IMO for Permanent and Total?

[cali_21B]

I was recently granted TDIU (with a 90% rating) 6 months ago. I filed new claim and was awarded a 10% rating for arthritis and 10% rating for scar tissue, which put me at 100% combined, but the VA did not make me permanent and total. I have had my ratings for over 10 years, which include 70% TBI (ptsd, anxiety, and depression is lumped under my TBI rating), 50% Sleep Apnea, 30% migraines, 20% Horners Syndrome, and six 10% ratings. 

I am hoping that my Dr's will see that my conditions are static and have not improved (they have actually gotten worse) and will fill out a form from the DAV that basically is saying that my conditions are static and not expected to improve. I am going to work with my primary care Doctor first to see if he agrees, if not I will go to my Psychiatrist, and if that doesn't work I guess I will reach out to Dr. Bash or Dr. Anise.

My question is, has anyone had any success getting their 100% combined rating with TDIU changed to permanent and total with a IMO? Any advice is appreciated also. Thanks in advance. If anyone needs any help with their TDIU claim, don't hesitate to contact me as I can assure you that I got it on the first try, with a LOT of help and advice from these forums.

Edited January 18, 2020 by cali_21B
Clarity

[FormerMember]

Dear Sir,

One fact is amiss here. Yous stated:

"I filed new claim and was awarded a 10% rating for arthritis, which put me at 100% schedular, but the VA did not make me permanent and total. I have had my ratings for over 10 years, which include 70% TBI (ptsd, anxiety, and depression is lumped under my TBI rating), 50% Sleep Apnea, 30% migraines, 20% Horners Syndrome, and four 10% ratings for scars and arthritis. "

I'm not trying to be picky but this is not 100% schedular. An example is DC 7354 100% for HCV. How about 100% schedular for DC 9411 PTSD.  Not all ratings go up to 100%. Some, like a back injury, top out at 60%. If the "combined amounts" of your disabilities equals or exceeds 100% using the VASRD §4.25, then you have what is referred to as a combined 100%. TDIU is less that 100% but is granted as an "extraschedular rating" to help you achieve a 100% paycheck. 

P&T is a different "rating" than TDIU and is obtained-usually after a period of five years- based on VA viewing the disability(ies) as static with no improvement foreseeable. If you're a charcoal briquette and obviously P&T in fact, they grant it instantly with the TDIU.

A fellow came to me in 2012 and had 15 10% ratings. It takes 22 ten percents to get to a combined rating of 100%. He will never get P&T going this route because the sum of the disabilities doesn't render him unemployable nor "totally disabled" as a doctor would define it. Never let ratings percentages convince you that you are qualified for P&T. I get a lot of my Vets total because one or two diseases combine to render you unemployable. I'll never get them to a true 100% schedular for any one disease but I don't have to reach that argument.

best of luck.

[blahsaysme2u]

49 minutes ago, asknod said:

He will never get P&T going this route because the sum of the disabilities doesn't render him unemployable nor "totally disabled" as a doctor would define it. Never let ratings percentages convince you that you are qualified for P&T.

just for my understanding and to clarify, combined 100% will never be rated as P&T?

that seems really sad if someone has been rated at 100% for 20 years and obviously not going going to improve(say with back injuries or OSA etc. as in my case. i also have a tbi and PTSD that is doubtful will ever improve more than they are now) can you show some documentation or precedent for this? i never heard it before. 

thanks 

Edited January 18, 2020 by blahsaysme2u
rewording

[cali_21B]

44 minutes ago, asknod said:

Dear Sir,

One fact is amiss here. Yous stated:

"I filed new claim and was awarded a 10% rating for arthritis, which put me at 100% schedular, but the VA did not make me permanent and total. I have had my ratings for over 10 years, which include 70% TBI (ptsd, anxiety, and depression is lumped under my TBI rating), 50% Sleep Apnea, 30% migraines, 20% Horners Syndrome, and four 10% ratings for scars and arthritis. "

I'm not trying to be picky but this is not 100% schedular. An example is DC 7354 100% for HCV. How about 100% schedular for DC 9411 PTSD.  Not all ratings go up to 100%. Some, like a back injury, top out at 60%. If the "combined amounts" of your disabilities equals or exceeds 100% using the VASRD §4.25, then you have what is referred to as a combined 100%. TDIU is less that 100% but is granted as an "extraschedular rating" to help you achieve a 100% paycheck. 

P&T is a different "rating" than TDIU and is obtained-usually after a period of five years- based on VA viewing the disability(ies) as static with no improvement foreseeable. If you're a charcoal briquette and obviously P&T in fact, they grant it instantly with the TDIU.

A fellow came to me in 2012 and had 15 10% ratings. It takes 22 ten percents to get to a combined rating of 100%. He will never get P&T going this route because the sum of the disabilities doesn't render him unemployable nor "totally disabled" as a doctor would define it. Never let ratings percentages convince you that you are qualified for P&T. I get a lot of my Vets total because one or two diseases combine to render you unemployable. I'll never get them to a true 100% schedular for any one disease but I don't have to reach that argument.

best of luck.

I am not sure what you are asking of me...Let me clarify a couple things. I was rated 90% combined before I applied for TDIU. I applied for TDIU while I was 90% and granted TDIU. During my TDIU claim, the VA awarded smc and smk (for loss of use of appendage and homebound). Ok, so after I am awarded TDIU @90% I put in a increase for arthritis and painful scar. I was awarded 10% for each of those claims. That put me at 100% TOTAL COMBINED. I think the confusion may be my use of the term SCHEDULAR. I am NOT RATED 100% for 1 disability, I am rated 100% COMBINED, but am still getting paid the TDIU rate.

I have edited my original post to reflect the COMBINED RATING which I mistakenly put as SCHEDULAR. Thank you clearing this up, I appreciate it.

Edited January 18, 2020 by cali_21B

[cali_21B]

23 hours ago, Dustoff 11 said:

What VA form did you use to file for P&T as I am just curious as I have been P&T for over 20 years and recent changes in claims and appeals make everything now very different.

I used a physicians questionnaire sent to me from the DAV-after the VA Dr's filled out the form I emailed it back to the DAV. I believe my DAV representative sent it to the VARO as a new claim. When the claim is reflected in VA.gov I will double check for you.

Permanent Disability Request.doc

[FormerMember]

On 1/18/2020 at 12:52 PM, cali_21B said:

I am rated 100% COMBINED, but am still getting paid the TDIU rate.

It doesn't work that way. When you reach a combined 100% rating, VA automatically switches you over from TDIU and announces it. With a combined 100%, they will never have to pay you for SMC because you used all your smaller ratings to combine to just get to "100% combined". §3.103(c) says they have to give you the most they can support by law. TDIU for 70% from TBI as a stand alone should be the basis for a TDIU. Anything related 2ndary to the PTSD/PTSD/TBI can't be used to build extras needed to reach SMC S.  I'll be honest and say few have a 100% schedular. Last I checked in '17 there were 111,500 or so at 100% Schedular and 103,000 at TDIU. 

Over the years a lot of Vets have come to me and said "Jez, I've had this batch of ratings for 16 years and they just reduced my residuals of Prostate cancer down from 60 to 30%. I got a letter saying I'm not TDIU and my new rating is 50%. What do I do?"  What you should already have is your most recent "Confirmed Rating Decision". Each disability is listed with a Diagnostic Code  (DC) number. When they write up the narrative that grants you your TDIU, it will say why they gave it to you by saying "the combo of this and that is the basis of our grant." If you're 70% all alone, they'd just say your PTSD or what ever was enough to prevent you from working etc. The most common TDIUs are granted for heart, mental or back/leg muscle injuries. VA sends us the Confirmed ratings sheet but never gives the Vet one. Who knows why. You never see the DC listed on the narrative decision. 

VA often lets you get really close to the 20 year total protection day and then springs a c&p on you for all of your current ratings. They whack you down below TDIU  and it takes two years to get it all back. Or worse, they reduce you below TDIU percentages and make a decision to increase on something else to qualify you again for TDIU. The difference is you before this all started, you had 10-year DIC protection for your spouse. The reduction and the new increase/new TDIU resets the 10-year clock for her to qualify.  

VA can be very ugly. The rating sheet below shows my Vet qualified twice with heart and PTSD. VA tried to say his PTSD alone didn't rise to the level of TDIU. I had to stick their nose in it and say no, but with a bum heart for 60% added on, he sure did. A month later they agreed and he got the TDIU. 

Ratings sheet..pdf

Edited January 19, 2020 by asknod

[blahsaysme2u]

3 hours ago, asknod said:

With a combined 100%, they will never have to pay you for SMC because you used all your smaller ratings to combine to just get to "100% combined"

what does this mean? why would you not qualify for SMC if you are 100% combined. i posted on another thread about smck for ED:

Quote

Generally, the VA will grant a 0-percent rating for erectile dysfunction unless you are eligible under the diagnostic codes above. However, service connection for erectile dysfunction, even at 0 percent, makes veterans eligible for Special Monthly Compensation (SMC) for loss of use of a creative organ. This is known as SMC (k) and it is paid out in your monthly VA compensation check.

this came from cck website.