TDIU claim rejected

[georgia126532]

I'm currently service connected at 70% for PTSD with alcohol use disorder and situational specific phobia.  I also have a 50% rating for cirrhosis with hepatitis and alcoholic gastritis. During my claim, I listed PTSD as the disability that makes me unemployable but I was under the impression that VA would consider the combined affects of all disabilities.  Is this not the case? If anyone has advise on how I should proceed, that would be wonderful. Based on the symptoms listed in the my award letter, is it even worthwhile to appeal?

 

 

[GBArmy]

georgia126532 I'm no expert but I assume that you haven't provided adequate evidence that your symptom at 70% rating, show that you should be granted TDIU. Yes, you're correct. The VA will take into account all of your service-connected disabilities, although non s-c also has negative weight. You need to get an independent eval from someone who makes these evals; it is a specialized field. His or her assessment of your conditions, if favorable, will result in a much better chance of your request being approved. It will cost you some $, but if you win, your 70% rate of $1400/month more than doubles. Worth the investment. Several others on the forum are more familiar with the process and hopefully will chime in.

[Buck52]

I Agree with GB Army on this.

  and add you need to ask a qualified Dr to read your medical records and state so in his summary/opinion of his examination of you and if he gives his medical opinion after he examines you  to state I have read this Veterans medical records and have examined him for his  mental health condition  he  is 70% service connected for from the VA,'' it is my professional opinion likely as not that due to THIS VETERAN MH Condition  he is unable to do any type of employment including any sematary type work  or something along these lines...

.you need a MH SPECIALIST to give his a summery (medical opinion) of why  he thinks in his professional opinion why you can't  do/find any type of employment due to your service connected disability.

or you might try to get into  the VA Voc Rehab Program to see if they can find you any type work you can do  with your 70% PTSD Rating, if they can't find you any type work you can do to make SGE or the threshold limit of employment ...then the counselor will write you a letter dismissing you from the voc-rehab program that  it is unfeasible to retrain this veteran at this time  due to his service connected disability.

if you were denied ''Increase'' you have a year to rebut this denial...and you do that with a new I.M.O. (Independent medical opinion) AS FURTHER EVIDENCE THAT YOU CAN'T WORK AND THE VOC-REHAB PROGRAM.  THOSE TWO THINGS SHOULD RENDER YOU UNEMPLOYABLE.  using the supplemental claim lane.

if you choose the higher lane review HLR   YOU can't use any new evidence   and this is basically a repeat review of what you already have been through  they get a DRO to review your claim and normally it is kept the same.

Edited October 23, 2020 by Buck52

[Buck52]

16 hours ago, georgia126532 said:

I'm currently service connected at 70% for PTSD with alcohol use disorder and situational specific phobia.  I also have a 50% rating for cirrhosis with hepatitis and alcoholic gastritis. During my claim, I listed PTSD as the disability that makes me unemployable but I was under the impression that VA would consider the combined affects of all disabilities.  Is this not the case? If anyone has advise on how I should proceed, that would be wonderful. Based on the symptoms listed in the my award letter, is it even worthwhile to appeal?

 

 

You need this to be added to the reason and bases of our decision / OR ''The reason for our decision'', its the number one rating criteria for 100% Mental Health Disorder for PTSD.

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%

[pacmanx1]

IN MY HUMBLE OPINNION (IMHO) when a veteran files for TDIU s/he should file for all service connected conditions. Your PTSD may have not increased and may not prevent you from employment but adding your other ratings may change things. Also if you are receiving SSDI will help your TDIU claim. I agree with BUCK and GBArmy, that you need an IMO and a Voc Rehab specialist opinion that you are unable to do any type of work. If you are drawing SSDI, they use their own Voc Rehab Specialist opinion so that may be half the battle.

Some IMOs can cost but if you can get an IMO from your treating VAMC doctor or a private doctor this will help. Some doctors don't like to get involved with disability letters but they are more willing to write a statement in the veteran's/patient's progress reports.

Edited October 23, 2020 by pacmanx1

[Buck52]

if your at 70% at present &  to get the 100%  you will need an additional 90% rating  or combined ratings to equal 90% along with your present rating at 70%  to reach the 100% scheduler rating  & this is very hard to do.

[LightofSolitude]

On 10/22/2020 at 11:11 AM, georgia126532 said:

I listed PTSD as the disability that makes me unemployable but I was under the impression that VA would consider the combined affects of all disabilities.  Is this not the case?

According to TDIU Fast Letter 13-13, it states the following:

"VA will no longer presume a claim for TDIU is a claim for increase in all serviceconnected disabilities. As part of a substantially complete application for TDIU, VA will require that the claimant with multiple service-connected disabilities specify at least one disability that he or she believes causes the unemployability."

In other words, VA will not consider the "combined effects" of all your disabilities with regards to TDIU unless you specifically state that in writing. Even if you think one of your disabilities doesn't contribute to unemployability, point it out anyway and let VA decide based on the evidence of record. If you do not have a medical opinion on file regarding your unemployability, now would be a good time to supplement the record (your claims file) with one.