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Input on TDIU claim

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Georgia12345

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Good afternoon everyone,

I was hoping that someone more knowledgeable may be able to provide input on my claim.  Im currently rated a combined 90%, 70% PTSD w/alcohol use disorder and 50% cirrhosis. I haven't been able to work since 2017. I filed a claim for TDIU but VA rejected the claim after my C&P so I retained an attorney. I then had a virtual assessment with a licensed psychologist who assessed me and wrote up his findings.

My attorney filed a supplemental claim and included the letter from the psychologist.  I received another rejection from VA stating that the doctor's letter "does not constitute relevant evidence because it does not prove or disprove a matter at issue within your claim." If someone can clarify this, I would greatly appreciated. I'm not quite sure how that information would not constitute relevant evidence.

My attorney then submitted an HLR which was also rejected. Last week, he submitted a new supplemental claim and added a letter from a vocational expert. I'm just concerned that they may not review this letter since they did not take the last one into account.

Does anyone have any input, advice, tips? I'm beyond desperate at this point.

Pysch IMO 
C&P Exam
Rating Decision
Vocational Assessment

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20 minutes ago, Buck52 said:

Thanks for the feedback. I'm applying for TDIU and If you'll take a look at my original posting, you'll see the rejection letter from the supplemental claim along with other documents.

 

 

 Georgia12345

Not sure what it was you were claiming to get denied?/?

if you can put up a redacted copy of your denial we can better help you , we need to know their reasons they denied you in their own words.

what evidence they used   ect,,,ect,,,

black out your name and claim # personal info.

As for as your MH Claim  it could be MDD ( Major Depression you can have private treatments records also...since you have a combined rating with different disability's  you have a 90% combined rating  50% and 70%.

you will need a letter from either VA Voc-Rehab counselor   known today as = The VA's Vocational Rehabilitation and Employment (VR&E)   or a Dr stating why you can't work  or why your not feasible to retrain at this time...due to your service connected Disability's

Also double check your 70% rating for  PTSD?   WAS YOUR SYSTOMPS ENOUGH FOR THE TOTAL 100% PTSD Rating?

If you have a 90% combined rating and you file for another separate & distant condition rated 60% or higher  you should get the SMC S Housebound...they add that to what your already getting paid  usually the SMC S HOUSEBOUND PAYS AN ADDITIONAL 370.00 BUCKS MONTHLY.

 

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  • HadIt.com Elder

ok sorry, I never seen your links.

Your rating is continued the same,,,which reflects the 70% rating & the rating formula according to your symptoms & according to what the C&P Examiner check in the boxes  which your symptoms best fits the 70%rating  you were denied the increase for PTSD . and is continued at 70%

Here is what you will need as for as the 100% PTSD symptoms Rating FORMULA.

''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.''

I would give an opinion that your VOC REHAB COUNSLOR is actually saying your not unemployable.  and what he/she put in her report hurt your chances for the TDIU .

YOU need to find a Qualified Dr to say why your MH Condition known as and a rating given  70% PTSD , why this keeps you from being unemployable./why.....remember filing for TDIU IS also filing for the increase  and these people are saying your not unemployable.

you need another IMO IN YOUR FAVOR from a qualified Dr, detailing why your unemployable  & can't do any type work  including sedentary work   or learn another trade   and that it would not be feasible to retrain you due to your service connected disability's

you need to wait and see what the new decision is? if its denied  then come back and let us know why they denied you?

Based on what you posted you never filed new and relevant evidence...so they based their decision on your old evidence  which reflects the 70% for PTSD.

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  • Moderator

Have you discussed this with your attorney? You should follow his advice, most attorneys dont want to take control of your claim then have you filing documents he was unaware of behind his back.  Your attorney has reviewed your file, we have not.  

But, it does not sound like this is an experienced attorney, as these sound like rookie mistakes, rarely made by experienced attorneys.  Before you run off and fire your attorney and take over your own claim you should consider such actions carefully.  Many of the same reasons you hired an attorney are still present now, correct?  I guess I could ask who your attorney is, I can probably tell you if he is an experienced pro, or wet behind the ears.  

Based on your post, the VA reasons for denial is that "the doctors statement" was not relevant in proving your claim.  

I read neither your decision, nor the doctors statement, but what you need to prove with TDIU is "does your SC conditions prevent you from obtaining or maintaining SGE".  

Did the doctor state the above?  Its not enough that your doc said you cant work, he has to say you can not work due to conditions which are sc. 

But, with TDIU, there is more.  Your doctor can opine "you are unable work due to sc conditions" but this does not preclude you being trained to do another type of work.  

Example:  You work in a warehouse.  You are sc for your knee.  Your doc says your bad knee means you cant lift over 10 pounds, but your warehouse job requires you to lift 50 pounds.  So, you are unable to work due to your SC knee.  However, a voc rehab specialist MAY say that you could be retrained in, say, computer programming, which would not put stress on your knee.  Therefore VA often denies you since you have to show you cant do ANY work, not just your present job.  

Now, you need a voc rehab specialist opinion.  Yea, I know.  With PTSD if you cant work in a warehouse because you "blow up" with anger at others, then you also can not work in a computer setting, because you would get mad there, also.  But dont expect VA to connect those dots.  Get a voc rehab specialist to opine that your PtSD PREVENTS YOU from doing any work, not just your present job, because you are not a suitable candidate for retraining in the computer (or other) field.  

As I explained, your doc can opine you cant do your job, but he is not a vocational speciallist and cant opine if you could do another job.  

You need to review your file and cover all of the above, probably with an IMO from a voc rehab specialist.  That is how I won MY tdiu claim.  

Edited by broncovet
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1 hour ago, Berta said:

I only saw one page of the VA rating decision.

 

Part of the Vocational specialist's statements were missing too-but what I read seemed very positive for TDIU.

It seems the Vocational Specialist's statements were not considered by the VA.................because they didnt receive that info until recently.

 

Did you supply the VA with contact info from your past employers?

Did you receive SSDI solely for your SC disability? If So does the VA know that?

"My attorney then submitted an HLR which was also rejected. Last week, he submitted a new supplemental claim and added a letter from a vocational expert. I'm just concerned that they may not review this letter since they did not take the last one into account."

I was unaware that a "new" supplement claim can be filed----that's great.***

If the VA does not reverse their decision, and denies the claim ,after receipt of that letter,  I hope your attorney is fully versed in CUE....which can be filed on any decision ( award or denial,) and can be filed at any time, to include a recent decision.

*** has anyone here file an additional  supplement claim?

 

 

 

 

The VA does have my former employer's contact information. I haven't applied for SSDI as of yet.

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2 hours ago, broncovet said:

Have you discussed this with your attorney? You should follow his advice, most attorneys dont want to take control of your claim then have you filing documents he was unaware of behind his back.  Your attorney has reviewed your file, we have not.  

But, it does not sound like this is an experienced attorney, as these sound like rookie mistakes, rarely made by experienced attorneys.  Before you run off and fire your attorney and take over your own claim you should consider such actions carefully.  Many of the same reasons you hired an attorney are still present now, correct?  I guess I could ask who your attorney is, I can probably tell you if he is an experienced pro, or wet behind the ears.  

Based on your post, the VA reasons for denial is that "the doctors statement" was not relevant in proving your claim.  

I read neither your decision, nor the doctors statement, but what you need to prove with TDIU is "does your SC conditions prevent you from obtaining or maintaining SGE".  

Did the doctor state the above?  Its not enough that your doc said you cant work, he has to say you can not work due to conditions which are sc. 

But, with TDIU, there is more.  Your doctor can opine "you are unable work due to sc conditions" but this does not preclude you being trained to do another type of work.  

Example:  You work in a warehouse.  You are sc for your knee.  Your doc says your bad knee means you cant lift over 10 pounds, but your warehouse job requires you to lift 50 pounds.  So, you are unable to work due to your SC knee.  However, a voc rehab specialist MAY say that you could be retrained in, say, computer programming, which would not put stress on your knee.  Therefore VA often denies you since you have to show you cant do ANY work, not just your present job.  

Now, you need a voc rehab specialist opinion.  Yea, I know.  With PTSD if you cant work in a warehouse because you "blow up" with anger at others, then you also can not work in a computer setting, because you would get mad there, also.  But dont expect VA to connect those dots.  Get a voc rehab specialist to opine that your PtSD PREVENTS YOU from doing any work, not just your present job, because you are not a suitable candidate for retraining in the computer (or other) field.  

As I explained, your doc can opine you cant do your job, but he is not a vocational speciallist and cant opine if you could do another job.  

You need to review your file and cover all of the above, probably with an IMO from a voc rehab specialist.  That is how I won MY tdiu claim.  

I don't intend to fire my attorney or do anything behind his back.I was just wondering if anyone else had experienced something similar. I am going to PM you my attorneys name. If you any feedback, please let me know.

 We got an IMO from a vocational specialist last week but the VA hasn't reviewed it.  Listed below is an excerpt from the letter.

If one assumes that Ms. XXXXX has the above mental health limitations, it is my opinion, on a more probable than not basis, to a reasonable degree of vocational certainty, that Ms. XXXXX would be,unable to obtain and follow a substantially gainful occupation. Competitive employers have very low tolerance for irritability and anger outbursts in the workplace. For instance, based on my experience, competitive employers will terminate a worker's employment after just one outburst of anger or irritability in the workplace, especially if such an outburst is unprovoked. Ms. XXXXXX inability to establish and maintain effective relationships would also cause her to be unable to obtain and follow a substantially gainful occupation because a worker who cannot accept or follow a supervisor's instructions on the proper way to perform a job or who cannot respond appropriately to criticism because she is unable to maintain effective relationships with her supervisor will be terminated, typically after the first or second time the individual refuses to follow a supervisor's instruction on how to perform a job or responds inappropriately to criticism. Every substantially gainful occupation also requires a worker to tolerate the presence of other co-workers even if the worker does not have to work as a member of a team with coworkers. Tolerating the presence of other coworkers necessarily requires the  worker to have the ability to establish and maintain effective relationships with co-workers, which means interacting appropriately, at least on a superficial, casual basis with at least one or two other co-workers. Such interactions occur when workers encounter each other on their way to or from a bathroom, in a lunch or break room, in a staff meeting, or while walking to or from the parking lot to the workplace. An individual who has an inability to establish and maintain effective relationships with co-workers on even a casual, superficial basis is therefore unable to follow a substantially gainful occupation. Again, anger outbursts, irritable behavior, and insubordination are not tolerated and will result in termination. Lastly, it is self-evident that a person who has an intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene, cannot perform the duties and tolerate the stress inherent in any substantially gainful occupation as being able to take care of one's own self and activities of daily living is a prerequisite to obtaining and following any substantially gainful occupation. For these-reasons, as I stated in the above, it is my opinion, on a more probable than not basis, to a reasonable degree of vocational certainty, that Ms. XXXXX cannot obtain and follow a substantially gainful occupation if one assumes she has the above limitations given by Dr. XXXXX.

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I read all this again-

 

you stated:

"My attorney filed a supplemental claim and included the letter from the psychologist.  I received another rejection from VA stating that the doctor's letter "does not constitute relevant evidence because it does not prove or disprove a matter at issue within your claim." If someone can clarify this, I would greatly appreciated. I'm not quite sure how that information would not constitute relevant evidence.

I am baffled by that- can you scan and attach here the "rejection letters" and the evidence list they used? Cover C file, name, address prior to scanning it.

There is only one page of the C & P exam.

There is only one page of Dr. Widen's IMO.

"My attorney filed a supplemental claim and included the letter from the psychologist.  I received another rejection from VA stating that the doctor's letter "does not constitute relevant evidence because it does not prove or disprove"

Was that Dr.Widen's  IMO?

I hope someone here will chime in-

Have any of you ever had or heard of the VA accepting an additional Supplement claim? If so did the VA act on it or reject it.

 

 

 

 

 

 

 

 

Edited by Berta
added more.
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