TDRL for PTSD/Depression

adbarnett5

Registered Member
#1
Hello everyone! I did some searching on my question before hand but didn't find anything relevant. I was recently med boarded from the Air Force with 70% DoD/100% VA, which is mostly from PTSD and Depression and placed on TDRL. I have my first follow up in March 7 with a clinic that is doing a blood draw and then I see some Doctor not sure what type.

I'm very happy with what I got, and I don't want my percentages to change. The main thing that I have been doing is going to therapy and taking medications. I am honestly sick of talk therapy. I been through every program that the military offers and some of them 2 times while active duty. Is just continuing the medications good enough to keep my ratings or should I continue seeing the social workers and psychiatrists regularly?
 

Warrior644

PEB Forum Veteran
Registered Member
#2
Hello everyone! I did some searching on my question before hand but didn't find anything relevant. I was recently med boarded from the Air Force with 70% DoD/100% VA, which is mostly from PTSD and Depression and placed on TDRL. I have my first follow up in March 7 with a clinic that is doing a blood draw and then I see some Doctor not sure what type.

I'm very happy with what I got, and I don't want my percentages to change. The main thing that I have been doing is going to therapy and taking medications. I am honestly sick of talk therapy. I been through every program that the military offers and some of them 2 times while active duty. Is just continuing the medications good enough to keep my ratings or should I continue seeing the social workers and psychiatrists regularly?
Welcome to the PEB Forum! :)

From an U.S. Army perspective while being placed onto the DoD military TDRL for 3.5+ years now for PTSD+MDD with severe psychosis, your medical condition must show that it's "permanent and stable" at the time of the TDRL re-evaluation in order to receive a DoD military PDRL adjudication. This is accomplished by the USAF TDRL PEB's reviewal of all available post-active duty military medical evidence and/or medical documentation to include the TDRL re-examination document.

As such, what does your post-military active duty medical documentation states about your PTSD/Depression PEB-referred medical condition? Does it state that your medical condition is better, getting worse, or has remained the same at this particular point in time? In retrospect, the TDRL PEB is suppose to review all available medical evidence and/or medical documentation AFTER your release from military active duty and officially start from placement onto the DoD military TDRL. Have you been seen by DoVA clinicians, retired military clinicians and/or civilian clinicians while on DoD military TDRL?

Indeed, whatever the status of your PEB-referred medical condition is currently, you will need to thoroughly explain it to the TDRL re-examination clinician in terms of the criteria as annotated in 38 CFR VASRD §4.130 Schedule of ratings—Mental disorders, "General Rating Formula for Mental Disorders" showing an "Occupational and social impairment, with deficiencies in most areas..." to at least maintain your current DoD 70% rating.

Bottom line, thoroughly explain your current entire medical status situation to the TDRL re-examination clinician and hopefully with the post-active duty military available medical evidence and/or medical documentation, an informed decision is rendered which supports your current DoD 70% rating.

Oh yes, it's highly important to mention that even if the TDRL re-examination clinician suggests that your PTSD/Depression PEB-referred medical condition still warrants a DoD 70% rating, the TDRL PEB could still decide to decrease or even increase the DoD rating for whatever reason albeit it should be based upon all available post-military active duty medical evidence and/or medical documentation which supports the criteria as annotated in 38 CFR VASRD §4.130 Schedule of ratings—Mental disorders. If an unfortunate DoD rating decrease occurs, then it's most beneficial to appeal the decision with the assistance of a PEB attorney and hopefully all post-active duty military available medical evidence and/or medical documentation supports a favorable TDRL PEB appeal. Take care!

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

Best Wishes!
 
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adbarnett5

Registered Member
#3
Hey Warrior 644, thank you so much for the reply. I read your post a while ago, I have been meaning to reply to you sooner.

My paperwork written by AF physicians lines up with what you mentioned warrants a 70% rating. Everything you wrote, I planned on doing anyway when going in for my evaluations. The only thing mentioned in my paperwork is that my condition "is not stable" which I have been having problems since 2011, so who the hell knows why I received that. Anyway, my question is, what have you been doing since you been on TDRL? Seems like 3.5 years is an extremely long time to be on TDRL. I actually haven't started TDRL yet, bc my separation date is 25 Feb. I'm on terminal leave.

I am sure you understand, I don't want to be on TDRL for 5 years and am interested in however it is possible closing that timeline and being placed on PDRL. Do you still go to therapy and I'm sure you're still taking medication?
 

Warrior644

PEB Forum Veteran
Registered Member
#4
Hey Warrior 644, thank you so much for the reply. I read your post a while ago, I have been meaning to reply to you sooner.

My paperwork written by AF physicians lines up with what you mentioned warrants a 70% rating. Everything you wrote, I planned on doing anyway when going in for my evaluations. The only thing mentioned in my paperwork is that my condition "is not stable" which I have been having problems since 2011, so who the hell knows why I received that. Anyway, my question is, what have you been doing since you been on TDRL? Seems like 3.5 years is an extremely long time to be on TDRL. I actually haven't started TDRL yet, bc my separation date is 25 Feb. I'm on terminal leave.

I am sure you understand, I don't want to be on TDRL for 5 years and am interested in however it is possible closing that timeline and being placed on PDRL. Do you still go to therapy and I'm sure you're still taking medication?
Indeed, you are quite welcome! No worries; respond wherever you have the time if you so choose. :)

In retrospect, please view this URL http://www.pebforum.com/threads/sec...ility-retirement-list-tdrl.37806/#post-177638 for an update concerning placement onto the DoD military TDRL. As such, I was not grandfathered to the new TDRL time duration; therefore, it's still a full five year time frame in my particular situation unfortunately.

Historically, at this time, it would seem that quite a few of military disabled retirees placed onto the DoD TDRL for a mental disorder are receiving a DoD PDRL recommendation on their first TDRL re-evaluation. There isn't any concrete proof of my assumption other than reading other PEB Forum member's posts who mentioned receiving a "first-time" DoD PDRL adjudication. In fact, I too was offered a DoD PDRL adjudication during my initial/first TDRL re-evaluation in 2015, but I appealed the LDES PEB decision because I felt that the DoD (Army) rating was "lowballed" to 70% from the DoVA comprehensive examination results yielding a 100% rating. Hmm, am I being punished by the US. Army for not accepting their initial PDRL offer in 2015, maybe (in my opinion) but will not sign any official DoD LDES PEB documentation while placed onto the DoD TDRL that contains erroneous information!

That all said, please remember that every individual's TDRL case file is different so different results shall definitely occur. Ensure that only you decide what's best for you and your family while placed onto the DoD TDRL for a total of three year at its maximum now. For me, I have reached my maximum benefit level of medical treatment (e.g., no more behavioral health therapy & no more behavioral health classes) that can be offered for my PTSD+MDD with severe psychosis medical conditions. So, currently, I only see my DoVA Psychiatrist every three months for VA prescription medication renewal. He always ask me how I am doing and I always respond with the same answer every time for the past 3.8 years!

To that extent, I am confident that the U.S. Army's TDRL PEB shall finally render a DoD PDRL adjudication during my upcoming (e.g., third and hopefully final) TDRL re-evaluation in May 2018 since I have been awarded a DoVA P&T rating (e.g., a "permanent and stable" finding for DoD rating purposes) since December 2015. If not, I shall definitely appeal the TDRL LDES PEB decision (once again), and hopefully receive a final favorable outcome inclusive of a DoD PDRL finding with an appropriate DoD (Army) 100% rating. Take care!

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

Best Wishes!
 

Wally3430

PEB Forum Veteran
Registered Member
#6
adbarnett5---I'm in a similar situation having been put on TDRL in Oct '16 with a 50% PTSD rating and 30% asthma rating for a overall DoD rating of 70%. I'm actually just now starting the 1st TDRL re-evaluation process. For me, I've been seeing civilian provider doing group therapy nearly once a week since I was put on TDRL. Interestingly, my civilian provider says "you most definitely belong in the 70% rating category". As Warrior mentioned, DoD can adjust ratings up or down on the TDRL review if they wish. I'm hoping for a PDRL placement and a bump to 75% overall on my DoD rating (that's if they increase my 50% PTSD to 70%). I don't see my PTSD rating being boosted though because I'm not getting another C&P from the VA prior to submitting all my post-active duty treatment details to the TDRL office. Besides, DoD is under no obligation to match the VA ratings for the re-eval (could be wrong).
 

Warrior644

PEB Forum Veteran
Registered Member
#7
...Besides, DoD is under no obligation to match the VA ratings for the re-eval (could be wrong).
In retrospect, you are correct. Since being placed onto the DoD military TDRL after the official completion of the DoD IDES, all TDRL participants now fall under the DoD LDES PEB process for further re-evaluation(s) of the designated PEB-referred "unfit for duty" medical condition(s) which was(were) considered "permanent and unstable" at that particular point in time.

Moreover, the total/maximum duration of time which can be spent on the DoD TDRL has been reduced effective January 1, 2017 to three years versus the previous five years maximum limit. Unfortunately, the new law doesn't have any grandfather clause for military individuals placed onto the DoD TDRL prior to January 1, 2017 (e.g., the five year maximum limit remains/continues for those applicable particular TDRL participants). Take care!

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

Best Wishes!
 

Wally3430

PEB Forum Veteran
Registered Member
#8
Warrior---For myself and others in the same boat, what would you recommend for increasing the DoD PTSD rating resulting in a potential overall DoD rating increase (ex. 70%-to 75%)? During IDES, DoD matches the ratings VA provides. However, once on TDRL and coming up for a re-eval, DoD doesn't need to match the VA rating. In my case, my counselor believes I'm an easy 70% PTSD rating but DoD is under no obligation to increase my rating at the re-evaluation. My thoughts are to obviously provide all of my treatment records since the initial VA rating and then see if my counselor will include very specific wording regarding stability and matching wording from VASRD 70% category. Other than that, I see no way to justify to DoD increasing the rating. Assuming DoD doesn't change my rating but puts me on PDRL, I suppose I can then request another exam by the VA for a rating increase.
 

Warrior644

PEB Forum Veteran
Registered Member
#9
Warrior---For myself and others in the same boat, what would you recommend for increasing the DoD PTSD rating resulting in a potential overall DoD rating increase (ex. 70%-to 75%)? During IDES, DoD matches the ratings VA provides. However, once on TDRL and coming up for a re-eval, DoD doesn't need to match the VA rating. In my case, my counselor believes I'm an easy 70% PTSD rating but DoD is under no obligation to increase my rating at the re-evaluation. My thoughts are to obviously provide all of my treatment records since the initial VA rating and then see if my counselor will include very specific wording regarding stability and matching wording from VASRD 70% category. Other than that, I see no way to justify to DoD increasing the rating. Assuming DoD doesn't change my rating but puts me on PDRL, I suppose I can then request another exam by the VA for a rating increase.
Upon notification to perform a DoD TDRL re-evaluation from your military department's TDRL office/section via an U.S. Army perspective, you will either by assigned to the closest military installation then given a PEBLO for TDRL coordination or assigned to a civilian contractor then given a VELO for TDRL coordination. Either the PEBLO or VELO will coordinate for your attendance at the TDRL re-examination. Depending upon how your mental disorder was rated by the DoVA D-RAS when in the DoD IDES, the DoVA may be required to re-evaluate the mental disorder (e.g., within six months after becoming a military disabled veteran). Otherwise, your military department's TDRL office/section will schedule the TDRL re-examination at your closest military installation, or an assigned civilian contractor will schedule the TDRL re-examination with a civilian mental health provider then forward it to your military department's TDRL office/section.

As such, the TDRL PEB will evaluate all available medical evidence and/or medical documentation in order to determine either a TDRL or PDRL finding with a supporting DoD rating. If the TDRL PEB adjudicates a PDRL finding without increasing the DoD rating and you don't agree then you will need to submit a TDRL PEB appeal with the assistance of a PEB attorney.

At that point, you will need to decide on how to proceed. What's more important to you; placement onto PDRL and/or an increased DoD rating? You could either accept the PDRL finding (if offered) with the same or lowered DoD rating then try to request relief (e.g., an increased DoD rating) via the appropriate appellate board upon placement onto the PDRL. This course of action will probably result in a very lengthy timeframe process and the potential goal/outcome my still not be accomplished. Otherwise, you could remain on the TDRL for probably another 12 months until the next TDRL re-evaluation is scheduled. Since you were placed onto the TDRL prior to January 1, 2017, you could potentially remain on the TDRL for a maximum of five years until the designated PEB-referred "unfit for duty" medical condition(s) is(are) deemed "permanent and stable" for DoD rating purposes. Indeed, there are a lot of factors to consider while on TDRL so please decide very wisely at least in my opinion.

Bottom line is that you shall receive a TDRL re-examination whether it's performed by the military, a civilian contractor or a DoVA VBA clinician. The key is how the mental disorder DBQ is completed in accordance with the criteria as annotated in the 38 CFR VASRD. It is very vital that you thoroughly express your mental disorder symptomology to the TDRL re-examination medical clinician in the terms as stated in 38 CFR VASRD so that the medical clinician can complete the DBQ's appropriate category to properly rate your medical condition. Of course, naturally, all available medical evidence and/or medical documentation needs to support the applicable criteria as annotated in the 38 CFR VASRD also. Take care!

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

Best Wishes!
 
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acsdre44

Registered Member
#10
In retrospect, you are correct. Since being placed onto the DoD military TDRL after the official completion of the DoD IDES, all TDRL participants now fall under the DoD LDES PEB process for further re-evaluation(s) of the designated PEB-referred "unfit for duty" medical condition(s) which was(were) considered "permanent and unstable" at that particular point in time.

Moreover, the total/maximum duration of time which can be spent on the DoD TDRL has been reduced effective January 1, 2017 to three years versus the previous five years maximum limit. Unfortunately, the new law doesn't have any grandfather clause for military individuals placed onto the DoD TDRL prior to January 1, 2017 (e.g., the five year maximum limit remains/continues for those applicable particular TDRL participants). Take care!

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

Best Wishes!
You are correct "Warrior644 , I just recently got my finding from the PEB from my reevaluation findings. I retired July 2016 with a 70% rating from DOD for (PTSD) and 100% rating from the VA. My reevaluation was July 2017 and I received my findings this week from the board. I was taken off TDRL and placed on Permanent Disability Retirement at the same rating of 70% DOD. While on TDRL I continued to take my medication and go to counseling on a bi-weekly basis.
 

adbarnett5

Registered Member
#11
Thanks for the info guys. So, I'm pretty sure my symptoms are always going to be there. I still take meds. I guess I should see a Psych every three months. But do I understand correctly that since my retirement date is 25 Feb 18, that it should be 3 years max?
 

CaliGrl03

PEB Forum Veteran
Registered Member
#12
Hello All -

I too have been placed on TDRL and am curious given the concerns about the increased DoD ratings. What's the importance of an increased DoD rating so long as one is placed on PDRL?
 

Warrior644

PEB Forum Veteran
Registered Member
#13
Thanks for the info guys. So, I'm pretty sure my symptoms are always going to be there. I still take meds. I guess I should see a Psych every three months. But do I understand correctly that since my retirement date is 25 Feb 18, that it should be 3 years max?
As based upon the information you provided, then yes.

As such, if your PEB-referred "unfit for duty" medical condition(s) placing you onto the DoD TDRL is(are) not deemed "permanent and stable" for DoD rating purposes at the follow-on DoD TDRL re-evaluations, then you could be subject to remain on the TDRL for up to a maximum of three years. At such point, a final DoD LDES PEB decision will have to be made while on TDRL. It will be either fit for duty, separation with disability severance pay, or placement onto the DoD PDRL. Take care!

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

Best Wishes!
 

Warrior644

PEB Forum Veteran
Registered Member
#14
Hello All -

I too have been placed on TDRL and am curious given the concerns about the increased DoD ratings. What's the importance of an increased DoD rating so long as one is placed on PDRL?
In retrospect, placement onto the DoD TDRL occurs due to receiving at least one PEB-referred "unfit for duty" medical condition which was deemed "permanent and unstable" for DoD rating purposes while in the DoD IDES MEB/PEB process. Upon a TDRL re-evaluation, the specific PEB-referred "unfit for duty" medical condition(s) is(are) re-evaluated for a "permanent and stable" potential finding. If deemed "permanent and stable" for DoD rating purposes then the DoD shall assign a DoD disability rating in accordance with the criteria as annotated in 38 CFR VASRD.

As such, if a DoD PDRL finding is adjudicated by the DoD LDES PEB during a TDRL re-evaluation, then the DoD rating may either increase, decrease (but not lower than 30%), or remain the same. Dependent upon each military disabled veteran's military computation of active federal years of service or qualifying reserve years of service shall determine if any DoD disability retirement pay is potentially changed.

So, what's the importance? An increased DoD rating upon placement onto the PDRL could only yield a potential to receive higher DoD disabled retiree pay which is dependent upon each military disabled veteran's military pay service record as aforementioned above. Take care!

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

Best Wishes!
 

CaliGrl03

PEB Forum Veteran
Registered Member
#15
Thank You for the follow-up. That said, am I to undertand if you are placed on PDRL you are able to receive DoD AND VA compensation? I thought it was only one or the other for those of us that did not reach the 20-year mark (I'm at 13 years AD time).
 

Wally3430

PEB Forum Veteran
Registered Member
#16
Thank You for the follow-up. That said, am I to undertand if you are placed on PDRL you are able to receive DoD AND VA compensation? I thought it was only one or the other for those of us that did not reach the 20-year mark (I'm at 13 years AD time).
Unless I'm missing something, the only way you get both when medically retired under 20 YOS is if you are awarded CRSC. This is my case.
 

Warrior644

PEB Forum Veteran
Registered Member
#17
Thank You for the follow-up. That said, am I to undertand if you are placed on PDRL you are able to receive DoD AND VA compensation? I thought it was only one or the other for those of us that did not reach the 20-year mark (I'm at 13 years AD time).
Unless I'm missing something, the only way you get both when medically retired under 20 YOS is if you are awarded CRSC. This is my case.
Indeed, @CaliGrl03, you are welcome and @Wally3430 is absolutely correct.

As such, Combat Related Special Compensation (CRSC) is a program that was created for disability and non-disability military retirees with combat-related disabilities. It is a tax free entitlement that you will be paid each month along with any military retired pay you may already be receiving. CRSC is not subject to the rules and regulations governing military retired pay; therefore, full concurrent receipt (e.g., retirees can receive either part or all of both their military retirement pay and DoVA disability compensation) is authorized if you meet all the qualifications for CRSC. Take care!

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

Best Wishes!
 

jeremymays92

PEB Forum Veteran
Registered Member
#18
I would recommend taking all medication, ALL recommended treatment and do not resist them at all. In the end, they will find you "non-compliant" for recommended treatment and that won't look good for helping your case. I questioned my psychiatrist last Friday as to why the Air Force would say this in my recent TDRL Re-Evaluation findings and she was clueless. I've made all of my appointments early, taken all medicine, done psychotherapy, speech appointments, neuropsych testing, polytrauma, MRIs, done every lab they've requested of me. Sometimes at the VA all day for 3 appointments. More in my post where I'd like to dispute this false claim. For someone non-compliant, my percentage still maxed out and being retained on TDRL just makes absolute logical sense.:rolleyes: I don't like having to travel halfway across the state for treatment but I want to get better. It's at most 5 years, 3 years for the new people on TDRL since 2017. If you want to keep your benefits, your condition has to not have improved and give them no reason to question your compliance. I wouldn't say it if it did not happen to me already. If you have been unable to cope socially or be gainfully employed because of your condition, that will prove just how much effect it has on living a productive life.

Back story on my history on the TDRL...

I just received findings on a TDRL Re-Evaluation for BPD & PTSD last week. I have been on TDRL for 3 years this March. I went in 2015 for a VA evaluation for a ratings increase. I saw my rating go up by the VA. I never had any contact with the Air Force then however they somehow got a hold of that VA C&P Exam and matched the VA rating to my benefit. The VA & DOD ratings are supposed to be exclusive so I to this day am confused how the Air Force got wind of that exam in 2015 when I had no contact with them.

When I had my most recent TDRL Re-Evaluation for the AF in January, the doctor told me what her recommendation was to be placed on the Permanent Disabled Retirement List and that my condition stabilized. The Doctor who did the evaluation said she was not sure why I had not been permanently retired after that first exam and if I did not receive a permanent retirement this time, I should seek legal counsel. Also said that only once the military did not take her recommendation and it was the Marines who did not based on a mistake. Long story short, I was retained on TDRL for at least another year when I got my findings last week. They will not always go with the doctor's recommendation based on recent experience of mine. I wish I did not hear my Doctor's recommendation because my hopes were up for PDRL and wanted to move on with life. Had I not known, I'd be more at peace over the recent findings for the next year to 2 remaining before TDRL expires in my case. My percentage did not change because I was already at 100% so they told me appeal options are not on the table. I disagree with no appeal being allowed because what if I wanted to pursue PDRL or RTD? Since there was no change, not given appellate rights to fight for the desired outcome of permanent status. I am scheduled for a VA C&P exam this week despite just going through an evaluation 1 month ago.

It seems to be correct that each organization is performing their own evaluations this time around however I am still confused why the AF went with the VA's findings in '15 with no exam of their own but the VA won't use an evaluation by the DOD just performed. As if my condition has drastically changed over the course of a month. For the record, even if you get a PDRL with the military the VA can still examine you for future evaluations until it's ruled P&T. You can appeal for permanent status with them based on the DOD findings and see if that will change your VA status. That's where getting PDRL Status can pay dividends.
 
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navycop

PEB Forum Veteran
Registered Member
#19
Does a MTF or the VA do the re eval for TDRL? I should be hearing back from the board this week. With a 40 dod for my back that I've had issues with since 2010 and it will never be better.
 

jeremymays92

PEB Forum Veteran
Registered Member
#20
Does a MTF or the VA do the re eval for TDRL? I should be hearing back from the board this week. With a 40 dod for my back that I've had issues with since 2010 and it will never be better.
The Air Force, (assuming the same with the Navy) gave me the option to have the nearest MTF do the evaluation or have a VA/Civilian provider do the re-eval. The Air Force will send you guidance for a civilian/VA provider to complete the evaluation. They also said if the evaluation performed by a VA/Civilian Doctor is deemed insufficient, a military re-evaluation will be scheduled regardless. I do not know how the process works for a VA/Civilian doctor so I went with a DOD provider. Did not want to have the headache of dealing with a resident psychiatrist that I was unsure about their ability to handle something as serious as a TDRL Re-Evaluation.
 
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