PTSD Claim Deferred, IU submitted by VA Despite Already at 100% Schedular

[Punisher]

I need some guidance or suggestions from the experts.

I am currently at 100% schedular (temporary, not P&T). My higher Service connections are:

• Dermatitis with Psoriasis (also claimed as psoriasis guttate, eczema/dermatitis)    = 60%
• Migraine including migraine variants - also claimed as decreased concentration    = 50%
• Residuals of traumatic brain injury (TBI)    = 40%
• Insomnia disorder - also claimed as sleep disorder and insomnia    10%
• and a dozen other 10% ratings for tinnitus, arthritis, degenerative disc/joint disease/lumbar spine, and as well as injuries to every joint.

I submitted a PTSD claim and it was moving right along and I'd already completed all C&P exams for it as well as the ones for another set of RFE claims the VA submitted for three other conditions (Migraines, TBI, Insomnia) that are still temporary ratings.

Now, two of the three RFE claims show as complete and the VA website says they sent a letter; however, one of the conditions (TBI) got moved over to my PTSD claim and the status went from the exams being complete and in the last phase or so, with a projected completion date sometime this month to December!  On top of that, the VA started a claim for "IU" on my behalf without asking me, so they also added the couple of VA forms required with the due date of 7/31/2020.

The IU part might not sound bad, but I was already 100% (temporary unfortunately) without the PTSD service connection and I believe I made a compelling case for at least 50% of that, if not 70% as I met most of that criteria.  So, I've always heard, read, seen in videos, and even been told directly that when someone is at 100%, albeit temporary, it's not wise to apply for TDIU since it pays the same AND the VA may then reduce other percentages.  Also, as you know, it can be easier for them to later remove the TDIU classification for technicalities.  Lastly, those forms are the worst part for me.  I DO NOT want to have to fill those out, especially the one you have to bring to your former employer.  My company was located off-base, so they never even observed my daily performance.  The military supervisors who were over me have since moved on as it's been over a year.  Finally, I usually burned up PTO to cover all the time away for appts and physical therapy, which they knew about, but as for PTSD issues I was going through, I sure as hell did not disclose to them as it was none of their business, super private, embarrassing, and I would have been worried about my security clearance!

The only thing about canceling the IU is that I don't want it to look like I AM capable of pursuing "gainful employment."  I would just definitely prefer to retain my 100%, which should be even stronger with a PTSD condition/connection added to my current list.

What is your take on all this?  Do you know if there's a way that I can have them close or remove the IU portion and the required forms?  Besides not wanting to apply for that or do the forms, I also do not want this to hold the rest of my claim(s) up or give them an easier way to assign lower percentages. 

Any help would be much appreciated.

[Berta]

I missed this thread due to spending some  time on my pending VA issue as well as something else I had to prepare  in form of a legal brief for a non claim related VA issue, It all takes time, and today I read this thread....... but I feel that you should wait for the actual decision-

You did Very well, as it appears to me....

You mentioned you heard some stuff that indicated it might not be a good idea to question the rating you had ( that was not permanent) and I hope no one here recommended that to you-that is often a mantra those socalled vet reps and VSO use, so they dont have to do any more work , with a claim ( if they actually did any work already at all.

because Nothing is impossible with the VA, and to 'lower' a vet's % rating is often very difficult for VA to do.

Congratulations on pursuing what you felt was best because that P & T designation means a lot to you and to your dependents...CHAMPVA, Chapter 35 Educational Benefits, and even maybe your Property Tax office might have exceptions for your taxes due to the 100% P & T.

I hope they gave you the correct EED for the 100% P & T but the actual decision will tell more.

 

 

[Punisher]

Berta,

No worries, I really appreciate you taking the time to respond. You must read thousands of these!

On 7/10/2020 at 3:30 PM, Punisher said:

"VA Rating Decision dated 06/30/2020 granted you 100% permanent and total (P&T) effective 06/23/2020, effective the date of the migraine examination because this brought your overall rating to 100% without the TBI and Mental Health (MH) issues.

The VA is still going to work on those issues and resolve them as it would potentially give the 100% P&T and earlier effective date.  The TBI and MH has gone back to the examiner for clarification.  The VA has asked the examiner to try and separate the symptoms between the two conditions (TBI) and MH).  No matter the outcome you will maintain the 100% P&T status but the outcome could provide an earlier date of the 100% P&T."

So this has gotten a bit messy, but first, for the exact reasons you stated (the benefits for my family) this is paramount for me to get it right.

For a few days, I was going by the Regional DAV's response above, but turns out the first part was completely wrong. I got my letter and the only two things that were actually decided were 1) that I had basic eligibility to DEA based on 06/23/2020 and 2) that their evaluation of my Migraines, currently at 50%, is continued.  So I was a bit confused when I read that. (Stick a pin in that for a minute...)

I spoke to another National DAV guy who told me NOT to just call the VA over the phone as I told him I was going to do at that point (last Friday 7/10/2020) to clear everything up, including the whole IU/TDIU mess.  He urged me to submit a signed statement for everything, so over the weekend, I did a 21-4138 and uploaded it to my claim, explaining just my reasons for not wanting to pursue IU/TDIU and to close or remove it, mark the two forms as no longer needed, and continue to process any pending claims in order to make a decision without further delay.

That got things moving yesterday, Monday 7/13/2020, to the next phase (Gathering Evidence), but all they did with the IU and forms was to move the due dates 3 days to the right (8/3/2020) and the expected completion date moved up to Nov.

Then today, I got a call from the contractor doing the C&P that they needed to schedule another exam............ for Migraines! That was literally the ONLY disability they actually made a decision on in the letter and I thought, per the DAV's explanation, that it was the connection which had qualified me for the P&T.  Can you see where I'm really getting confused now?  I also noticed, upon further inspection of the date the letter referred to (06/23/2020) going back to my calendar, that it was actually a TBI exam I had labeled as PTSD. Whoa!

So I called the VA, spoke to the rudest, most condescending person I've ever encountered on the phone, (which has NEVER been my experience, probably just luck), and leaving that whole drama aside, he said he put in a message to remove the IU/TDIU, but beyond that, he wasn't helpful.

Any thoughts?  Even though this is SUPER painful for my psyche (remember what kind of issues I'm dealing with), I do figure that most of this SHOULD work itself out.  That said, I'm very uneasy about my P&T being based on something that is supposedly "Deferred" and/or will be undergoing yet another exam.

Sorry this has been so long in the tooth, but this is the most convoluted situation I've seen since embarking on this journey.

[Berta]

Wow, it is confusing- I guess they used the Migraine EED as first day medical evidence warranted that rating.

But they make many mistakes on EEDS.

It will be great when we can opine more with the actual decision, when it comes-hope it doesn't take too long.

I recently had to go over my past VA Paperwork, and all of my claims were denied right off the bat because they had ignored my evidence.They even managed to convolute  a very simple SMC accrued CUE .It was set for BVA transfer 7 years after I filed the CUE, and asked them to reconsider based on the evidence, but they still could not read.The Nehmer VARO awarded it.    

I am concerned here- that you do not want to drop any claim that could possibly award you SMC in the future.

 

 

[Punisher]

Berta,

I apologize for my convoluted write-up, but it was pretty difficult to describe this craziness.

3 hours ago, Berta said:

I guess they used the Migraine EED as first day medical evidence warranted that rating.

That's what the DAV told me the VA had based it on, and after having SO many exams and appts in such a short timeframe, I also thought that day must have been my Neurology appt, but I finally looked at my calendar yesterday and saw I had a PTSD/TBI C&P Exam that day.  So now I'm more worried than ever about my P&T if it's, in fact, based on an exam for a claim that's still "deferred" and pending.

Have you, or anyone else here, ever seen the VA do that?  I've never heard of that and I was even a Career Councilor during my military career and been a member here for years. (Still nowhere near an expert on these matters though)

3 hours ago, Berta said:

I am concerned here- that you do not want to drop any claim that could possibly award you SMC in the future.

Are you referring to dropping the IU/TDIU?  If so, I realize it could help with a few things, including a future SSDI claim as well, however, I feel my 100% Schedular P&T is safer and enables my kids to use it to pay for school now, rather than take any risks of NOT having it or waiting 20 years for a temp TDIU to become permanent. Also, the two forms they're asking for will be very difficult, mostly the employer one, as I haven't worked there for over 1.5 years and the people I worked for are no longer around, nor did they know much about my MH info. Therefore, I do not see the results being helpful in my case.

[pacmanx1]

47 minutes ago, Punisher said:

Are you referring to dropping the IU/TDIU?  If so, I realize it could help with a few things, including a future SSDI claim as well, however, I feel my 100% Schedular P&T is safer and enables my kids to use it to pay for school now, rather than take any risks of NOT having it or waiting 20 years for a temp TDIU to become permanent.

A veteran can be rated 100% scheduler P & T or 100% TDIU P & T. They pay the same rate of compensation.  A 100% scheduler or 100% TDIU veteran does not have to wait 20 years before their rating becomes P & T. Depending on the disability and its severity, a veteran can be granted/awarded P & T at any stage of his/her rating. When I was granted/awarded 100% scheduler, I was also granted/awarded P & T in the same rating decision. If your symptoms continue and are the same as when you were granted 100% scheduler, VA cannot reduce your rating.  Even if VA tried to reduce your rating, you can appeal and will most likely retain your rating. While in the appeal status, VA cannot change your compensation pay. So basically, you would have nothing to lose. If VA would grant a new disability, it could change your effective date and generate a retro payment or increase your monthly payment with a SMC payment which is a little more than the regular pay schedule. I had been rated 100% scheduler for many years and I recently won a BVA grant for an EED(Earlier Effective Date) of a new disability. This new rating will grant me a retro payment of my new combined rating.  This new BVA decision has been in appeal status for well over a decade.  VA called and asked me if I wanted to close or cancel all my appeals since I was granted 100% scheduler. I said no because I knew that this disability was one of the first claims I filed and I knew it warranted service connection and I finally got it after my claim went to CVAC and then to BVA and granted.

[Punisher]

All,

I finally got my letter from the VA on Friday, with all the info included from the decision, and it's reflected on eBenefits too!

They took away my Insomnia and replaced it with the PTSD rating since they combined the symptoms.  They also combined TBI instead of waiting longer to separate the overlapping symptoms, but though the letter said the TBI would be combined, backdated to the same day as the PTSD (04/27/2020), there is still a "residuals of traumatic brain injury (TBI)," rated at 40%.

 

I was surprised that, if I'm finally 100% P&T (officially now), in that big thick package, there was nothing overtly stating that, neither in writing nor in any checkbox like I've read about.  They do show benefits we're eligible for that fit that category.  Also, they used to show statements saying whether I'd have further exams or not, but that wasn't mentioned in there either.

 

 

 

Any thoughts or comments on re-examinations?  When you become 100% P&T, does that automatically apply to everything you're rated for?

 

Thanks again everyone!  I couldn't have done this without this Forum--I had no other outside help. Not even from VSO!