2 replies to this topic

[Ethan'sGrandma]

Would like to ask for some help in understanding TDIU evaluations, please. If a vet does not meet the % requirements for TDIU, is it necessary to submit a request for a higher rating, also, or does the TDIU application presume that? Does the VA look at evidence for a higher rating before making any decisions for TDIU? I am aware that VA and SSA do not have to follow each other's decisions, but if the vet was awarded SSDI based solely on VA and military medical records, the vocational aspects, and the judge's decision that the vet is not able to obtain or maintain gainful employment according to their law, will that help with VA's decision, although the VA had only rated the vet @ 30% for mental disorder and 10% for physical disorder? The TDIU evaluation seems to be moving rather quickly considering the backlog as the vet has already been scheduled for two C&P's...one for psychiatric; other for physical reason. Another concern is that in the notice of receipt for TDIU claim, it seems like VA keeps hitting on the "unusual circumstances" necessary for an extra schedular TDIU...is that just protocol in their form letters, or is that something to worry about? What "unusual circumstances" do they look for? I looked but couldn't get any clear picture of what that entails. Thank you very much to anyone that may assist with these questions.

Edited by Ethan'sGrandma, 14 September 2012 - 07:16 PM.

[Berta]

My personal example might help.

Husband was 30% SC PTSD from 1983.

In 1992 he requested a higher rating for his PTSD and then a few months later he sent them a TDIU form.

In 1992 SSDI awarded sole for a NSC stroke (was SCed under 1151 this past January at 100%)

I asked SSDI to reconsider the award as his PTSD had not been considered by the SSA,although they had all of his PTSD records.

A few months later they changed his SSDI from a 1992 stroke solely to PTSD with a very favorable onset date of 1991.

I did a lot of work to support the reconsideration and the better EED.Both SSA and a SSA lawyer tried to discourage me but evidence is what it is.I had some very unusual evidence too. It was generated by an ADA EEOC complaint. My husband was the first disabled veteran in NY to win under those discrimination regulations.Also I used VA testimony from an EEOC case he had filed against the VA.

N one is confined to just 'medical' evidence on many issues they might have regarding SSA and the VA claims process.



This new SSA award info was sent to the VA to support Rod's claim for higher PTSD rating and the subsequent TDIU claim he filed.

But he died while his VA claims were pending ( including a 1151 claim too)and I re opened them as the widow of the veteran.

A few months prior to the 1151 DIC award, the VA awarded posthumously, retroactive 100% P & T for PTSD back to 1991,using the same date the SSDI reconsideration award had given him.

So, here was a vet at 30 % and DAV reps had told him he was not eligible for TDIU and certainly not 100%.

I read the TDIU form over carefully in 1993 and saw that it contained no specific SC percentage criteria at all.

Although 70 % SC triggers the VA to consider TDIU, there is no statement on the form saying a vet can't request TDIU regardless of their current SC.rating.

I think his death made the TDIU a moot issue and that is why the award was for 100% P & T and not TDIU P & T.

So your point is correct except for one thing:

"but if the vet was awarded SSDI based solely on VA and military medical records, the vocational aspects, and the judge's decision that the vet is not able to obtain or maintain gainful employment according to their law, will that help with VA's decision, although the VA had only rated the vet @ 30% for mental disorder and 10% for physical disorder? The TDIU evaluation seems to be moving rather quickly",

the SSA award must solely regard the exact same SC conditions claimed.Any NSC part of the SSDI determination can make the SSDI award very problematic and not the best evidence for TDIU.

Often SSA focuses the prime medical condition only. As in my husband's case, they considered his stroke as the prime problem he had.

However his SSA app specified his PTSD as well ,and by time of the VA decision on his claims, his med recs revealed it was catastrophic.

He too had Voc Rehab records and significant other VA medical documentation( and from other sources) to support the SSA and also the posthumous VA 100% PTSD award.

I think if he had lived the award would have been the same, but for TDIU P & T.

Then again his med evidence matched the 100% SC PTSD rating criteria.

Edited by Berta, 15 September 2012 - 07:08 AM.

[Ethan'sGrandma]

Thank you very much, Bertha. The vet only has sc conditions, so hopefully, the SSDI info. will help...