What Rating Do I qualify for

[Hotdigitty]

I went for my mental health C&P and these are the checked diagnoses.  What % do I fall under in your opinion?

1. Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood
2. Depressed mood
3. Anxiety
4. Panic attacks that occur weekly or less often
5. Panic attacks more than once a week
6. Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively
7. Chronic sleep impairment
8. Mild memory loss, such as forgetting names, directions or recent events
9. Disturbances of motivation and mood
10. Difficulty in establishing and maintaining effective work and social relationships
11. Difficulty adapting to stressful circumstances, including work or a work like setting
12. Suicidal ideation
13. Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene.

[GBArmy]

With what you have provided, I would think a 70% rating would likely be given IMHO.  But that keep in mind we don't the rest of the file. SI is the driver. If it is that high and you can not work, consider putting in for TDIU if they don't do it themselves.

[broncovet]

Before, you start calculating your rating, make sure you have all 3 Caluza elements.  Dont be like the football player who starts running, then forgets to catch the ball first. 

One MORE question:  Are you working?  If you are employed, then its hard for VA to say you meet the 100 percent criteria (total occupational and social impairment).  

I do agree with GB Army, however.  Generally VA benefits are designed to replace lost income from working.  That is why its especially tough to get 100 percent while working.  

The big question is how much does your disability impair your abiliity to earn a living?  You have to answer that one.  

Lowballing is a favorite thing of VA, after delays and denials.  So, many times you have to appeal.  

Edited January 11, 2022 by broncovet

[Hotdigitty]

Right now I am out on FMLA leave because of the service-connected disabilities.  I am only there because I am in my vested year and my co-workers help me out tremendously, however I will be  retiring this year.

[broncovet]

Interesting, and potentailly problem matic.  At my VAMC, when you check in for an appointment, they ask, 
"are any of your issues today work related?" 

    You obviosly need to be truthful, there, as always.  

    And, most of the time, if you are on Unemployment, they make you sign a statment, 
"I am ready, willing, and ABLE to work."  

This pretty much prohibits people from going on unemployment while waiting on VA disability benefits.  You either "are" able to work, or you are NOT able to work, but you cant be "able to work" for unemployment purposes, then "UNable" to work for VA disability purposes at the same time.  

   You posted you are "on FMLA".  I really have no idea, but, if you take off work "for family reasons", such as having a child, etc, etc., its pretty hard to tell your work its "family reasons" but then turn around and tell VA "oh its because of  a SC disability".  

     Please, understand:  IM NOT repeat, NOT accusing you of anything, of course.  YOUR FMLA policy may well permit you to go off work because of a service connected disability..I have no idea.  But, I kinda think that is probably not the intent of FMLA.  

    The government does not want you to be able to get duplicate benefits.  In other words you cant likely get benefits for unemployment, Veterans disability, and workmans comp at the same period of time..for an understandable reason.  

    Im just suggesting you you use discrection and common sense, and, dont deceive the VA, nor workmans comp.  They tend to catch up to these things, and then...its bad.  Just be consistent...if the injury is service connected, so be it.  But it cant both service connected AND a work related injury.  Of course, a SC injury "could well aggravate" a work injury.  Just be careful, and probably read your FMLA.  I really am unsure if FMLA permits time off for a SC injury or not.  But the VA will likely find out, if they dont already know, that you are on FMLA.  

     With all the above said, its perfectly legal for 100 percent Disabled Vets to ALSO get Social security disability, provided that they meet the criteria for Both VA and SS.  

     To the contrary, if a Veteran gets social security disability, and the reasons for that disability have been determined by VA to be SC, then you can actually put pressure on the VA.  In other words, if social security says you cant work (for reasons which are SC), then VA pretty much has to agree.  But, if you are SC for PTSD, but social security says you "cant work because of knee or back problems" you just may have a problem.  You may need to try to get SC for your back and knee problems, to get VA and SS both.  

     There is a reason for VA's "over 50 percent", that is, "at least as likely as not due to an event in service.  

     Your injury, by defination cant be "51%" caused by military service AND ALSO 51 percent cause by a work injury after military service.  Its one or the other, not both.  

Edited January 11, 2022 by broncovet

[Rivet62]

1 hour ago, broncovet said:

I really am unsure if FMLA permits time off for a SC injury or not.

In my experience as an employee at a VAMC my FMLA request and approval was solely for service connected issues, although my primary care doctor at the same VAMC did not state specifically "service connected issues."  If the Varo were to explore my medical record together with my employment record only then could it be seen that FMLA issues were clearly those same issues for which I had received service connect. 

For patient privacy the VAMC as an employer could not look into my medical record at the same VAMC where I also received care. Likewise, the VAMC as a health provider, cannot disclose patient information to VAMC the employer. Only with a signed release could the two overlap, such that the two were not separate information silos. The records that did overlap were statements made by my providers for the purpose of sick leave, unpaid time off, and FMLA. I later used those records to support individual unemployability.

The VAMC as employer did allow time off specifically for C&P exams, although these were unpaid time off.

I don't think I even tried to claim injury or aggravation at my work at the VAMC HR department, knowing that I had a pending claim for VA service connect because the issues go way back before my employment at the VAMC.

I ran into the "ready, willing, and able to work" scenario and chose not to state I was able. I know that when I checked into appointments at a kiosk at a VAMC or VA clinic, it always asks is this work related?  I interpret the question as VA's attempt for reimbursement from an insurer or state workman's comp claim.  So I always answered no to that question.  Yes my reasons for the appointments are for work reasons while enlisted in military service, but that has no bearing on the VAMC's pursuit of monetary reimbursement, so I always answered no to that question. In fact, I think I did ask staff what was meant by that question at the kiosk. It is for monetary reimbursement.

[Rivet62]

22 hours ago, Hotdigitty said:

I went for my mental health C&P and these are the checked diagnoses.  What % do I fall under in your opinion?

1. Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood
2. Depressed mood
3. Anxiety
4. Panic attacks that occur weekly or less often
5. Panic attacks more than once a week
6. Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively
7. Chronic sleep impairment
8. Mild memory loss, such as forgetting names, directions or recent events
9. Disturbances of motivation and mood
10. Difficulty in establishing and maintaining effective work and social relationships
11. Difficulty adapting to stressful circumstances, including work or a work like setting
12. Suicidal ideation
13. Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene.

 

This is my rating decision of 70% for Depression:

 

Here's the general rating formula for mental disorders, shown on https://www.law.cornell.edu/cfr/text/38/4.130

Edited January 11, 2022 by Rivet62