tdiu Is Total And Permanent Needed For Individual Unemployability?

[tssnave]

Is it necessary to have a “total and permanent” assessment verified to get Individual Unemployment?

The reason I ask is that I have a form from my POA for my doctor to complete. It has the rating schedule for mental disorders at 70% (where my symptoms fall out) and 100% (where, thankfully, they don’t). However, because of my symptoms, I am not able to hold down a job so we are going to go for 100% IU. I haven’t worked for the last several years other than a brief job that I got fired from due to my sc mental disability causing attendance and concentration problems.

In addition to the 70% and 100% rating criteria, this form also asks if the doctor believes that “In your opinion, is the veteran unemployable due to his service connected psychiatric condition (to include sedentary employment) Yes/No.”

OK, no problem with that one. I believe both my doc and psychologist will say yes to that one due to my problems and work history I am unemployable.

There is a second question that asks, “In your opinion, is the veteran’s service connected psychiatric condition permanent and total in nature? Yes/No”

I believe this last question will present a problem. Even though I have been treated for my mental disorder for over 25 years and have had severe reactions to psychotropic drugs, since there are new drugs on the market that I have not tried (and am afraid to try given the severe reactions I’ve had to other drugs) I do not believe either one of them will say yes, it is permanent and total.

No psychologist wants to say he can’t fix you with counseling and a referral to a psychiatrist for drugs. My primary care doctor refuses to prescribe any psych meds because of my past history with bad reactions and wants me to go to a psychiatrist as well for a med referral. At the present, I have not gone to a psychiatrist nor do I intend to (look, I’ve almost killed myself on psych drugs and at least when I’m not on drugs I don’t kill myself – call me crazy, I do have mental disorder – but I just don’t see the percentage in trying any more drugs).

So, while I believe they will check the rating schedule for 70% which is where my symptoms fall out and they will check yes for unemployable, I do not think they will check yes for permanent and total.

If they say that my psychiatric condition is not permanent and total in nature will it prevent me from being rated 100% for Individual Unemployability?

Thanks,

tssnave

Edited April 3, 2007 by tssnave

[tssnave]

Hoppy,

You wrote, "Your GAF of 49 might not be low enough for them to give you a 70%" - please tell me that the VA cannot use your GAF score alone as the sole determination for your rating. Don't they have to consider the actual words that the examiner writes about your disability?!?

My IMO doc gave me a GAF of 35 so if this is the issue with my rating hopefully the IMO doc's GAF should help.

I have a letter from the CPA who does our taxes stating that I haven't worked since 1998 and then I only earned $4,000. Will send that in as well.

Thanks for the post.

TS

[Testvet]

you need to ask for a reconsideration of the award and the percentage granted in lieu of the fact you show you have only earned 4000 in the past 10 years, the IMO shows a GAF of 35 versus the CA C&P quickie of 49 GAFs are not supposed to be the sole basis for % the other factors should be taken into account, treatment record, family and social skill level etc, on any given day you can fluctuate on GAF from 35 to 70 depending on if you took your meds, are you having a good day or a bad day did you get dressed for Sunday church when you went for the C&P when you don't normally dress that way, with the stress of the VA for PTSD awards right now, it's a struggle I think it's harder now to get a correct rating than it was last year, because of the news focus and the cost have you filed for SSD based on PTSD

[john999]

TS

If you can get SSDI you can get TDIU. I think you should have gotten 70%. I got it with a GAF of 50, but I had plenty of other evidence of being unemployable including SSDI and disability retirement from the federal government. I had a Voc Rehab letter saying I was not fit for rehab. All these things add up.

[spike]

I'd like to add one thing to this thread. Someone said something about sending in a letter from the CPA to the VA. Listen, To file for IU there is a form in which you have to put the dates and the addresses of your previous employers. You don't need to and please excuse me if this sounds rude, overboard i.e. sending in letters from your CPA, next door neighbor etc......What that will do is make your C File become overloaded with a whole bunch of stuff that will confuse the PreDetermination Team, the VSR's the Rating Board and Authorizers more than it will do good for your case. The simple saying of K.I.S.S. Keep it Simple Stupid saying works great with the VA. They already make a ton of errors already.

Another thing, it is natural human reaction to look at a pile of 1 cm folders and look at a 12 inch thick file, and pick the 1 cm stacked folders, if given the opportunity. They are evaluated at how many files they turn out. Help them help you get your file done as quickly as possible.

Simply fill out the form, get your previous employers to respond quickly, and get a IMO to support your claim for I/U, and you will be on your way. From start to finish for my I/U.....I sent it up March 4 it was granted, returned and authorized with payment in hand by the 9th of April.

[Hoppy]

Spike,

You tell the VA where to get your medical records also. Then they deny your claim and say they could not get the records. They denied one of mine saying that the VAMC I told them had my records did not respond to the RO's request for medical records. My SO, who was a rating specialist for the VA for 20 years before becoming an SO, said the best way to have the RO make a decision on a claim is to submit it yourself.

Although you need to turn in the document Spike pointed out, I would not rely on the VA contacting employers. If you have or can get a letter from an employer obtain it your self and submit it. I am not sure though that the VA wants to hear from a CPA. They also do not need to hear from your neighbors. However, keeping it simple does not work with the VA. The Social Security income report will do much verify and clarify for the RO any statement you make to a doctor about being unemployed.

If the RO people were more reliable at obtaining info they would not have to deal with documents submitted by the veteran. In my case, not only did the RO get the records from the VAMC, they lost them and then said the VAMC did not respond. When I got the decision and read that the VAMC did not respond, I went to the VAMC and went nuts on the records people. The VAMC produced a copy of the documented signed and dated by the RO employeee who picked up the records. The VAMC told me this was not the first time a veteran came in their office with a decision saying that the VAMC did not respond. That is why they require the RO to sign for the documents.

TS,

The VA does not have to give weight to every word or assesment a doctor puts in a report. The logic as to how the determination was made is also important. A previous post points out that when there is a question as to the reliability of the determination by the doctor then the RO can weigh the reliability of the report. If the report is well written and supported then the RO can only rebut it with medical evidence.

Veterans who try to win psych claims based on a single C&P exam have a difficult time. The best way to win a psych claim is to be in treatment and submit ongoing treatment records. Like John said he had a GAF of 50 plus some other good evidence. Also, the other poster said. GAF's can change from day to day. So can any other determination based on your explanation of your condition to an examiner on a single exam. If the C&P examiner bases the GAF on the one exam, it is not as strong as a GAF given by a C&P examiner who bases the GAF on a stack of treatment reports that have an ongoing history of a GAF.

When I went to my C&P I had been in treatment at a VA hospital for two years and all the C&P examiner did was site a significant history of treatment reports showing a GAF of 40.

The best way to win is with strong and ongoing medical/psych treatment and evidence that such treatment produces. A C&P can work but I would not rely on a single exam for anything with the VA.

One other problem that occurs and you are noticing is that the denials are written in such a way as to leave you confused as to what it was that caused them to make their decision. Their logic is supposed to be clear. However this is not always the case and can be cited as reason for a new decision. I wrote my appeal saying the decision was so vague as not to meet VA standards. This is a phrase I got from reading BVA remands. I am not sure where the exact instruction is in the M-21 that expalns the adjudicators obligation to write a decision with clear logic.

[Hoppy]

TS,

By the way the reason I had two years worth of treatment notes available to the C&P examiner is because of my SO. I told my So I wanted to tack a secondary psych claim to my service connected angioedema. My SO had been in the business over 20 years. He filed the claim before I left the office.

He told me specifically to enter therapy at a VA hospital and plead my case to VA shrinks. He told me that it would be quicker and less complicated than using private doctors.

There is more than one way to work this system. However, my SO's plan went through smooth as silk. I was never denied the secondary conditions and even though the VA sought a C&P to verify what was a matter of record the C&P examiner could not rebut the treating doctors based on the amount of work and the quality of the reports written by the VA treating doctors.

My SO thought that just waiting for a C&P was not a good idea. I would recommended this approach based on my success. However, keep in mind that each case is different and the doctors respond to their patients differently. They used very disguised techniques and have specific questions designed to determine if you are being deceptive. The MA actually made a report to the PHD that he detected deception. The PHD accidently or maybe on purpose gave me the report when returnng other documents back to me. Sometimes they do things to see how you will react. I found this report and scheduled an extra appt. with the PHD to straighten out the MA. That appointment went well and the PHD admitted that the original test used by the MA was not one of those designed to determine deception. The PHD wrote very favorable reports on my behalf.

I was seen on numerous occassions by a Psychiatrist, a PHD in clinical and had many tests given by an intern with a MA. There were some minor complications based on mis information documented by the MA. However, it was all straightened out by the PHD.

I think that the RO takes into acccount the psych tests and or lack of psych tests and treatment when giving weight to a diagnosis. They are usually vague as to why they do not give weight a specific opinion. However, strong diagnoses are based on numerous appointments and the standard psych tests used by the shrinks.

I rec'd retro all the back to the original filing date.