VA added IU claim...what if I'm not ready?

[mb76]

I just did an REF for MDD/GAD. VA.gov has a "IU (new)" claim and also a request for a TDUI application within 30 days. I'm a little miffed because I understood that the rating decision would have been made within weeks but now they estimate it to be in November.

What are the ramifications of me not filing an application for TDIU now but possibly filing one down the road (months or years)? How can I tell the VA to forget about TDIU and hurry up with the rating? The anxiety is bothering me. I want to know if they will lower, keep the same, or increase my rating. I can't sleep.

[broncovet]

Relax.  If you dont want to send it the tdiu, then just dont send the application form.  

You can file it later.  However, filing later = lower retro, filing now means greater retro.  

The short answer is we dont know whthre they will lower, increase or keep the rating the same.  However, you "can" figure out the criteria for each disability, and view your medical records to see which rating criteria, if any, you feel you deserve.  

Most Vets, if they persist long enough and dont quit or die, will eventually get the rating they deserve.  

Mostly, the VA cant reduce Vets rating, "unless" they meet the applicable criteria, which normally means you had to have "actual improvement (sustained improvement) under "ordinary conditions of life".

Allow me to explain with 2 not so far fetched examples.  

1.You are rated 30 percent for knee issues.  You are not able to work, so you stay home and rest, but your knee feels better because you are not on it all day.  Did you have "actual improvement under ordinary conditions of life"?   No.  You improved because you rested your knee and stay off of it by not working.  

2.  You are rated 100 percent for PTSD.  Since you dont have a job, your stress levels are decreased.  But the minute you get around people, your stress levels increase.  You dont have "actual improvement under ordinary conditions of life" because not working decreeases your stress and "ordinary people" work, but you are not working so getting away from stress on the job helping you is insufficient reasons for VA to reduce you.  

Read this, thoroughly:

Quote

§ 3.344 Stabilization of disability evaluations.

(a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c) Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

 

[mb76]

Interesting, thanks.

[mb76]

3 hours ago, broncovet said:

Relax.  If you dont want to send it the tdiu, then just dont send the application form.  

You can file it later.  However, filing later = lower retro, filing now means greater retro.  

 

 

Can I file an an Intent To File for TDIU to protect my effective date? Also, how can I do this without holding up my RFE decision? I really want to know ASAP.

[GBArmy]

mb76 I don't believe a ITF applies to a TDIU. If you qualify, the VA is supposed to start the process for you automatically. If they don't, you can request it but it is their process to initiate. In your case, you have the paperwork to send in if you want to. That takes the place of an ITF, so to speak. Just as broncovet said, if you don't want to file now , don't send in the form. I would assume that your claim would start to move again once the VA figures out you have no more evidence to submit. If that is the case, maybe upload a memo declining to submit at this time, but may request again in the future. Others can comment but you wanted a quick answer.

[Christie]

So now I am confused. You are already 100% P/T but yet they are trying to TDIU you? Do you currently work? Pay and benefit wise they are the same thing. So I am totally lost.

[pacmanx1]

Tbird/Moderators

IMHO, I think there is some confusion here and these posts should be separated. The OP(Original Post) and Seminoles post will just confuse posters and ruin mb75 thread. It's OK to share experience but when you get into asking questions and or venting your own issues, it takes away from the OP.