ptsd When Two Disabilities Are Combined Into One Rating?

[RockyA1911]

OK,

The VA combined my PTSD with my already 10% for Brain Trauma,Post Concussion Residuals, Left Temporal Lobe, chronic and then added WITH PTSD to it for a combined rating of 50% based on the higher evaluation of the 50% for PTSD.

Since I am now at 70% combined rating, does the 50% for PCS/PTSD count as one of the disabilities being 40% or better with a total of a combined rating meeting the 70% threshold?

This is what I have right now (Keep in mind the skull loss is in error and NOD submitted, as it should be 50% by itself instead of the errorneous rating of 30%). (Should be total of 80% combined rating).

PCS/PTSD - 50%

Skull Loss - 30%

Tinnitus - 10%

Scar - 10%

Since the reg states if there are more than one disability, there must be one rated at least 40% with the other disabilities combined to bring the total combined rating of 70%. I'm wondering if they will split the PCS/PTSD stating that it is not ONE disability with at least 40% since there are two combined into the 50%?

[mobie16r]

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,

Rocky i hope this helps

mobie

[RockyA1911]

Thanks,

But that doesn't answer my question. My question was does the "Brain Trauma Residuals, Left Temporal Lobe, Chronic WITH PTSD" rated at 50% count as the "One disability ratable at 40% percent or more?"

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.

I had a previous rating of 10% for the TBI residuals since 1976. The PTSD was evaluated at 50%. The VA says you can't have more than one mental disorder, so they combined the two into one rating and came up with 50%.

So, since there are TWO disabilities COMBINED into one rating, would it count as JUST ONE, because they say DISABILITY rated at 40% or more not combined disability. I guess if they zeroed in on one at this stage, they would still have to take the higher of the two evaluations for mental disorders which would be the current 50% for PTSD? Am I correct?

[RockyA1911]

From what you provided, I don't see any ONE disability rated at 40% or more. Yours are entirely separate ratings, then combined for a total combined rating. My head for example is considered ONE etiology, because one of the disabilities previously rated at 10% for post concussion residuals and PTSD rated at 50%. They consider both to be mental disorders even though the TBI was a physical injury resulting in physical post traumatic encephalopathy due to TBI. They combined those TWO disabilities into ONE rating for a single disability total of 50% for the TBI residuals WITH PTSD. My total combined rating of all disabilities is currently 70%.

I can't see where there is any combined disabilities in any of the evalauations you've listed. What you have listed is 64.7 something rounded down to a total combined rating of 60% with the highest disability being 30%.

So far you have not met any of the two requirements for TDIU, one single disability, or if more than one disability of 40% or more with additional disabilities bringing it up to a total combined rating of 70%.

[john999]

Rocky

I think the VA is treating all you head problems as one injury rated at 50% from the way you represent it. I think you have enough now for IU. Just from the way the rating presented your head injury and PTSD it sounds like one individual rating made up of several disabilites. With 50% for PTSD alone you have enough combined to make 70% to get IU. I think you are on your way.

[Speaking Out]

Here are my facts. I am 50% PTSD and 10% endometriosis with an increase pending. I am settling a tort claim for medical malpractice against the VA, waiting on paperwork, but the deal has been made. I havent' been able to work since the malpractice due to my PTSD. Am I eligible for IU? I did not file 1151 benefits.

[john999]

Speaking Out

I believe you are entitled to IU based on a combined rating of 60% with one condition rated at 50%. If the SC conditions are the sole cause for your being unemployable then you should file for it.

[john999]

If you meet the percentages and are unemployable you have a great shot at IU. If you are combined 70% and one disability is 40% you are OK. If you don't meet the percentages you are still eligible for IU, but the VA will probably ignore the part ( of the IU regulation and make you fight another battle. If the VA decides you are IU then they will alter the percentages to make the right fit. That is what they did in my case. I was 30% when I filed for IU. My doctor said I could not work and the VA bumped me up to 70% and then IU. It took a while and I had to fight every step of the way for everything. I already had SSDI and disability retirement approved and the VA fought me over IU and chapter 35, as well.

[RockyA1911]

Army,

I see what you mean about the red portion. Truth is I just don't know. Mine is different because they DID combine the PCS residuals with PTSD. Even though the PTSD occurred a lot earlier. I was in Vietnam 1968 - 1969 and the TBI didn't occur until 1972. Both PCS TBI residuals and PTSD share some of the same symptoms such as memory loss, anxiety, depression, irregular sleep, nightmares, word finding, and some other cognitive symptoms.

I don't know if they will combine all of yours together. If they do combine them into one rating just remember, when they do that they take the highest evaluation of all of them and assign the highest rating to it. The highest you have right now is 30%.

But to tell you the truth, I really am not sure and would not tell you that you are not eligible. I will say even if they combine them at one 30% or 60% with one highest at 30%, you will need a statement from an MD stating you are unemployable due to your S/C disabilities to even have a chance.

When you get the MD statement, then throw the dice and see what happens is what I recommend buddy!

Edited March 19, 2007 by RockyA1911 (see edit history)

[spike]

using the combined rating schedule you meet the schedular rating requirements being that from what I got you are total rating of 80%. However, is there any future exams? Sometimes they do this on PTSD claims. If your ratings are considered permanent you should be able to file for I/U. However, your disabilities MUST make you unemployable. Which means you can not work. They take Voc Rehab into consideration, and how your job affects you. Supporting letters can be made by your doctors.

[Guest RickB54]

Just some friendly advice:

There are a least three different questions by three different posters in this thread. Rocky has asked a complex question, and other have chimed in with ther answers, but have also asked there own question in the process. I sugggest if you have a question to post it as an new topic. Sometimes, especially in long threads it is hard to get a grasp on the question at hand. If new questions are asked along the way, and the new questions has nothing to do with the original question then things really get hairy. By keeping topics seperately it is much eaiser to understand the thread and give a proper answer, and this serves the veteran better.

[Guest RickB54]

OK,

The VA combined my PTSD with my already 10% for Brain Trauma,Post Concussion Residuals, Left Temporal Lobe, chronic and then added WITH PTSD to it for a combined rating of 50% based on the higher evaluation of the 50% for PTSD.

Since I am now at 70% combined rating, does the 50% for PCS/PTSD count as one of the disabilities being 40% or better with a total of a combined rating meeting the 70% threshold?

This is what I have right now (Keep in mind the skull loss is in error and NOD submitted, as it should be 50% by itself instead of the errorneous rating of 30%). (Should be total of 80% combined rating).

PCS/PTSD - 50%

Skull Loss - 30%

Tinnitus - 10%

Scar - 10%

Since the reg states if there are more than one disability, there must be one rated at least 40% with the other disabilities combined to bring the total combined rating of 70%. I'm wondering if they will split the PCS/PTSD stating that it is not ONE disability with at least 40% since there are two combined into the 50%?

Rocky,

Based on what you have stated in the initial question, Your 50% rating is one rating regardless of the fact that in may cover two disabilities. As long as you meet the 70% requirement that is one disability at 40% with other disabilities combined at 70% you met the schedular requirement for TDIU. The next step is to show the va that you cannot work or find substantial employment.

[Guest RickB54]

I have a few claims in and they all are related to one combat action (see red print, above). How does that work:

30% - claim #1

30% - #2

10% - #3

10% - #4

10% - #5

0% - #6

0% - #7

0% - #8

How does the above rating work with IU requirements, all based on one combat wound action/Purple Heart, etc ???

Let us look and seek what 4.16 says, EXACTLY:

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

top

(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.

************************************************************

As you can see, it is a bit different than what mobie16r posted, below. How does the part in red ink mean to my rating scheme and IU ???? Pls ???? Now, what is your opinion, please ? Thanks.

Army VV,

I think you are reading into the regulation. The bottom line is one disability rated at 60% or one disability rated 40% with additional disabilities for a combined rating at 70%. If you do not meet this requirement then it is unlikely that you will be granted TDIU. ( The disabilities you hope to be awarded and combine to 64.27% rounded down to 60%.)

What you are citing in red means nothing for the purposes of the schedular requirements. What you are cititing is just one example of a catagory that the disabilities could fall into.

It is also very doubtful that you will be given the ratings you have cited, if the disabilities resulted from one combat incident. (In other words as an example if you have shrapnel wounds in the forearm and the shoulder from the same combat action, you get one rating not two.)

Hope this answers you question.

Edited March 20, 2007 by RickB54 (see edit history)

[spike]

i apologize, i took his claim numbers and used the combined rating schedule. my mistake...it is hard to keep up with all the different threads....very good recommendation.

[Guest RickB54]

Here are my facts. I am 50% PTSD and 10% endometriosis with an increase pending. I am settling a tort claim for medical malpractice against the VA, waiting on paperwork, but the deal has been made. I havent' been able to work since the malpractice due to my PTSD. Am I eligible for IU? I did not file 1151 benefits.

Speaking out,

The ratings you cited combined to 55 rounded up to 60%. Based on what you have stated you would not be eligible for IU. You will have to wait for that rating increase before you will know if you meet the schedular requirements for TDIU.

I am almost positive that even under the malpractice claim you mentioned you will not be granted TDIU. This is because TDIU is granted for a service connection injury or disease that prohibits a veteran from working.