PTSD increase and TDIU

[Sharon Mamath]

I  am currently at 80%, applied for increase of PTSD and TDIU, had C & P exam Jan. 25, 2022, my claim has moved in the "preparation for decision" phase since Feb. 16, 2022. However, now the claim appears to be stuck. Does anyone know timeline due to backlogs? In addition, wondering if I qualify for TDIU with 50% PTSD, 10% tinnitus, and 50% migraines. Today I finally hit the request for decision on ebenefits.

[ShrekTheTank]

I am not sure that button speeds anything up as it looks to be you are just saying you have no more evidence.

After 30 or 60 day it really does not matter and they are never that fast.  

[broncovet]

Allow me to show you the regulation concerning TDIU. 

Dont "stop reading" until you also read 4.16 B.

In a nutshell, 4.16 B shows that you do "not" have to meet the minimum percentage requirements of 4.16 A.  Instead, TDIU is available "at any percentage" provided that you are unable to maintain SGE (substantial gainful employement) due to SC conditions.  

This said, its often a long fight to get VA to award Extraschedular TDIU.  (meaning you dont meet the percentages in 4.16A).

However, VA often fights Veterans on every nickel, so this isnt suprising.  

Since I dont know (your medical history) if your disabilities come from "a common etiology" (quoting 4.16A), its unclear if you qualify under 4.16A, but you certainly should qualify under 4.16 B, if you are unable to work.  (Due to sc conditions).   You probably know if your PTSD and migraines are related or from the same eitiology. 

 

Im not gonna address the "how long will it take for VA to process my claim questions", because, its always a guess.  Even if I looked up the current "average time", yours could take MUCH MUCH longer.  I advise claimants waiting for benefits to "get a hobby" rather than try to "watch the kettle" to see when it boils.  (You know the saying..the "watched kettle never boils"). 

At a minimum, getting a hobby can distract you from the stress of dealing with VA.  

My advice is to consider, if you have not already, applying for an increase (if any SC conditions have worsened), or, to apply for new disabilities also, if you have others, but may not have applied earlier for whatever reasons.  An application for tdiu "is an application for increase", but many of us experienced with VA dont want to leave that to chance, so we apply for tdiu, plus increases in the other disabiities at the same time.  Counting on VA employees to do their job, is not always productive or accurate.  

Quote

§ 4.16 Total disability ratings for compensation based on unemployability of the individual.

(a) Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided That, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. It is provided further that the existence or degree of nonservice-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the veteran unemployable. Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination.

(Authority: 38 U.S.C. 501)

(b) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue.

[40 FR 42535, Sept. 15, 1975, as amended at 54 FR 4281

 

[Sharon Mamath]

Thank you.

[asdf]

You are absolutely eligible to apply for TDIU based off of 80% combined and a single rating over 40%. Now getting the VA to approve is the next step. The average claim is taking 162 days to process and TDIU are usually on the longer end of the spectrum.

[Sharon Mamath]

Thanks for clarifying if I am eligible for TDIU based off the combined rating of 80%. and average time for claim.