UNfitting Psych condition - Pilot Program Rating Questions

nwlivewire

nwlivewire

PEB Forum Regular Member
PEB Forum Veteran
Question One:

If you are found Unfit by the Army for a specific psychiatric condition (ex: PTSD), and,
you are in this Pilot program,

are you rated by the VA and the Army with the same percentage for this condition?

Or, can the Army rate you at one percentage (50%), the VA at another (70%) for the same condition in this Pilot Program?

And which agency does the rating for the Army unfitting condition?

Question Two:

If you have been diagnosed with PTSD and have had this diagnosis for greater than two years already, are you still placed on TDRL?

Thank-you for clearing this up for me.

v/r,
nwlivewire
 
The answer to your first question is yes. The purpose of the pilot program is to have more of an equality in the VA and DOD rating process, so your ratings for all conditions will be the same (for DOD if you are found unfit) from the VA and DOD. Not sure about your other question, but common sense would tell you that two years is pretty stable; the DOD may see it otherwise.
 
In the pilot, DoD is required to apply the VA rating for unfitting conditons. PTSD most likely to be placed on TDRL. Stability is in terms of the rating. If the rating can go up or down over the next five years then TDRL is supposed to be used. While PTSD will likely be a permanent concern, it's impact can wax and wane. Plus, VASRD 4.129 requires a minimum 50% rating for PTSD if bad enough to warrant separation from service followed by a reevaluation 6 months after separation. I personally have never seen a PTSD PDRL decision from an initial PEB.

Mike
 
Thank-you Marine 32!

Any others care to chime in on an answer to Question 2?

I'm going to go through the pilot Program at Fort Lewis (already had med appts. done).

v/r,
nwlivewire
 
Thank-you maparker!

Wow. Interesting to note that PTSD is treated as TDRL.

I have had a consistant rating of chronic severe for PTSD during these last two years, even after having gone through a VA PTSD treatment program - VA still said Chronic Severe.

Thanks for your quick response!

v/r,
nwlivewire
 
If they rate you for PTSD by reference to 4.129, then almost by definition you should go on the TDRL (because your rating is temporary). However, they could rate you using the schedule normally in place for rating mental health conditions with a result of PDRL, so long as that results in either a 50 percent or higher rating and the conditions is found stable. Note that I said, "could," as it seems to be the overwhelming trend that the PEBs are rating under 4.129 and not rating on the schedule very often in the initial evaluation (though, logically, it makes sense that the 50% minimum rating under 4.129 would be appropriate in the majority of cases).
 
Interesting as I am getting ready to have my Narsum written and the process to start. I am over 20 and also attended a VA residential program with the Chronic Severe diagnosis. AF doc says we are going to medical retire me. So I wonder if it will also be TDRL at first. To think about having to continue with the goat rope is not a very pleasant thought.

Tomcat98
 
Dear Tomcat98:

I wonder if your having more than 20 years of AD service would make the difference between a TDRL and a PDRL finding for you? That would be too good to be true!

I know what you mean about the goat rope continuing. Don't look forward to that part myself. This whole process has been nothing but a fight-fight-fight, merry-go-round, screwed up goat rope for me. And I haven't even hit the Boards yet. With a TDRL rating, I can only imagine the potential for more institutional insanity.

Holy Cow!

Please keep us posted as to how things are going for you.

And please be sure to share your findings with us as we're all in the same cluster you-know-what!

v/r,
nwlivewire
 
According to what the regulations state, there should be no distinction between those with more or less than 20 years. The issue is "stability for rating purposes." (Though, there is a provision of DoDI 1332.38 that states that if you have stable conditions that combine to 80% or more, you should be placed on PDRL (which makes sense, because the ultimate outcome of being paid the maximum of 75% of the retired base pay will not change based on the unstable condition).

That said, the Army has recently changed its evidentiary standard for placement on TDRL and I do think that some "extra-legal" consideration come into play in some cases...Also, I have seen a greater number of PDRL findings than in the past. I can't say for sure that something has changed in the way the PEBs are looking at the "stability" question, but I suspect there has been some change in the last year.
 
I just think about having to have to go back for evaluations once I am out. I get tired of telling the same things over and over. Just read the F'N notes and files. I assume I will be TDRL and not PDRL. I also plan to be receiving treatment from the VA and to think about having to deal with AF paperwork seems more stress. I do get to go to VA groups now but all other providers are mother AF. Just what I need as I am not sure they have the expertise with PTSD. In a way I am jealous of the Army in that at least they appear to have part of their act together. I feel so isolated. The AF provider can't even get the records from my inpatient VA program from the AF hospital to write the Narsum and they are in the same unit. I have my copy but to be honest am a little pissed that they can't figure it out. More untrust in the "system".

I am sure I will have some questions for the board members and will share part of my experience as it progresses. At this point I am just trying to stay ahead of this thing and work on getting better or at least not getting worse. The holidays have been pretty hard. I assume the AF will call me when they need me of course they approved my retirement request because left hand and right hand is not talking. Now they have to go back and disapprove.

My frustrating thing is that it appears they don't know what to do with me. It seems like no one has ground truth. It all depends who you ask.

I still have trouble trying to figure out the steps in the process. It is just not clicking for me.

Tomcat98
 
Tomcat98,

I wish the system was not so frustrating. I can't offer much help with "changing" the system as it is supposed to be (that power is for Congress, DoD, and the military branches), I can only tell you how things should go and how they actually go in many cases (the two are, of course, not the same). All I can say is hang in there and feel free to ask questions. There are many folks who have been in your boots, they might be able to give you some insight, too.

Good luck!
 
Hey NWLivewire,

I too have chronic PTSD, first diagnosed by the military after my first deployment and began treatment for it in 2006 and have been continuously treated since. So it's well established as chronic. But from what I've been led to believe talking to the soldiers' counsel types and PEBLO and so on, they say that they have never seen anyone get PDRL out of the pilot here (the WRAMC DES) based on their PTSD diagnosis no matter how long they've had it and how "stable" it's been while on active duty. I guess the reasoning is that getting out is likely to impact your PTSD in one way or another (possibly improve it if you are no longer exposed to some of the triggers, possibly worsen it if you isolate and feel alienated), so they want to see how that goes before assigning a Permanent rating to it. Of course, I'm suspicious of their motives and feel that it's just going to keep my life in suspended animation longer. I fear that when I get out, if I try to work they'll say "See! She's out there working! She's all better now! we'll rate her at 10%" or something like that. It's a catch 22. The retirement they give you isn't enough to actually live on, so you have to try to work, and then I worry that they'll use that as evidence that you are "cured" when you leave the military.

Maybe I'm paranoid and lacking in trust of the system..... I wonder how I got that way?

Murph
 
Dear rugbymurf:

From my readings of the postings on this website, it appears that TDRL re-evals vary from Servicemeber to Servicemember, place to place, etc. I get left with an impression that there doesn't appear to be a uniformity of standards, or it appears that there is alot of subjectivity in the re-eval for PTSD sufferers.

I have one friend who was placed on TDRL with 50% (PTSD), who went in on their re-eval and got knocked down to 20%. He was told that because he was attending school full-time, that he warranted a reduction in rating (must be improved!). Never mind that he had special tutors and special help at school, and spent many more hours than is usual just to get a passing grade of "pass/fail" or a "C". And these extra efforts was from a guy that used to be a practically "straight A" student before PTSD.

It seemed to me that he was penalized for pressing on in his fight and trying to improve his lot in life. And no, he didn't work at a job because he spent his time just trying to get through school with passing grades.

I know this is just one Servicemembers experience with PTSD/TDRL, and that this ought not to color the entire spectrum. Still, I can't help but wonder about this myself and the possibility of a "Catch 22".

I guess I'll find out in a few months from now when I get placed on TDRL.

All I know is to keep taking your meds, keep seeing your Mental Health professionals on a regular basis, and keep your paper trail well documented.

Perhaps others here on this site can shed some more light on this and their experience with PTSD/TDRL.

Keep your chin up Grrl! This system can drag you down sometimes, and with PTSD, some days are just barely tolerable. But remember, every day is a new day - and we must make the best of it as we can.

**********

I know this sounds corny, but I have some positive sayings on my bathroom mirror that I have to look at when I go in there. Some are just single words, some are quotes. Sometimes they help my head and heart when I think all is dark and lost. I also have cut out pictures of places I'd like to visit and have them on a piece of paper to remind me - give me hope - a future - a goal if you will. Don't know if this will help you, but I just thought I'd share this. But the idea is for you to find out what trips your triggers - what inspires you - and make a word or picture paper - or both - that captures these elements of hope and future and inspiration. For me, there have been times that just looking at these things in my bathroom works better than a Big Pharma pill, and helps put things in perspective.

***********

v/r,
nwlivewire
 
Tomcat98 said:
I just think about having to have to go back for evaluations once I am out. I get tired of telling the same things over and over. Just read the F'N notes and files....
Tomcat98
Click to expand...

This right here is my biggest concern, and is almost enough for me to tell them to not even consider the PTSD for the MEB. The thought of constantly having to relive everything umteen times with God knows who, isn't worth whatever percentage they deem my mental stability is or isn't worth.
 
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