Damn, wait... what!?

[pacmanx1]

When I was awarded/granted 100% scheduler I was also granted P & T.  IMHO, I think that when veteran's are awarded/granted 100% scheduler, they are granted P & T due to the fact that according to the combined rating schedule, those veterans are most likely at least 250% or higher. Not impossible but very hard to overcome/recover from those disability percentages. Now when a veteran is awarded/ granted 100% TDIU, he/she is also not likely to overcome/recover from those disabilities but in a lot of cases, VA would establish a re-evaluation date to determine if their rating is permanent or not. Let's not forget that the human body is a remarkable thing and for some unknown reasons some can actually overcome/recover and some cannot. Who knows why but there are miracles that do happen and VA will take advantage if a veteran's doctor state that the veteran's condition has improved causing the veteran to be re-evaluated. When a veteran is awarded P & T, he/she is always given a VA form 21-8760 in his/her award packet ( ADDITIONAL  INFORMATION FOR VETERANS WITH SERVICE-CONNECTED PERMANENT AND TOTAL DISABILITY). At one time you could find this form online but now you can only find it online as a PDF form.

I know some may disagree but TDIU (Total Disability based on Individual Unemployability) as I stated is like all other ratings in a way that it is not permanent and it is not temporary, it is simply a rating that has a re-evaluation date established. Most ratings do not have a re-evaluation date established and in most case will not be re-evaluated unless a veteran files for an increase or VA decides to re-evaluate due to medical opinion (medical opinion that the veteran's condition has improved).

Thanks VYNC, if we disagree we disagree and if I am wrong, I am wrong.

[FormerMember]

During this Corona madness, we are seeing a lot of reductions in ratings. Here's the gig. If they send you a reduction notice, you have 30 days to stop the action and request a hearing. If you do, they cannot adjudicate the reduction without doing a hearing. If you fail to respond within the 30 days, they will effect the reduction within six months. However, if you fight the reduction after the 30 day point, you get a total of 60 days to request the hearing. If you do not, the reduction stands and you have to file anew to get an increase back to where you were.

I have a combat medic with a 50% for PTSD he just got in 2016. They whacked him back to 10% on one exam by a quickie VES exam last month. Sadly, he didn't get in touch with me quickly enough. Worse, it took 20 days to get my POA accepted. §3.344 forbids this. The reduction has to be based on a lot of factors they ignored but I'll end up fighting this up to the BVA. I'll be forced to go buy a good IMO and it (the reduction) will end up being thrown out. But... just to be an butthead, I'm striking back and filing a 995 and using the new IMO to get an increase to 70%. This way I let them know we're on the warpath and their actions have only stirred the hornet's nest.

The eventual BVA decision throwing out the reduction will be anticlimatic but necessary to stop this foolishness. Another ploy I see in rater's notes in VBMS is scheming to reduce the rating on one injury/disease and increasing it on another. Thus they don't even have to go the regular §3.344 route for reductions. What you don't see is the fact that you didn't get TDIU. 

Example: Vet has 80% for 6 ratings. He files for new claims or increases. They grant the new stuff but subtly reduce some the Vet has had for almost 18 years. The end result was no change but not quite. The new or increased ratings would have logically put him into TDIU but VA avoids §3.105(e) with the reductions. I see they are whacking Vets at TDIU/P&T w/ 19 years and approaching 20 year protection of their ratings. The reduction can restart the effective date of the TDIU clock. If you die tomorrow, your spouse's DIC flies out the window because you haven't had it for 10 years. VA will act magnanimous and say even though they reduced your _______, at least you are still TDIU or P&T. Unfortunately, your new effective date is May 1, 2020-not April 1, 2002.

P&T generally protects you and pulls the plug on these shenanigans but not always. I have had VA come back and try to screw with my clients using CUE and saying they just discovered that ___________ was illegally awarded in 1993 and must be revoked/reduced. I spend a year or two showing the VA has to abide by the same rules we do on CUE and it falls flat on appeal based on how the evidence was reviewed. But... that sometimes takes 3 years to fix. You would think at some point they'd pull a rater's authority to revoke arbitrarily. I think most is generated by computer automatically but not always. Jackson MI, Little Rock and Houston are famous for this crap. The problem is the NWQ. Now, a rater in Manila can pull the plug and you cannot just call up your Portland RO and say hold the phone Ramone. They'll tell you to take it up with Manila. 

The new AMA is starting to show its true colors. 

Edited May 16, 2020 by asknod

[kanewnut]

2 hours ago, asknod said:

During this Corona madness, we are seeing a lot of reductions in ratings. Here's the gig. If they send you a reduction notice, you have 30 days to stop the action and request a hearing. If you do, they cannot adjudicate the reduction without doing a hearing.

In my case I received a rating decision that is reducing a 40% back to 20% based on the latest C&P exam. It doesn't affect my overall 90% rate that I am paid at, but will make it harder to get 100% scheduler. The 40% was granted July 2016. I have had two C&P exams prior to this one that they used to reduce my rating. My 40% was continued by the other two C&P exams. Does this fall into what you are discussing about stopping the action and requesting a hearing?  

[pacmanx1]

In order to stop or hold the reduction, you must request a hearing and your time is very limited.  In order to overcome the reduction you must show proof of symptoms that you meet the current rating criteria or higher.

[kevin4998]

Well the letter states Total and Permanent but does not say anything about No Future Exams.  So I guess I can still be re-evaluated for decrease.  Not sure what the letter is stating other than the fact they did reduce my Somatic Disorder from 70% to 50%.   This is all very confusing because they seem to change wording so easly.   Such as

"Because your disability improved as of the date of the exam which is the second exam to show an improvement, your ptsd evaluation of 50 percent with a final overall unchanged combined 90 percent will not be reduced with your individual unemployability. 38 CFR 3.500" 

That is saying I have PTSD, not Somatic.   

Another issue is when I had the conference call with the lady she mentioned a review done back in 2018, and also so do this letter.   But, for the life of me I do not recall going to the facility, or third party or a phone call about a review.  Where they are getting this review in 2018 I have absolutely no clue. I need to call them tomorrow and ask them to send me all documents of me actually requesting a review.   Apparently I did so in 2017, but I never actually saw a doctor/nurse of any kind.   Some how (after reading what was online just now).  they decided my condition was better.   Only thing I remember is something about being declined for something or another, and never followed up on it.  I think it was too request to add my Sleep Apnea to be service-connected due too Somatic disorder which caused my Sleep Apnea.  

Any way I am confused to whether or not if I will have a review one day or another to end my TDIU.   That is where I am at and this issue back in 2017/2018.

 

[kevin4998]

After reading up on the Total and Permanent.   It appears since they say in the document "Total SERVICE-CONNECTED disability, PERMANENT in nature", this would make me believe even though they still refer to my TDIU in the letter, it is a MUTE at this point as per that particular line would make me 100%.   BUT it still does NOT say those key words "No future exams".   I understand that I am still going to have exams to reduce or even raise my ratings, but it still worries me that they my go back to me being TDIU as per this letter and review the TDIU and remove it.   They really love to play the word games here, by omitting No Future Exams that leaves the door open to do as they please... that is if I did not fight it.