PDRL Threshold Question

[zerohedge]

Hi,

I'm a 25 year active duty Navy CWO that just received PEB findings. I got proposed ratings from the PEB of 90%DOD and 100% VA and to be put on the TDRL. My unfitting conditions are 70% MH, 50% Migraines, 40% lumbar spine DDD/spondylolisthesis and 30% cervicalgia/DDD.

My question is why TDRL instead of PDRL? Was that just an admin mistake? I know MH usually goes to TDRL, but I have read on dfas and elsewhere that members with over =>30% ratings are automatically retired and placed on PDRL. Also, I've read other threads on here that said if you have 80% stable conditions, you will be placed on the PDRL. My 3 other conditions (rated stable) add up to 79% - so 80% alone without the MH.

This is somewhat time sensitive as my attorney is looking into getting the record corrected vs going FPEB and I only have 10 days. Any help is much appreciated.

 

[Provis]

Hi,

I'm a 25 year active duty Navy CWO that just received PEB findings. I got proposed ratings from the PEB of 90%DOD and 100% VA and to be put on the TDRL. My unfitting conditions are 70% MH, 50% Migraines, 40% lumbar spine DDD/spondylolisthesis and 30% cervicalgia/DDD.

My question is why TDRL instead of PDRL? Was that just an admin mistake? I know MH usually goes to TDRL, but I have read on dfas and elsewhere that members with over =>30% ratings are automatically retired and placed on PDRL. Also, I've read other threads on here that said if you have 80% stable conditions, you will be placed on the PDRL. My 3 other conditions (rated stable) add up to 79% - so 80% alone without the MH.

This is somewhat time sensitive as my attorney is looking into getting the record corrected vs going FPEB and I only have 10 days. Any help is much appreciated.

Was every condition TDRL? I would be shocked if everyone one of those was TDRL. They should list it by item.

Also, you can do the FPEB to fight for PDRL for any conditions that are TDRL. If you are trying to get that changed you need to talk to an attorney asap and work on getting medical evidence. For example if a doctor stated that your condition is stable and not expected to improve over the next 3 years that would bolster your case.

 

[zerohedge]

Thanks for the reply. Not sure what you mean. The letter lists all of my conditions, combat zone related (which some don’t state even though all should- separate issue), stable or unstable and %. Then in the explanation section it says I will be put on the tdrl.
All conditions listed as stable except MH.

My attorney is checking to see if it can be administratively corrected without going to FPEB. I’m just curious if it is blatantly wrong or if anyone has any info on how that has been adjudicated before.

 

[Jason Perry]

The below is the main reason why most mental health conditions end up with a TDRL finding:

"§ 4.129 Mental disorders due to traumatic stress.​

When a mental disorder that develops in service as a result of a highly stressful event is severe enough to bring about the veteran's release from active military service, the rating agency shall assign an evaluation of not less than 50 percent and schedule an examination within the six month period following the veteran's discharge to determine whether a change in evaluation is warranted."

38 CFR § 4.129.
You did not specify what your mental health condition is or the cause of it. Outside of the cause of the MH condition that might take it outside of the cited regulation is the issue of the length of treatment, the opinion of your medical providers, and whether or not there has been a change in your treatment such that it might impact the "stability" determination.

Under SECNAV M-1850.1, Chapter 1, Paragraph 7, a. 1 (a.)(1.) (b.):
"A Service Member with unstable conditions rated at a minimum of 80 percent who is not expected to improve to less than an 80 percent rating will be permanently retired."

If your other unfitting conditions that are stable equal 80% or more, you should be placed on the PDRL.

I think that is your case, based on the following:

50% Migraines Plus
40% lumbar spine DDD/spondylolisthesis = 70%
70% plus 30% (cervicalgia/DDD) = 79% (which rounds up to 80%).

So, my best guess based on the information you provided is that (so long as each of the above additional conditions are also stable) you should be placed on the PDRL.

I hope this was helpful and that all goes well for you. Best of luck!

 

[Jason Perry]

The below is the main reason why most mental health conditions end up with a TDRL finding:

"§ 4.129 Mental disorders due to traumatic stress.​

When a mental disorder that develops in service as a result of a highly stressful event is severe enough to bring about the veteran's release from active military service, the rating agency shall assign an evaluation of not less than 50 percent and schedule an examination within the six month period following the veteran's discharge to determine whether a change in evaluation is warranted."

38 CFR § 4.129.
You did not specify what your mental health condition is or the cause of it. Outside of the cause of the MH condition that might take it outside of the cited regulation is the issue of the length of treatment, the opinion of your medical providers, and whether or not there has been a change in your treatment such that it might impact the "stability" determination.

Under SECNAV M-1850.1, Chapter 1, Paragraph 7, a. 1 (a.)(1.) (b.):
"A Service Member with unstable conditions rated at a minimum of 80 percent who is not expected to improve to less than an 80 percent rating will be permanently retired."

If your other unfitting conditions that are stable equal 80% or more, you should be placed on the PDRL.

I think that is your case, based on the following:

50% Migraines Plus
40% lumbar spine DDD/spondylolisthesis = 70%
70% plus 30% (cervicalgia/DDD) = 79% (which rounds up to 80%).

So, my best guess based on the information you provided is that (so long as each of the above additional conditions are also stable) you should be placed on the PDRL.

I hope this was helpful and that all goes well for you. Best of luck!

Also, just my commentary, the language in the SECNAV Manual is a bit "unwieldy." It is cleaner in the DoD Instruction 1332.18 (Appendix 4 to Enclosure 3, 1.b.,:
"Service members with unstable conditions rated at a minimum of 80 percent that are not expected to improve to less than an 80 percent rating will be permanently retired."

 

[zerohedge]

Great info, I appreciate it. I have ptsd, dysthymia and TBI which they lumped together and I have been getting treatment for 18 months. I don’t think my Psych really mentions stability in the notes. I guess it will come down to which regulation supersedes the other.

 

[Provis]

Great info, I appreciate it. I have ptsd, dysthymia and TBI which they lumped together and I have been getting treatment for 18 months. I don’t think my Psych really mentions stability in the notes. I guess it will come down to which regulation supersedes the other.

From your first post I am assuming you have 25 active duty years correct? If so, the consequences are minimal regardless of the results. If your DOD% ends up higher than longevity and you have at least one unfitting condition as combat related your pension would be exempt from federal taxes. You would qualify for CRDP. So your net income should be the same & you don't need to apply for CRSC because the only time that makes sense is to get the income tax free. CRDP restores the pension offset by the VA. If that pension is exempt due to combat related designation you are set. So the PDRL vs. TDRL questions doesn't really matter unless you need that TDRL condition to ensure your DOD% ends up staying higher than your longevity earned.

 

[zerohedge]

Yes, all active duty years. My biggest concern with tdrl is the 6 month reevaluations for 3 years and the potential to be down graded. Ive heard some horror stories. Seems like pdrl would be standard since I’ll be close to 30 years at the end of that time.

I was hoping to be done with all this and since the law supports it I think I will appeal. Although the uncertainty and difficulty of the process makes it very tempting to just accept it as is and move on.

 

[Provis]

Yes, all active duty years. My biggest concern with tdrl is the 6 month reevaluations for 3 years and the potential to be down graded. Ive heard some horror stories. Seems like pdrl would be standard since I’ll be close to 30 years at the end of that time.

I was hoping to be done with all this and since the law supports it I think I will appeal. Although the uncertainty and difficulty of the process makes it very tempting to just accept it as is and move on.

If you are maxed DOD% without the TDRL condition they will waive it and put you on PDRL orders since the TDRL condition will have no bearing on your final results

 

[zerohedge]

Okay, sorry to keep beating this horse, but this is great feedback. At what stage in the process will the waiver happen? Because as of now the proposed rating letter from the PEB says I will be placed on the tdrl.
Are you saying I need to go forward with the FPEB and they will waive it?
Or NAVPERS will waive it when they cut my retirement orders? I’d be signing that I agree with the findings to include tdrl so what assurance would I have?

 

[Provis]

Okay, sorry to keep beating this horse, but this is great feedback. At what stage in the process will the waiver happen? Because as of now the proposed rating letter from the PEB says I will be placed on the tdrl.
Are you saying I need to go forward with the FPEB and they will waive it?
Or NAVPERS will waive it when they cut my retirement orders? I’d be signing that I agree with the findings to include tdrl so what assurance would I have?

This is technical stuff. You should discuss with your assigned IDES legal representative.

 

[zerohedge]

Okay, thanks. I have and it seems like a gray area that can’t be determined ahead of time. Due to time constraints, I’m leaning towards accepting tdrl.
My second issue is combat related injuries. The IPEB only listed combat related on the ptsd. My other stable conditions are chronic from repetitive blasts and impacts during combat training, deployments, combat operations etc and the evidence was in the original MEB package.
Should the combat/combat related designation be next to each unfit condition or do they usually only list it next to one?
I have 70% for combat related ptsd but the other conditions total 80%. Is this worth fighting for or would it not change anything?

Also, if I defer, how hard is that to correct after I retire?

 

[Provis]

Okay, thanks. I have and it seems like a gray area that can’t be determined ahead of time. Due to time constraints, I’m leaning towards accepting tdrl.
My second issue is combat related injuries. The IPEB only listed combat related on the ptsd. My other stable conditions are chronic from repetitive blasts and impacts during combat training, deployments, combat operations etc and the evidence was in the original MEB package.
Should the combat/combat related designation be next to each unfit condition or do they usually only list it next to one?
I have 70% for combat related ptsd but the other conditions total 80%. Is this worth fighting for or would it not change anything?

Also, if I defer, how hard is that to correct after I retire?

It always better to fight it now than later. Things like combat related aren't easy to change after the fact. Your service designates each condition as combat related. If the other unfitting conditions = 80% they should put you on PDRL because the PTSD TDRL condition wont affect your final rating. Its up to you but I would push back on that. If other unfitting conditions should be combat related you can contest them with a FPEB. If you go that route might as well argue that PTSD should be PDRL too.

Or you can just concur since non of this is really going to make a difference financially. If you have one combat related condition then your pension is tax exempt from federal taxes and since you have 20+ years you qualify for CRDP to receive up to your longevity earned + VA compensation.