TDRL PTSD Review

Travelerusa40

Travelerusa40

PEB Forum Regular Member
PEB Forum Veteran
1. I am active duty ARmy. When you are placed on the TDRL for 5 years for PTSD who does your followup Exam? The VA or the Army?

2. Also, during the TDRL period can I check in with my civilian provider for mental health or do I have to be seen my a military or VA every time I check in. When you are on PTSD medication you have to normally check in every month with your provider. But can my provider be a civilian or do I have to drive to an MTF or a VA clinic?
 
When on TDRL you have Tricare and VA benefits. You choose what's best for you. You don't need to work with the MTF's if you don't want to. Even if you request to use the MTF's, they may not have room for a retiree; low man on the totem pole.

For re-evaluation VA should be doing it if you're IDES. If Legacy, should be MTF. The Army seems to have contracted some of it out. Just make sure you stay on top of your paperwork so you don't miss the appointment in the future and ultimately focus on your treatment during the next months to years.

Wish you well...
 
I'm not sure on this one. The Army has to determine whether your disability has stabilized to the point where it can be permanently rated, so I would imagine the examination must be done at an MTF. Only than would the Army forward your case back to the VA for an updated rating.
 
Ed Mercanti said:
I'm not sure on this one. The Army has to determine whether your disability has stabilized to the point where it can be permanently rated, so I would imagine the examination must be done at an MTF. Only than would the Army forward your case back to the VA for an updated rating.
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Thanks. Found my error Ed. Just want this cleared up.
How often will I have to undergo a physical examination?​
You are required by law to undergo physical examinations at least once every 18 months. However, examinations may be scheduled as early as six (6) months if deemed necessary by appropriate medical/disability authorities. Your re-examination month will be reflected in block 9 of your DA Form 199 (Physical Evaluation Board Proceedings). See AR 635-40, paragraph 7-4; 10 USC 1210.​
Must I undergo TDRL physical examinations if I have elected to receive VA compensation instead of retired pay from the Army?​
Yes. You are required by law to undergo periodic physical examinations as ordered by the Secretary of the Army. This requirement exists even if you waive Army retired pay in favor of VA compensation or are receiving treatment at a VA Hospital. Examinations administered by the VA to determine the amount of compensation you are eligible to receive from that agency cannot take the place of examinations required by the Army. In other words, your responsibilities to the Army and the VA with respect to physical examinations are separate and distinct. See AR 635-40; para 7-4 (a).​
If I apply for benefits from the VA, which I may be entitled to, will these benefits be based on the percentage of disability I received from the Army?​
No. If you processed through the DoD/VA Integrated Disability Evaluation System (IDES), you received proposed VA ratings at that time. The disability percentage you received from the Army was based on your unfitting conditions, while the percentage from the VA was based on all conditions that are service connected. The total ratings may be the same or may differ. If you did not process through the IDES, you will have to apply to the VA separately and the VA ratings may differ from those you received from the Army.​
I received notice that my re-examination will be done by a contractor and not by an Army Medical Treatment Facility (MTF). Why? When I was placed on the TDRL I was told that my re-exam would be done by an Army MTF.​
The Army’s Medical Command (MEDCOM) determines who conducts TDRL re-examinations. In late 2010, the Northern Regional Medical Command (NRMC) contracted the performance of TDRL re-examinations to Ivan Walks and Associates (IWA). This affects all TDRL members who live in the northeast, along the Atlantic coast from North Carolina northward, and many members living in the northern Midwest region. These individuals will be notified by PDA that their re-examinations will be performed by IWA, and IWA will contact them to schedule their re-examinations. More information on IWA is available at the following website: www.ivanwalks.com. They can be reached at 301-583-5191 ext 8000 or by email at TDRL@ivanwalks.com.​
Who can furnish advice and assistance when I report to for examination?​
Each MTF has on its staff a Physical Evaluation Board Liaison Officer (PEBLO). The PEBLO's job is to offer counseling and provide assistance to members as appropriate. You are encouraged to take advantage of the services provided by the PEBLO. If your re-examination is being done by IWA, the Doctor’s office/medical facility will be expecting you and prepared to assist you. Your Veterans Evaluation Liaison Officer (VELO), with duties similar to a PEBLO, may also be contacted for assistance. See AR 635-40, para 7-5.​
Where will my examinations take place?​
Your medical file will normally be referred to the Army Medical Treatment Facility (MTF) closest to your home. The hospital commander will be responsible for conducting the examination at his facility or scheduling it at another federal medical facility or civilian hospital/clinic at or near your home. If your re-examination is being done by IWA, they will schedule you at a doctor’s office or medical facility that is normally within 150 miles of your home.​
When and how will I be scheduled for examination?​
The USAPDA will forward a letter to the designated hospital four (4) months in advance requesting that a physical examination be conducted. After an appointment has been made for you, the hospital commander will send you additional correspondence advising you of the exact date and time to report. If your re-examination is being done by IWA, you will receive correspondence notifying you of the exact date(s) and time(s) of your scheduled appointment (s). See AR 635-40, para 7-9.​
I was placed on the TDRL via the Department of Defense (DOD)/VA Integrated Disability Evaluation System (IDES) program. Where will my examination take place?​
Under current procedures, your reevaluation will be conducted the same as for individuals placed on the TDRL via the legacy (non-IDES) system. Procedures described above apply to all TDRL members, whether placed on TDRL via IDES or legacy processing.​
 
pittpan2005 said:
I was placed on the TDRL via the Department of Defense (DOD)/VA Integrated Disability Evaluation System (IDES) program. Where will my examination take place?
Under current procedures, your reevaluation will be conducted the same as for individuals placed on the TDRL via the legacy (non-IDES) system. Procedures described above apply to all TDRL members, whether placed on TDRL via IDES or legacy processing.
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NO!!!

This is what is happening in many cases now. But this is clearly wrong under the DTM 11-015:

“4. SECRETARIES OF THE MILITARY DEPARTMENTS. The Secretaries of the Military Departments shall:…
v. Establish procedures for their respective Military Departments to ensure all IDES case files include an assessment of whether each unfitting disabling condition is temporary or permanent in nature based on accepted medical principles. Accept the proposed disability rating(s) of the compensable unfitting condition(s), as determined by the Military Department concerned, rendered by the Disability Evaluation System Rating Activity Site (D-RAS) under Part 4 of Reference (h) in determining separation and other administrative matters including final disposition from the Temporary Disability Retirement List (TDRL).”

“APPENDIX 11 TO ATTACHMENT 4, D-RAS PROCEDURES…
2. The D-RAS will rate the Service member’s referred and claimed Service-connected disabilities and provide a proposed rating decision, with rationale, to the PEB within 15 days of notification by the PEB administration staff that a Service member is unfit. If the D-RAS determines that the disability examination report(s) are insufficient for rating purposes, the PEB will return the VA C&P disability examination report to the appropriate examining facility for correction or completion. Once the D-RAS has rated all unfitting conditions, the D-RAS will provide their proposed rating decision to the PEB. The D-RAS will defer rating all other conditions that require additional claim development in accordance with VA business practices and regulations…

5. The responsibilities assigned in this appendix are related to veteran or Service members placed on the TDRL. For all Service members found unfit for continued service and separated via the IDES model and placed on the TDRL, VA will establish future examinations in accordance with existing laws and regulations. VA will prepare rating decisions on all future examinations in accordance with existing laws and regulations.” (emphasis added)."

Now, what I have seen shake out (especially in the Dept. of the Navy) is that the Service claims that the VA did not follow up and conduct a TDRL re-examination, so the military department may step in and "fill the gap." This is dead wrong and illegal in my view (almost all TDRL cases require a later re-exam under VA rules....I won't go into to the limited exceptions for this now).

So, bottom line, I think it is likely we will see the military departments provide TDRL re-examinations of IDES cases. If they do, I think it is illegal and open to challenge. I would challenge it if they try to do so.
 
Thanks Jason,
I'll contact them Monday and ask them to update it or at least remove wrong info. Also, thanks for the DTM, couldn't find the one I wanted.
 
Jason said:
NO!!!

This is what is happening in many cases now. But this is clearly wrong under the DTM 11-015:



5. The responsibilities assigned in this appendix are related to veteran or Service members placed on the TDRL. For all Service members found unfit for continued service and separated via the IDES model and placed on the TDRL, VA will establish future examinations in accordance with existing laws and regulations. VA will prepare rating decisions on all future examinations in accordance with existing laws and regulations.” (emphasis added)."

Now, what I have seen shake out (especially in the Dept. of the Navy) is that the Service claims that the VA did not follow up and conduct a TDRL re-examination, so the military department may step in and "fill the gap." This is dead wrong and illegal in my view (almost all TDRL cases require a later re-exam under VA rules....I won't go into to the limited exceptions for this now).

So, bottom line, I think it is likely we will see the military departments provide TDRL re-examinations of IDES cases. If they do, I think it is illegal and open to challenge. I would challenge it if they try to do so.
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VA is required to complete the TDRL(IDES) re-evals according to DTM 11-015. If the VA "fails" to schedule and military department doesn't step in and fill the gap, what is the potential recourse for SM's if removed from TDRL for failure to appear for scheduled(unscheduled) appointments?
 
pittpan2005 said:
VA is required to complete the TDRL(IDES) re-evals according to DTM 11-015. If the VA "fails" to schedule and military department doesn't step in and fill the gap, what is the potential recourse for SM's if removed from TDRL for failure to appear for scheduled(unscheduled) appointments?
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I don't see this (failure to appear for appointments) implicated unless one is actually scheduled and the member does not appear. Not sure if this question is tied into the issue of expiration of the 5 year period in the question posed, but I think this is a separate issue: who conducts the exam and rating determination vice what happens at the end to 5 year TDRL period.

That aside, the recourse is to challenge the adverse determination, either in administrative venue (probably BCMR/BCNR) or in Court.

Like most issues, you need specific facts to provide specific analyses.
 
Jason said:
Not sure if this question is tied into the issue of expiration of the 5 year period in the question posed, but I think this is a separate issue: who conducts the exam and rating determination vice what happens at the end to 5 year TDRL period.

That aside, the recourse is to challenge the adverse determination, either in administrative venue (probably BCMR/BCNR) or in Court.

Like most issues, you need specific facts to provide specific analyses.
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Two separate for sure.......

TDRL seems like a "black hole" for no better analogy. Paperwork can be slow reaching the SM causing him/her to miss appointments. Sometimes there is an address error and it's not the SM's fault(I do believe the SM/Vet has a responsibility to ensure appropriate agencies/departments have it). There is also the 5 year problem where a member's 5 years on TDRL is up and no final determination has been made so DFAS cuts him/her off. They have recourse to appeal via BCMR or in Federal Court, but that's time, needed money lost(temporarily), and medical insurance lost. I guess it just frustrates me that an error can be no fault to the SM, but ultimately he has to defend himself and prove the institution wrong.

I wouldn't have as many concerns and chalk it up as "failure of personal responsibility," but my TDRL experience would have been a disaster had I not been proactive and caught errors. DoD sent my appointment info to the wrong address despite my update with everyone. I called and it was re-scheduled. The new scheduled reporting paperwork was sent to an old address again. I called and they "fixed" it again. After two wrong addresses and approaching 18 months I called the nearest MTF and asked them when my appointment would be; they scheduled and I attended it. Once the appointments started it was rather smooth, but getting to the appointment was a concern.

Recently the VA sent my files to an address in a state where I have never lived. Where they came up with that address is beyond me and 4 VA reps still can't get to the bottom of it. They still don't know, but promised me I had nothing to worry about......I am keeping my credit check monitoring service anyhow!! I wanted some records, which I later received, showing they in fact never completed numerous tests during my C&P. It was an eye opener for sure.

I think the VA responsibility(appointment scheduler, reviewer and rater) is a tremendous improvement for IDES TDRL members, but the same VA does make some "big" mistakes and makes me fearful for them.

Maybe I just expect to much, but the system seems more complicated for TDRL guys/gals than it needs to be. Sorry, no real question just a bit of a rant I guess.

Thanks for clearing up the issue about who should complete the exams.
 
So the military department will make a decision on whether a disability is stabilized enough to rate and whether it is still unfitting based on the VA exam. Actually makes sense. Otherwise the individual would have two exams, one from the military department for permanancy and unfitness, and a second from the VA for percentage.
 
Can a SM going though the IDES program for ptsd and other medical issues be rated PDRL w/o being TDRL first
 
usmcgeorge said:
Can a SM going though the IDES program for ptsd and other medical issues be rated PDRL w/o being TDRL first
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Yes...if there is one or more unstable conditions (which would normally result in TDRL placement) the member can still be placed on PDRL is the stable conditions rate at 80% or more. DoDI 1332.38 covers this, as do other service regulations.
 
Jason Perry said:
NO!!!

This is what is happening in many cases now. But this is clearly wrong under the DTM 11-015:

“4. SECRETARIES OF THE MILITARY DEPARTMENTS. The Secretaries of the Military Departments shall:…
v. Establish procedures for their respective Military Departments to ensure all IDES case files include an assessment of whether each unfitting disabling condition is temporary or permanent in nature based on accepted medical principles. Accept the proposed disability rating(s) of the compensable unfitting condition(s), as determined by the Military Department concerned, rendered by the Disability Evaluation System Rating Activity Site (D-RAS) under Part 4 of Reference (h) in determining separation and other administrative matters including final disposition from the Temporary Disability Retirement List (TDRL).”

“APPENDIX 11 TO ATTACHMENT 4, D-RAS PROCEDURES…
2. The D-RAS will rate the Service member’s referred and claimed Service-connected disabilities and provide a proposed rating decision, with rationale, to the PEB within 15 days of notification by the PEB administration staff that a Service member is unfit. If the D-RAS determines that the disability examination report(s) are insufficient for rating purposes, the PEB will return the VA C&P disability examination report to the appropriate examining facility for correction or completion. Once the D-RAS has rated all unfitting conditions, the D-RAS will provide their proposed rating decision to the PEB. The D-RAS will defer rating all other conditions that require additional claim development in accordance with VA business practices and regulations…

5. The responsibilities assigned in this appendix are related to veteran or Service members placed on the TDRL. For all Service members found unfit for continued service and separated via the IDES model and placed on the TDRL, VA will establish future examinations in accordance with existing laws and regulations. VA will prepare rating decisions on all future examinations in accordance with existing laws and regulations.” (emphasis added)."

Now, what I have seen shake out (especially in the Dept. of the Navy) is that the Service claims that the VA did not follow up and conduct a TDRL re-examination, so the military department may step in and "fill the gap." This is dead wrong and illegal in my view (almost all TDRL cases require a later re-exam under VA rules....I won't go into to the limited exceptions for this now).

So, bottom line, I think it is likely we will see the military departments provide TDRL re-examinations of IDES cases. If they do, I think it is illegal and open to challenge. I would challenge it if they try to do so.
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I just signed my 199 today. I received 90% Army and 100% VA and TDRL due to PTSD. Which sucks because I have 21 years active and I really want to be finished clowning with these guys. I was given a date of 05/2014 for a reexamination. My PEBLO said it would most likely be at a MTF but she couldn't be certain. As soon as she said MTF I felt sick. It was Madigan who tried to ruin my life to begin with (along with many other soldiers). I hope like hell I can have the reeval at the VA and not with one of these quacks at Madigan who think PTSD is a fairytale. And yes I am still a little bitter :-)
 
Txrottie said:
I just signed my 199 today. I received 90% Army and 100% VA and TDRL due to PTSD. Which sucks because I have 21 years active and I really want to be finished clowning with these guys. I was given a date of 05/2014 for a reexamination. My PEBLO said it would most likely be at a MTF but she couldn't be certain. As soon as she said MTF I felt sick. It was Madigan who tried to ruin my life to begin with (along with many other soldiers). I hope like hell I can have the reeval at the VA and not with one of these quacks at Madigan who think PTSD is a fairytale. And yes I am still a little bitter :)
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Welcome to the PEB Forum! :)

Congratulations on the recent and acceptance of your IPEB findings inclusive of DoD 90% rating with TDRL and DoVA 100% rating. :cool:

Indeed, in my opinion it's totally comprehensible about the TDRL finding and a continued involvement with the USAPDA after retirement albeit temporary in nature. :(

In retrospect, I am in a similar situation currently but still awaiting receipt of my VARR request results then revised DA Form 199 if warranted. I have over 32 years in total military service with over 25 years of military active duty! That said, I am definitely not looking forward to the six-month medical re-evaluation via Ivan Walks and Associates (IWA) then non-IDES processing by the USAPDA PEB if the USAPDA PEB adjudicates a TDRL finding after receipt of the VARR results! :mad:

As @Jason Perry stated earlier in this thread, the military departments are not following the DTM 11-015. For the U.S. Army, in September 2010, IWA received a competitive small business award to pilot a Temporary Disability Retired List (TDRL) administration program in collaboration with the Army's North Atlantic Region Medical Center (NaRMC); simply stating that the IWA was awarded a contract to provide TDRL support to the U.S. Army.

To that extent, the ongoing U.S. Army trend as explained to me by the Chief Attorney at NCRPEB SPEBC is a continued lower PTSD rating by the USAPDA PEB (not the DoVA D-RAS) after receipt of the IWA medical examination results and other medical evidence if provided by the military veteran.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
I have a question...I am currently on TDRL from the Army for PTSD at 70%...I just went to a C & P exam for the VA...I got my results saying that I am 100% P & T for PTSD....Do I still have to do an exam for the Army...Even if the VA rated me 100% P & T....
 
You should not have to (if they follow the regs, i.e., DoD Manual 1332.18 Vol. II). Unfortunately, the services seem to not like that reg so they routinely ignore the sections on TDRL.
 
The Army coordinated a re-evaluation with a contracted civilian provider. It had nothing to do with my tricare or the VA. I truly was a random psychologist in a sketchy part of town with no markings on the building. They put me on PDRL, however.
 
kn1080, I have not done TDRL, but I am imagining things. I am suspecting that your process was largely driven by successful communication. Spell out how that communication went down, por favor.

The main question that arises in my mind is when did you do the exam, who directed it, and how close it was to the PDRL determination. Many have not been as successful as you and I am guessing those questions are a big factor in why.
 
kn1080 said:
The Army coordinated a re-evaluation with a contracted civilian provider. It had nothing to do with my tricare or the VA. I truly was a random psychologist in a sketchy part of town with no markings on the building. They put me on PDRL, however.
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Indeed congratulations! Hmm, the primary questions which sparked my interest after your placement onto the PDRL are as follows:

Q1. What medical conditions were re-evaluated while on TDRL?

Q2. If PTSD was inclusive during the TDRL re-evaluation, did your rating increase, decrease, or remain the same as the PEB adjudicated a PDRL finding?

Q3. If not PTSD but another mental condition during the TDRL re-evaluation, did your rating increase, decrease, or remain the same as the PEB adjudicated a PDRL finding?

With that all said, take care and thanks! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
1. The conditions that were re-evaluated while on TDRL were; PTSD, Migraines, TBI and degenerative disc disease of the spine. I only had one re-evaluation. That company Ivan walks had forgotten about me so, I called an army department responsible for overseeing them and requested my re-eval at just about 2 years. The army took care of it.

2. The PTSD rating remained the same. It became permanant 50%.

My overall Army rating increased from 60% to 70%. I dont remember what increased. It may have been my TBI. I had decided, I was not going to appeal anything greater than 30%.

Currently, I am

USA 70% PDRL
VA 100%
CRSC 100%
SSDI
 
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