100 percent, then start working, the same thing could happen.  

    I can not see the benfit to acquiring 100 percent for mental disorders if you want to work.  

Having been an entrepenuer much of my life, I can do a few of the things I used to do...but do them when I want and how I want.  

For me, the amount I earn is pretty 

 

[MarineLCpl]

2 hours ago, broncovet said:

Its not EXACTLY true that if you are 100 percent schedular (for mental disorders), you can get a full time job and earn all you want.  

You take a similar risk of reduction with 100 percent schedular for mental disorders as you do with TDIU.  This is the criteria for mental disorders:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.	100
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.	70
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.	50
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).	30
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.	10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.	0

If you are working full time, then you are not "totally occupationally impaired".  

For me, I would not go down that rabbit hole, its my opinion it wont accomplish your desired result.  

Instead, you can go ahead and persue employment on tdiu.  You have at least 12 months to see if you can actually work full time.  (You have to report your earned income each year).  

So, you have a 12 month trial period.  If you can work, yes you could be reduced back to your original rating without tdiu.  However, if you are 70 percent, get an increase to 100 percent, then start working, the same thing could happen.  

    I can not see the benfit to acquiring 100 percent for mental disorders if you want to work.  

Having been an entrepenuer much of my life, I can do a few of the things I used to do...but do them when I want and how I want.  

For me, the amount I earn is pretty 

 

See, this is where I’m being misunderstood. All I seek is being able to work on my own accord at my home(freelance only with no actual employer). With my conditions affecting me daily, it would be hit or miss as to how much work actually gets done. I do not see my earned income exceeding 5-10k a year and I’d be lucky to make even that. But it would allow me to contribute SOMETHING to an IRA..whether it be $5 or 5k. 

Im being told that attempting to do this on IU alone isn’t a good idea. So I thought I would at the very least pursue P&T status before attempting it. If they still want to evaluate me after I report any income, so be it. But at least it gives me support in that the work I’m doing is a far cry from what I consider to be ‘substantially gainful employment.’ 

As far as pursuing a scheduler claim, while it would be nice to not even have to worry about hassle for reported income, I’m not sure I’d be eligible for PTSD alone based on the criteria for 100% that you provided. Maybe, but can’t be sure.

Edited May 27, 2019 by MarineLCpl

[MarineLCpl]

At this point, I’m left weighing 80% TDIU vs 80% TDIU P&T. Some make it seem like there’s a benefit in there, others say it’s not worth getting on their radar. Let’s say I do happen to bring in 5k if earned income from home, would being P&T be advantageous in any way versus being TDIU only? If not, I may just leave it be for the time being. Just figured it’d help my case if they tried to reduce. But regs say earned income has to be above the poverty line to be a problem, so if it never reaches that point, I just don’t see how they’d have a case against me...

 

Edited May 27, 2019 by MarineLCpl

[brokensoldier244th]

I worked for several years with an 80% total rating (combined of 40% physical and 60% MH and was never scheduled for a mandatory re-eval. Whether or not that was due to my relatively regular MH and physical appointments or not I can't say. I also wasn't threatened with reduction for working, and at the time I made between 35,000 and 42,000 a year, at different times (two different jobs). I wasn't P and T at that point, either. That didnt happen until I hit 100%. If you are TDIU P/T, you are still TDIU. If you are schedular, you can work, barring a 100% MH only rating based on the criteria that Buck posted above. 

 

CAS

Edited May 27, 2019 by brokensoldier244th

[broncovet]

You remind me of the farmer..who sold his farm to go and seek diamonds.  

They found a very large diamond mine in his farmers field. 

VA website explains tdiu, which permits just as you posted:

https://www.va.gov/disability/eligibility/special-claims/unemployability/

In pertinet part:

Quote

• You can’t hold down a steady job that supports you financially (known as substantially gainful employment) because of your service-connected disability. Odd jobs (marginal employment), don’t count.

In other places, the Va "defines" SGE as a Veteran earning below the poverty level in the most recent 12 months.  Depending upon your number of Dependents, "poverty level" is defined by VA as about 12,000 per year.  

If you want, feel free to research this.   I have looked up some of it for you.  You can look up "marginal employment" or "sheltered employment".  

Now, Im not advocating you defraud VA and earn income and not report it to VA.  Never.  Instead, however, you can push the envelope "a bit" and earn up to the poverty level, report it to VA. If you push it to far, up to or exceeding poverty level, then you run into trouble.  You had spoke of earning 5000 per year, which is well under that envelope.  

Edited May 27, 2019 by broncovet
add more.

[Buck52]

You need to apply for increse from your 70% rating first.

Please read this information below from woods &woods LLC

(VETERANS FIRM) They might just answer all your questions.

''Three things you are going to have to prove to the VA for a 100% Permanent and Total PTSD rating:''

1.That your PTSD is service-connected.
When applying for a 100% P&T PTSD rating, you want to show the VA through evidence that first, you have a service-connected condition. You are going to need to prove that your PTSD is service-connected through a stressor event. This can include events such as a rape in the military, an IED in Iraq, an enemy ambush in Vietnam, seeing a service member killed in basic training, etc. There are lots of different stressors that the VA will accept for your 100% Permanent and Total PTSD rating.''

2.''That your PTSD affects your life at the 100% rating.
You want to prove to the VA through evidence that you are eligible for a 100% P&T PTSD rating. You can do so through statements about your daily life. You can submit lay statements from friends and family to detail your daily activities, breakdowns, unusual habits, fears, etc. If you have a gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behavior, tell the VA about it. If you are ever in persistent danger of hurting yourself or others, talk about that in your brief. To obtain a 100% P&T PTSD rating you should also cover disorientation in time and place and memory loss if you have those issues.''

3..''That your PTSD is not expected to improve during your lifetime.
This is a major hurdle to obtaining a 100% Permanent and Total PTSD rating. Many mental conditions, including PTSD, do improve over time with treatment. If you are a veteran that has treated for PTSD for many years and have not seen any improvement, your chances of obtaining a 100% P&T PTSD rating will increase. If you have years of PTSD medical treatment records, submit those to the VA with your claim. You can submit medical records, treatment records, reports from psychologists and doctors, and other evidence that proves a long history of PTSD treatment.''

Frequently Asked Questions: 100% P&T PTSD VA Benefits

Q: What are 100% Permanent and Total (P&T) ratings?
A: 100% Permanent and Total ratings are for veterans with disabilities totaling 100% that have conditions that are not expected to improve.

Who is eligible for a 100% Permanent and Total PTSD rating?
A: Veterans that have severe PTSD that is not expected to improve over the course of their life may be eligible for a 100% Permanent and Total PTSD rating.

Q: What if I was denied a 100% Permanent and Total PTSD rating?
A: If you were denied a 100% P&T PTSD rating you have one year to appeal from the date on your VA disability Rating Decision letter. If you have waited longer than one year to appeal for a 100% P&T PTSD rating, you can file a new claim.

Q: Will I have to take my claim to the BVA to obtain a 100% P&T PTSD rating?
A: If you are denied a 100% P&T PTSD rating, your best bet is to appeal and get your claim headed to the Board of Veterans Appeals (BVA). Our lawyers like the BVA because we find the panel of judges to understand VA law better than bureaucrats during the application process.

Q: If my appeal for a 100% P&T PTSD rating is approved, will I get back pay?
A: If you appeal a 100% P&T PTSD rating denial and win, you should receive a check from the VA covering your missing back pay. These are the benefits you would have been receiving had your 100% P&T PTSD rating claim been approved in the first place. 

Q: Should I hire a lawyer to receive my 100%P&T PTSD rating?
A: We can’t stress how important it is to work with a VA disability lawyer if your 100% Permanent and Total PTSD rating was denied. VA law is much more complex than most veterans realize. A large number of our clients come to us after being denied several times. Many of them used free veterans service organizations. At Woods & Woods, we use our firm’s resources to get the evidence veterans need. We often hire doctors, psychologists, vocational experts, and other medical professionals to help clients win their claims.

Q: Can I afford a lawyer to get a 100% Permanent and Total PTSD rating?
A: Yes. Woods & Woods VA disability compensation lawyers will never ask for money upfront. We only charge a fee if you win your appeal. Our fee is 20% of back pay and case expenses. We will never touch your future benefits. If your appeal is not successful, you don’t pay our lawyers a penny.

Q: What roadblocks should I expect when trying to get a 100 P&T PTSD rating?
A: There’s going to be lots of roadblocks. The biggest roadblock is the VA itself. The claims agents are horribly inconsistent. One VARO may approve one veteran and another VARO may deny a veteran with the same conditions and facts. We see Ratings Decisions come from the VA that are missing conditions. We have even seen the VA send veterans someone else’s Rating Decision. Another common mistake we see is the VA will rate the wrong foot or hand in a Rating Decision.

Q: Can I work if I have a 100% Permanent and Total PTSD rating?
A: Yes. Veterans that obtain a 100% Permanent and Total PTSD rating can work while receiving benefits. The confusion over this issue is due to Individual Unemployability benefits, which are covered later in this article. The difference between a 100% rating and Individual Unemployability is the employability factor. Veterans that obtain a 100% P&T PTSD rating get that rating because of their conditions alone. Veterans that obtain Individual Unemployability got their rating partially because of their inability to work. There are VA Unemployability income limits. Veterans with Individual Unemployability can work, but it has to be very limited with accommodations.

100% Permanent and Total PTSD Rating Appeals and Denials

If you are denied only a 100% rating: If you were denied a 100% PTSD rating, our VA benefits appeals lawyersmay be able to help. The law allows lawyers to help veterans appeal denials and appeal for ratings increases. Woods & Woods has worked for thousands of veterans with PTSD.

If you are denied only a Permanent and Total rating: If you received a 100% rating but were denied for only your Permanent and Total rating, I regret to inform you our VA disability denial lawyers cannot help. Unfortunately, there is no way for our firm to represent veterans for only being denied their Permanent and Total rating. You can appeal the VA’s decision on your own fairly simply if you are only going after the P&T rating.

If you were denied both a P&T rating and a 100% PTSD rating: If you were denied both your P&T rating and your 100% PTSD rating, then our veterans benefits lawyers may be able to help. Once again, the law allows VA disability lawyers to help veterans appeal denials and appeal for ratings increases.