TDRL PTSD 18 Month Reassesment. What is the Typical Ruling

E

Eric53

PEB Forum Regular Member
Does anyone know what the typical result of a TDRL is for PTSD when they reassess at the 18 month point? Do they typically retire permanently or continue on the TDRL for another 18 months or discharge with severance pay or try to return to duty. I was initially assessed and placed on TDRL at 30%. Please let me know. Thanks.:confused:
 
There is really no chart or formula. So it would be hard to predict.

X
 
It really depends on your condition. If you have been the same, with similar functional limitations, it is more likely they will place you on PDRL. Very few people last the entire 5 years on TDRL and I have seen many final dispositions (either PDRL or separation) after the initial TDRL period.

Things that I have seen that mitigate towards continuation on TDRL are changes in medication or condition. Full employment or full time studies with good grades have been the basis for reduced ratings and severance pay. The doctor's unput will carry a lot of weight, so you want to ensure you discuss all your functional limitations and symptoms of your condition at your re-evaluation.

Please let us know any questions and best of luck!
 
I to was placed at 30 % rating and figured it like this..........



* They either did that becuase they already planned to take me of tdrl later on, and knew i would only recive a years worth of pay and then thats it.
Instead of a big lump sum.

* They did it becuase they knew that i probably wouldnt get better, and knew leaving me active duty getting treatment every day was a waste of time, and did it hoping i would but excpecting I wouldnt .


Either way, it is a very stressful thing, kinda like waiting for an aids test to come back !!!!!!

I just had my yearly evaluation 2 months ago, and havent heard a thing yet.
So once again more sweating to do.

I honestly feel so much worse now then what i did, i have abused the medications i recive from them, becuase its the only way i find a small sense of happiness, and can face the world, to leave my house to get milk or whatever.

I also have social security and va benefits to fall back on, if they say i am good for duty, but i like others, would like to keep the tricare, for my 4 kids.

I hold onto the hope that they wont try to screw me and remove me from retirment, If they did, i would of rather took the huge severance check which would of worked out to be 10 times more then a years worth of 50 % pay !!!

I havent worked since i got out, and as far as i know, when they reevaluate you, it is based on the same factors like , "are you able to do your job as an infantryman ?"
Not....."Are you able to walk to the store to get some milk"

Becuase technically there is a very small part of you that is still active duty.
You are like a ghost at your old company, that may return someday !!!

Myself like many others placed on tdrl has felt the huge depression of what is going to happen to my family and me, if they dont understand the whole story i tell them, or if the reviewing doctor has somthing against me !!!

That isnt what anyone with ptsd needs right now. All it does is blur the future, and keeps the spinning wheel turning in our heads.

Ill be honest with you brother. It does get worse as the time aproaches for the evaluation. You kinda hope they will forget all about you, but they wont.
They even send you offical orders, which is somthing i thought i never would have again.

And afterwards, it gets worse, because now i am waiting for the offical desicion.
I would prefer retirment, but if it is just another year of tdrl, i guess it will take the stress of for a few more months.

Guess i didnt really answer you question huh ?

But just know ,your not the only one who feels that way right now.
And honestly, i dont know anyone that was ever found fit for duty, unless they wanted to be fit for duty.

bye
 
My husband just got his letter saying his TDRL assessment is coming up. This is his first one. I, too, am interested in actual experiences that anyone can share. Thanks!
 
Thanks to all of you for replying. I won my social security case for disability. I have tried to attend school but I can not concentrate. I have had to withdraw from several classes. I barely got a C in one class and that was only because the teacher gave me a lot of extra time to study and to actually take the test. My overall health has declined since I left the service but I was only boarded for PTSD/Depression yet I have Psoriasis and Psoriatic Arthritis along with Sleep Apnea. My Doctors believe that my Psoriasis was brought about as a result of my PTSD/Depression stress condition. Can I ask them to consider this as a secondary condition when I go in for my re-evaluation? I got the official notice as well for me to report in for a re-evaluation in 2 weeks. I have only been on the TDRL for 13 months and when I report in 2 weeks it will have been 14 months. So what happens next? What type of questions do they ask when you go in for re-evaluation? Do you get to include a personal statement when your package gets sent off to Headquarters for a re-evaluation determintation? Since social security finds me to be unable to work primarily due to the mental condition does this help the case with the Air Force aka Department of Defense MEB/PEB TDRL Re-evaluation process. Brother you are right this TDRL sucks big time. It is so stressful and so wrong to have more stress on you when you already have a stress condition. Any advice you can give is appreciated. Do I want to have letters from my psychologist and psychiatrist as to my treatment history and symptoms since leaving the service when I go to my appointment? Do they give you the long questionaires to assess you like they did when they discharge you or is it simply an interview? Are there blood tests given for the PTSD/Depression? Any advice you can give is appreciated. I am stressed to the point of beomg ready for a breakdown.
 
Eric53,

If you don’t mind me asking what did you get form AFPC? It should say what clinic(s) to report to.

From TDRL evals that I’ve helped set up, the psychiatrist will want to see anything you can bring on treatment and therapy. If you civilian provider is willing, something along the lines of a summary is more useful to them than pages and pages of visits to decipher. Other info on your ability to work, take classes and function in society as a whole is also very important. Its difficult if they’ve never seen you before but they should conduct a full mental health evaluation to confirm your diagnosis and its severity.

I suggest you take the following to your appointment:
- Summary from civilian docs or copies of treatment notes
- Whatever you have from Social Security
- Anything you have from your school, maybe from a councilor or professor, confirming your difficulties

I don’t believe they can add psoriasis since you are already retired but if it is related it to your PTSD it is certainly relevant to your revaluation and should be mentioned by you or your civilian doc. Were you being treated for this prior to getting out? You may be able to apply to the VA to consider rating this.

Good luck and try not stress out. The best thing you can do is collect your info and thoughts and let the psychiatrist know what all has been going on in the last 14 months.
 
1. Your VA rating for your PTSD, if relatively recent, it can be used to demonstrate your currently level of disability.

2. If you are rated less than 30% on reeval, you will be given lump sum severance at that time. If this rating is given before December 31st 2009, you will be eligible to appeal to the Physical Disability Board of Review or the Board for the Correction of Military Records. After that date you can appeal to the Board for the Correction of Military records.

3. The reeval PEB will not consider conditions that were not originally deemed unfitting. However, the original MEB was required to document all of your current medical conditions with complete clinical information on each. If they did not, you should appeal to the Board for the Correction of Military Records.

4. The Anthrax Vaccination Expert Committee has stated that the onset and/or aggravation of Psoriatic Arthritis are possibly/probably related to Anthrax inoculations. Psoriatic Arthritis is a form of spondyloarthropathy/HLA-B27+ arthropathy:


Results Nearly half the reports noted a local injection-site AE, with more than one-third of these involving a moderate to large degree of inflammation. Six events qualified as serious AEs (SAEs), and all were judged to be certain consequences of vaccination. Three-quarters of the reports cited a systemic AE (most common: flu-like symptoms, malaise, rash, arthralgia, headache), but only six individual medically important events were judged possibly or probably due to vaccine (aggravation of spondyloarthropathy (2), anaphylactoid reaction, arthritis (2), bronchiolitis obliterans organizing pneumonia).
http://www.anthrax.osd.mil/documents/library/AVEC_ms.pdf (2002 Report)


Seven systemic SAEs (‘anaphylactic-like reaction’ [2], bronchiolitis obliterans organizing pneumonia [BOOP], ulnar nerve neuropathy, urticaria, rash, muscle spasms) and seven systemic OMIAEs (‘anaphylactic-like reaction’ [3], arthritis [2], aggravation of spondyloarthropathy and HLA B-27+ arthropathy) were judged to be possible, probable, or very likely/ certain consequences of vaccination with AVA (Table 2).
http://www.anthrax.osd.mil/documents/library/SeverArticle.pdf (2003 Report)


Mike
 
Mike,

Anthrax info u stated any relation to regular old arthritis, GERD, IBS, Menieres, Headaches, Vertigo or PTSD...before anyone laughs..its just a question....need as much ammo as u can get for VA and DOD...

THX

Jack
 
Follow the links to the reports in my post above and you may see some conncetions reported.

Mike
 
Eric,
I just went through the TDRL review and have been advised I will be removed from TDRL. I faxed in my appeal last week.

When you go for your TDRL review bring everything you have documenting your treatment since being placed in TDRL. I had nearly 300 pages of medical records documenting my treatment, none of it showing improvement. The basis for my removal from TDRL is apparently the fact that I am attending school full time. I struggle to get by, but I have succeeded so far due in large part to the fact that I have been able to utilize the services available to disabled students.

I take any exams in a separate quiet room at the disabled student services center. I am also given time and a half to complete any exams. I recommend that if you are struggling to go to school you seek help and testing accommodations. It made a huge difference in my testing scores.

Unfortunately I still have trouble with memory, completing tasks, focus, and a slew of other problems that are causing me to struggle day to day. It is hard, but nothing worth doing is easy. I am not sure I'll be able to work if and when I graduate, but I didn't want to sit at home and hide from the world. That is one of my biggest problems, I have isolated myself from most activities. I go to school but other than that have little social interaction.

My doctor once told me "I don't want you to become a professional patient." I have tried to do everything possible to be able to work at some point, and I will continue to do so. I'm not saying you have to go to school, just try to stay as active as you can and continue to challenge yourself when possible.

I'll keep you posted on how my appeal goes. Considering the TDRL review doctors recommended I remain in TDRL I think I have a good case. Since I got my notice stating I would have to go through the appeal to remain in TDRL I have had trouble sleeping even more so than normal. 4 of the last 12 days I didn't go to sleep. I can't stop ruminating about the appeal.

The appeals process is stressful and makes you focus on all the things that are going bad with your condition. Personally I try to avoid dwelling on the areas I struggle day to day, but now when I have a panic attack I say to myself "how can they say I'm stable and my condition is resolved" when I am still having the same problems. It is terribly frustrating.
 
Another thing I would recommend to anyone going through a PEB for PTSD is to have your provider perform a CAPS exam periodically and make sure that goes into your medical records. CAPS exams are the standard for diagnosing PTSD.

Another thing I would recommend for you personally if you are suffering from PTSD is to read a book called Rule Number 2 by Dr Heidi Kraft. She is a Navy Psychiatrist who served in Iraq. I saw her give a presentation a few weeks ago and she has had a great deal of success in treating PTSD. She is unique in that she is a mental health professional who has gone through much of went I went through in my combat experience. I strongly recommend her book.

There are two rules of war.
Rule number one is that young men die in war.
Rule number two is that doctors can't change rule number one.
She got the title from season one of Mash

She spoke about how she felt PTSD should be viewed as an injury, not an illness. She strongly believes that if you continue to treat and rehab your PTSD you will eventually return to normal function ability. She encourages exposure therapy.

I have been in therapy and on medications since 2004, I know it is not easy to get through this, but I hope someday to sleep through a night without medication or to be able to go to an airport without having a panic attack. You have to keep working at it, it can overwhelm you. I've had suicidal thoughts at times when I feel like I'm not going to be able to get back to being the person I once was, but at those times you have to fight, you can't give up. Sorry, I have a tendency to ramble, hope you don't mind the ramblings of a frustrated veteran :)
 
hebert0911,

It is good to have you here, and thank you for your comments.

I am sorry the IPEB apparently did not make correct findings in your case. It certainly sounds like you have not improved, but I am not surprised that they used attending school as a basis for changing your findings. All is not lost, your Formal hearing may well come back with a correct finding. The PEBs do not always get things right, but they also don't always get things wrong, either.

I hope all goes well for you, both in the PEB realm, and with your treatment/recovery.
 
h0911 brought up a very good point about maintaining that 300 pages of documentation.
i really beilieve that if you take 2 different people w/the same TDRL rating and identical stuff and 1 goes for treatment regularly and 1 doesn't the chances of the 1 w/the treatment has a better chance @ PDRL or better rating goes up.

i saw it 1'st hand w/my dad and my father-in-law. my dad almost gave up fighting his rating years ago, he went for very little treatment in the beginning. his ratings finally went up over the past few years, after sticking w/it and going consistantly to the VA, med. appts. and counseling.
now my father-in-law started his battle around the same time as my dad, but did not stop going to the VA, med. appts, counseling and didn't stop appealing his rating. he's been 100% T and P for quite a while now and my dad is 70%.

don't give up and don't let them win!
 
Jason said:
hebert0911,

It is good to have you here, and thank you for your comments.

I am sorry the IPEB apparently did not make correct findings in your case. It certainly sounds like you have not improved, but I am not surprised that they used attending school as a basis for changing your findings. All is not lost, your Formal hearing may well come back with a correct finding. The PEBs do not always get things right, but they also don't always get things wrong, either.

I hope all goes well for you, both in the PEB realm, and with your treatment/recovery.
Click to expand...


Jason,
Thank you for the well wishes. I appreciate the information. I know all is not lost yet, but I feel like I'm fighting a losing battle. In your experience, is attending school a strong case for them to deny placing me into PDRL? I know that every board is unique, but your experience in this may help to calm my fears somewhat. I'm ruminating and obsessing over what is going to happen.


I know no one can tell me what is going to happen, but I just don't have a very positive mindset right now.
 
hebert0911 said:
Jason,
Thank you for the well wishes. I appreciate the information. I know all is not lost yet, but I feel like I'm fighting a losing battle. In your experience, is attending school a strong case for them to deny placing me into PDRL? I know that every board is unique, but your experience in this may help to calm my fears somewhat. I'm ruminating and obsessing over what is going to happen.


I know no one can tell me what is going to happen, but I just don't have a very positive mindset right now.
Click to expand...

I think it depends. If you are taking a full class load and getting good grades, then they may tend to hold that against you. Things that "help" are lower grades (especially if measured against previous success), having withdrawn from classes, carrying less than a full schedule, or having significant accomodations. This does not mean that this is the correct outcome, just what the board is likely to weigh in their deliberations.

The two separate issues are fitness and degree of disability. I think any level of success is correctly separated from how you might fare in a military environment (i.e., doing well in a classroom environment has little to do with how you might do in a military environment that may require you to be faced with stressors, including firing weapons or being confronted with reminders of your stressing events).

Once you are past the fitness question, academic performance can be a proper basis for determining your degree of disability. If you track with what I am saying, it is less likely that academic performance relates to fitness than for degree of disability.
 
That makes sense Jason. Thank you again.
On my 199 they said "The soldier reports he continues to experience symptoms of anxiety, sleep disturbance and panic attacks. He continues to receive counseling and medication to control symptoms. The soldier continues to be unfit due to the risk of decompensation in a high stress military environment. The soldier is currently a full time university student. Stable for final rating. Rated 10% for symptoms controlled with continuous medication"
"Your condition has not improved to the extent that you are now fit for duty"

So they are saying I'm unfit, but because I am in school my level of disability is at 10%. I think my doctors would argue that my ability to attend school is not a basis for the argument that I have stabilized. The boards decision just seems to assume that I'm getting A's and coasting through school. I don't think any of the doctors asked how i'm doing in school, they just asked if I was attending.

Basically I need to show the board the accommodations that enable me to succeed in school and show that even with this success I am still struggling? I have had 3 incomplete classes and one withdrawal since returning to school but have otherwise averaged B's. Although I have had two professors pass me with a B because they saw me struggling to do my best.

I see my psychologist and psychiatrist next week, both have documented my struggles in school so I think they can provide helpful statements to the board.

My panic is starting to subside about this whole thing. Shocking... I was catastrophizing, ugghh, I used to be so calm under fire, now things like this make me jump to every worst possible outcome. Well, thank you again for your help. Understanding what they are thinking helps me to reason the situation and hope for a better outcome.

The waiting part is sometimes unbearable because your mind can come up with so many negative outcomes but hardly imagine success. We'll see.
 
Glad to help. That is the whole purpose of this forum!

It seems like you have a good grasp of the situation. An interesting question, one worth pursuing, is the legal question of how 38 CFR 4.129 operates with a final finding. If you have stabilized, the rule still states that a separation from the military requires a 50% finding with a follow up in 6 months. To my knowledge this issue has not come up before. But I would argue that the (final) separation still requires a 50% rating. That the military does not have a mechanism for looking at revised ratings after 6 months for final determinations does not change the effect of the rule. I would think that they would not address this correctly, but on appeal I think this is a viable basis for a win on appeal.

Best to win at the PEB, but if that is not in the cards, you have some interesting issues that may win on appeal. Good luck! Please let us know any questions.
 
Update:
I talked to my lawyer yesterday, he actually called me at 8pm. I wrote him an email on Sunday explaining that things were not going well and I wanted to avoid an additional TDRL hearing if possible. The whole process is too stressful and counterproductive. In the email I told him about how I hurt my knee in Iraq, Dec03, and due to the seriousness of the injury and continued problems they wanted to medivac me... my captain decided I was mission essential so I walked around*by walked around I mean I conducted normal operations;ie combat patrols, raids, assessments; and at the end of each day I was on pain pills and couldn't walk* on a torn ACL and ended up doing more damage to the initial knee(right) and I tore up my left knee by compensating. I explained to my lawyer that I didn't fight even though I saw the manifest for me to be medievac'd, TWICE. I felt if my unit needed me I would continue to do my best and I did. So I told my lawyer in this email that I didn't want to let this fight go, that I felt I should be rated for PDRL, that there is clear evidence to support a 30% or higher rating.

He calls me last night and said he went over my file after reading the email, and he not only wants to push for PDRL so I never have to go through this again, he wants to have my knee rated this time. In my initial med-board my knee was found fit for duty*somehow, I should have appealed that* but when the doctors reevaluated it this time they saw that my condition had deteriorated and its more severe than before. He asked me what kind of treatment I was currently receiving on the knee and I explained the VA is talking total knee replacement now, which I'm not exactly open to at 32. Upon hearing this my lawyer said he would move to add the knee. Because the knee was "fit" on my intitial PEB it was not included in rating and is not allowed to be included in this board. He is apparently going to appeal that.

I told him of what I was told by Mr. Parker and Jason, that the VA's findings could be used as evidence, since my VA percentage (50) was much higher than the Army's(10) and he said he would use this as evidence against the 10% finding. He is working on gathering information from my doctors and said I'll probably have a date in January. He is going on leave for two weeks in mid December so I don't have to worry about a Christmas board.

So all and all, after two plus weeks of Dan going crazy... crazier :)... caused mostly by sleep issues being exacerbated by this process, I slept well last night. It took a klonopin and three ambien*normal doses* but I actually went to sleep and feel pretty good this morning. I'm going try to hold on to this until the next set-back, but I feel good right now.

Thank you for your help, especially Parker and Jason. I'm sure this process is going to drag out and have issues, but I feel like I'm on the right track and that makes a huge difference for me.

Sincerely,
Daniel Hebert
 
Jason,
It has taken awhile but finally the board came back with a finding of an increase from my initial placement on TDRL 18 months ago. Initially I was placed on TDRL with 30% and left the Air Force. Now I received a copy of the narrative which had some misquotes of my statements and placed me on another TDRL observation period with a 50% rating and indicating that my condition has worsened and that I am distrustful to the point of bordering on psychotic. I need to know what I need to do at this point. No paperwork was included saying I could challenge their decision nor anything outlining the process to contest their decision so what can I do at this point? Can I appeal or do I just accept this and hope that next year when I am reevaluated that they permanently retire me for PTSD/Major Depression??? Please help. I am so angry and frustrated at this point. It just isn't right. I would have been happy with just the 30%. Its not about the money for me. It is about the Tricare healthcare. WIth all of the medical conditions I developed while in the military obtaining healthcare let alone even buying life insurance is truly expensive. Any help/advice you can provide is appreciated. my exact conditions are listed above in my other reply. I receive social security primarily due to my PTSD. I am not considered to be unemployable by the V.A. but I am 100% service connected. Do I go ahead and try to file for unemployability with the V.A. Will this help my case? I know the social security office has access to the V.A.'s medical records and files. Does the Air Force aka DOD have access without a consent to release form to my social security medical records and evaluations?? I just can't believe they didn't just retire me with 30% and leave me alone. I hate that I ever joined the service now at this point. They sure know how to treat a veteran. I imagine I would be even more upset had I lost a leg or something. I can only imagine how some of the other veterans who have lost legs or worse feel.
 
You must log in or register to reply here.
Top