TDRL to PDRL Offer Lowers PTSD Rating NARSUM disagrees

Sorry that you did not get a fair or good outcome.

K9cop said:
Well in my case there is no way the VA provided the final rating. I had my re-eval with the VA months prior to my TDRL appointment and the VA upheld my 70% for ptsd. Screw it. After advice from my attorney and my wounded Warrior program liason I decided to take the 50% and PDRL from the af. I'm sick of fighting.
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I won't second guess you or your decision. You have to do what is right for you. Only point out the following so that others can make their own decision.

It would go no where anyway. That's what they want you to do anyway. Give up. It's what is the lowest % we can offer so they'll take it and we don't have to pay.
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I agree that the services do not seem to want to comply with the regulation. However, I have had good luck with the outcome in cases where I have raised the issue (which, is not to say that they have decided based on the VA not having done the rating- but, they have avoided the issue by giving the higher rating or by continuing client on TDRL). I have seen some change in the board's attitude about this issue. Not massive, but, some change. About a year ago, I would get disagreement from the PEB's, especially Navy PEB, on the requirement. Last time I raised it before the Navy board, about 4 months ago, all the board members acknowledged the rule. So, I think it is not the case that fighting that issue is pointless.
 
So is this the military rated you a 50 percent PDRL ? I read somewhere if rated at 50 or higher for PTSD the VA rates you at 100 percent . Dont know if its true ? Also apply for CSRC . That should also help a lot as well.
 
jeffb said:
So is this the military rated you a 50 percent PDRL ? I read somewhere if rated at 50 or higher for PTSD the VA rates you at 100 percent . Dont know if its true ? Also apply for CSRC . That should also help a lot as well.
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Hmm, if a military service member is accepted into the DoD IDES MEB/PEB process, then the MEB shall determine all "medically unacceptable" and "medically acceptable" conditions for continue military service. Upon the determination of at least one "medically unacceptable" condition by the MEB, the MEB case file is forwarded to the PEB.

If there exist at least one "unfit for duty" medical condition as determined by the PEB, your PEB case file will be forwarded to the DoVA D-RAS for completion of PEB referred condition proposed ratings and proposed ratings for all VA claim conditions as annotated on the VA Form 21-0819.

Upon the receipt of the DoVA D-RAS proposed ratings with rationale, the PEB shall adjudicate the case file for a PDRL or TDRL finding and must adopt the DoVA proposed ratings for each PEB referred unfitting condition(s).

With that all said, if the DoVA D-RAS evaluated the symptomatology for a PEB referred unfitting PTSD medical condition and determined that a 50% (proposed) rating meets VASRD criteria, then the PEB must adopt the proposed rating assigned by the DoVA D-RAS.

To that extent, please remember within the DoD IDES process, the DoVA D-RAS provide the disability ratings for all PEB referred unfitting conditions and DoVA claimed conditions/contentions per new DoD IDES requirements. The overall DoVA proposed rating shall include the DoVA D-RAS ratings assigned to the PEB referred unfitting condition(s).

As such, there exist only one PTSD (proposed) rating for a PEB referred unfitting condition, and combined proposed ratings for the DoVA claimed conditions/contentions as annotated on VA Form 21-0819.

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

Best Wishes!
 
Ahh ok so the VA sees TDRL and PDRL as the same correct ?
 
jeffb said:
Ahh ok so the VA sees TDRL and PDRL as the same correct ?
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In essence, it could unofficially be viewed as such in my opinion since the DoVA hasn't any decisional authority with the PEB's adjudication of a DoD PDRL finding or a DoD TDRL finding.

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

Best Wishes!
 
Also the reason why I asked is because the Dod rating usually comes before the VA rating . not the other way around as it Should be .
 
jeffb said:
Also the reason why I asked is because the Dod rating usually comes before the VA rating . not the other way around as it Should be .
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Indeed, albeit please recall that the DoD rating is taken/extracted/adopted from the DoVA proposed rating decision documentation; therefore, in essence they are determined simultaneously via the DoVA D-RAS.

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

Best Wishes!
 
You are right but they use the manual but the actual rating comes from the VA . And the rating that the VA gives is the rating the DOD has to use am I correct ?


So basically if the VA rates you for PTSD at 50 percent the DOD has to rate you at 50 percent am I correct ?
 
jeffb said:
You are right but they use the manual but the actual rating comes from the VA . And the rating that the VA gives is the rating the DOD has to use am I correct ?

So basically if the VA rates you for PTSD at 50 percent the DOD has to rate you at 50 percent am I correct ?
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Indeed, if you are currently in the DoD IDES MEB/PEB process and getting DoVA proposed ratings then the answer is yes.

Moreover, if you otherwise qualify for permanent disability retirement then you will be placed on TDRL if the PEB determines that your condition is not stable for rating purpose.

As such, DoD IDES procedures are not currently used for rating of TDRL cases; meaning the PEB will determine the disability ratings for all military service members being removed from the TDRL unfortunately.

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

Best Wishes!
 
Due to the recent post of this it appears this is the most ideal place to pose/post my request for guidance. I have been on the Dept. of the Navy TDRL since Jan 2012 and rated at 70%.
1: 50% Major Depressive Disorder D-codes 9394-9411

1.1 Hx of PTSD (related Cat 2 diagnosis)
1.2 Anxiety Disorder not otherwise specified. (related Cat 2 diagnosis) ,

2: 20% (bilateral factor applied) D-codes 5099-5024
Right Shoulder Painful Limitation of motion status post superior labrum anterior and posterior repair ,

3: 10% Vertigo D-codes 6299-6204, peripheral, episodic & motion sickness associated with pressure changes to ear.

4: 10% (bilateral factor applied) D-Codes 5299-5201.
L Shoulder pain w/ decreased range of motion and recurrent instability status post 3 surgical stabilization repair & revisions to L shoulder

4.1 Hx of L subscapular nerve injections w/ L thumb/Volar pad numbness. (related Cat 2 Diagnosis).

I recently had my first Re-eval for the 4 unfitting conditions only. These tardy evals occurred from November 2012-February 2013 (long story) and my board apparently convened 28 Feb. Yesterday, (March 15th) I received my results which read that "After a thorough review" I have been rated at 60% and will be removed from the TDRL and placed on the PDRL.

Good news after initially waiting so long and then not having to spend 5 years on TDRL right?

Herein lies some recent history and my dilemma.

Sept 21 2013 I received notice from the VA that I had been rated at 100% due to IU retroactive to the day I was released from active duty. It was then modified retro to July 2012 as 100% scheduled (read: not total and permanent).

This was merely days prior to the PEB requesting that I start my TDRL re-eval. The VA continued my R shoulder % at 20 and obviously raised several others as well as adding one to reach 100%. None have to do with my dilemma except the R shoulder hence my inclusion here.

Along with my Jan 12-Present medical records, I sent the VA findings and rating documentation. They contacted me requesting a mental health, ENT, and Ortho re-eval anyway. I returned with a "Why? since I just sent you everything that was recent including my rating decision taken directly from the VASRD which you will be using anyway?" They stated to do it anyway or else...so, being far from the hospital they ordered me to, I asked who else could perform the ortho and mental health portion. The board secretary told me and my wife twice via phone call that I could have the "nearest MTF, civilian through Tricare, or "THE ORTHO DR. AT THE LOCAL VA"". What the hell? So I stated, that my MTF was Air Force and does most things differently, a civilian will be even more clueless than a medicine man writing this up, and they (PEB Board) just told me a few days before that the Local VA decision dated 21 Sep 2013 wasn't good enough for them. Pure confusion.
Anyway, I schedule the exams at the Air Force MTF and actually found assistance from a PEBLO just assigned there. My Mental Health obviously went well went, My Ortho measurements were take by a physical therapist (which is authorized but probably not preferred over an ortho Doc.) on forms they use for their TDRL cases which look nothing like the DON or VA. They actually take averages. Regardless, my averages and writeups regarding ROM and pain all qualified for the 20% level according to the VASRD.

Hence my confusion about the downgrade discrepancy in their board finding.

I have been told and have read on this very forum that my TDRL should be a Head-to-Toe evaluation of all service connected conditions. Even after raising this question with the PEB they emphatically said "No!".

My other issue with their documentation is that in the findings block 6, they continue to credit me with 11 years 7 months of service when I have just under 18 years day for day service and nearly 22 years overall.

In their findings they also state that it did not result from a combat related injury when in fact two (plus a back injury that happened the same moment my L shoulder injury occurred but was not found to be unfitting by DoN but was 20% by VA) of my three unfitting conditions occurred in a combat related situation.

I have mentioned these two discrepancies in appeals before but it has not been corrected. This is obviously affecting me by having to physically apply for CRSC, but would the LOS affect any pay due me past, present, or future?

I am also curious that if in the future since I am not "permanent and total", the VA downgrades my PTSD from 50% to 0%, this would obviously affect my DoD % resulting in possibly dropping below 30% and a theoretical end to DoD retirement benefits and pay if/when both drop down.

I have waited so long for the TDRL/PDRL results, and now that I have them, I had an overwhelming relief, only to again pop out of bed in the middle of the night frantically considering that this mere 10% drop could negatively affect future DoD percentages since a loss of 50% would put me below 30% for the DoD.

Does anyone have any thoughts on
1. My need to appeal 10% while staying on the TDRL (which I am not currently receiving any monetary benefit anyway due to the VA 100% mark) or just accept the findings?
2. Appeal due to wording in block 6 for my LOS and additional findings that it was not combat related?
3. Appeal due to Orthopedic measurement oddities which obviously confused the board members as well?
4. Appeal due to wording of finding # 1 being classified as a "Major Depressive Disorder" vice simply PTSD which the code already identifies (9411)?
and:
5. Should I just be happy I obtained PDRL status, be done with the fight and move on hoping the VA keeps all of my unfitting conditions the same for 20+ years?

Thank any and all who make it through my post and can provide meaningful and experiential advice.
 
Betur6,

It is best that you start your own separate thread regarding these issues, you will likely get more answers that way.

As far as your situation, when I had my TDRL exams (Air Force), only my unfitting conditions were evaluated not all of my service connected issues. Ultimately, the decision to appeal will be up to you but it may be suggested that if this does not affect your monetary benefits, then perhaps it is in your best interest to accept.

The wording of "Major Depressive Disorder" rather than "PTSD" does not impact the rating itself. Appealing for combat related being added for your LOS would benefit you when you apply for CRSC.

I wish I could help but hopefully the subject matter experts on this board will be able to help with your questions. Good luck!
 
Kim76 said:
Betur6,

It is best that you start your own separate thread regarding these issues, you will likely get more answers that way.

As far as your situation, when I had my TDRL exams (Air Force), only my unfitting conditions were evaluated not all of my service connected issues. Ultimately, the decision to appeal will be up to you but it may be suggested that if this does not affect your monetary benefits, then perhaps it is in your best interest to accept.

The wording of "Major Depressive Disorder" rather than "PTSD" does not impact the rating itself. Appealing for combat related being added for your LOS would benefit you when you apply for CRSC.

I wish I could help but hopefully the subject matter experts on this board will be able to help with your questions. Good luck!
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Kim76,
Thank you for your assistance.
 
Kim76 said:
Betur6,

It is best that you start your own separate thread regarding these issues, you will likely get more answers that way.

luck!
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Where do I start a new thread? I always have a hard time find the right spot.
 
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