Entering IDES w/ existing VA Rating or Open VA Claim

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DaveK

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Entering IDES w/ existing VA Rating or Open VA Claim

Can a service member/veteran enter the IDES process with an existing VA rating and NOT have that rating reopened/reviewed subjecting the VA rating to a possible different finding?

Yes, it appears that a service member/veteran can elect to NOT file a VA Claim during the IDES process. By not filing a new VA Claim during the process the existing VA rating will not be reviewed for rating changes. The service member/veteran must elect to only be examined by the VA via IDES for DoD purposes in their initial meeting with the Military Services Coordinator (MSC).

A VA claim that is open (no rating yet) prior to entering the IDES process will either be permitted to be rated via the VA system separately or it will be closed and replaced within the submitted claims of the IDES system. Please see the link below as there are many possible scenarios.

Active personnel are referenced as service members. Anyone not on active duty i.e. reserve and guard members are referenced as veterans in the regulation.

Many service members may make less beneficial choices should they believe that they may get a reduction in their VA ratings by going through the IDES process. I have put in a request that the option for service members/veterans to maintain an existing VA rating during the IDES be added to all presentations and general data to the Chief of the IDES process. The online community of Veterans, my state level and unit level service members, and VSOs do not seem to have clear guidance on this topic. It has taken me weeks to discover its location and confirmation.

VA Regulation M21-1, Part X, Subpart i, Chapter 6, Section K - Special Situations Related to Integrated Disability Evaluation System (IDES)

Article ID: 554400000177960

Key word searches on the below link (“decline”, “national guard”)

https://www.knowva.ebenefits.va.gov...grated-Disability-Evaluation-System-(IDES)#1e

If MODs find this information to be correct, would it be possible to “PIN” the information so that others may discover it easily?

Thank you all for the endless help you have given me.

Dave
 

DRASs must prepare a notification letter to IDES participants who have declined to file a claim for VA benefits during the IDES process. The notification letter must include the following language and be uploaded into the participant’s eFolder:

Thank you for your service to our country.

Your military Service Department requested a disability assessment from VA as part of your participation in the Integrated Disability Evaluation System (IDES). We have provided the attached proposed rating decision to your Service Department.

Our records indicate that you declined to submit a claim for VA benefits as part of the IDES program; therefore, the attached proposed rating decision will be used for Department of Defense purposes only. VA compensation will not be awarded as a result of your participation in IDES.

If you would like to submit a claim for VA Benefits, you can do so at the appropriate time. You can file a Pre-Discharge claim once you are within 180 days of your projected separation or retirement date. You can also file a VA claim at any time after your discharge from service.
 
JakeTrilla said:
Thank you for posting this.

I have had the same question in the past and this helps!
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Happy to help if I can, as everyone here helps me and others constantly. I also just discovered the below info. Definitely take a look at the below linked IDES/LDES Manual.

DoD Manual 1332.18
7.1. GENERAL. The LDES is the disability evaluation mechanism that is administered entirely by DoD to assess ill or injured Service members’ fitness for continued military service and, if unfit, the appropriate disability disposition. Unless otherwise noted below, the LDES process incorporates the same procedures as the IDES.

a. The Secretaries of the Military Departments may enroll a Service member into the LDES if:
(1) Requested by a Service member;
(2) There is a compelling and individualized reason; or
(3) A Service member refuses to claim or submit a VA disability claim for a potentially unfitting condition.

b. The Secretaries of the Military Departments may not enroll a Service member into the LDES if the Service member’s case has started the VA Disability Examination stage of the IDES process.

 
Some more relevant info. I met with a VA Admin rep at local VA HQ during my discovery process of the correct info regarding entering the IDES process with an existing VA rating. Below is that info from a VA MSC and a corresponding link discovered separately. Please note in the Army NG there are military MSC's which are separate from the VA MSC's.

“When a person is referred to a med board, he is automatically referred to the MSC. We have to perform the exam for the referred condition, if he wants to file a VA claim for anything else, we also will do the exams for any claimed conditions. If he chooses not to file a claim, he can decline to file. However, we still have to examine him for the condition he is being referred for. We will do a rating for DOD purposes and we share the rating and exam results with the DOD so the DOD board can make their determination on whether the service member is fit or unfit.

The IDES process only starts when they are referred to us by the DOD PEBLO. It is not a voluntary process.

If the condition for what the service member was referred for has been examined within 1 year and nothing has changed, the service member can write a statement that nothing has changed and we can use those exams. Now if they decline to file, our rating is for DOD purposes only and it won’t affect his rating at all. Once they decide to decline to file, we can’t reverse that decision.

The DOD has not referred his case to the VA. He will be briefed on all of this one he is referred and he will be assigned a DOD liaison and a VA MSC.”




The DRAS must prepare a proposed evaluation for PEB purposes only when there are
The proposed decision must include a clear indication that the evaluation assigned is for PEB purposes only.

Note: Evaluations for PEB purposes only must not be
  • prepared for any issue for which SC cannot be established (these conditions must be handled in accordance with M21-1, Part X, Subpart i, 6.H.2.e), or
  • indicated on final VA ratings (cases involving participants who are not on active duty that require evaluations for PEB purposes only must be handled in accordance with M21-1, Part X, Subpart i, 6.K.2.e).

 
What happens if the VA Rated you for a service connected condition and the non duty PEB rates you not service connected?
 
On face value without details of a specific case that could change things... Non-duty PEB is only for unfitting conditions that are not service connected. VA rating is for any service connected condition even if it's not unfitting by DoD PEB standards.

So a service member could be non-duty separated via PEB and also have a service connected VA rating.

The question would be should the service member have been submitted for duty vs non-duty? Is the VA rated condition also an unfitting condition by DoD standards? As an example I have a VA rating for some minor lasting damage to my wrist which I broke a lifetime ago in boot camp. While it has a VA rating, it would not be a DoD unfitting condition unless that damage stopped me from doing my job.

Another concern would be if the service member received separation pay would their circumstances require repayment of that pay before receiving any VA pay?

Please note that their are some great experts on this board. I on the other hand am just another person learning about this process as I go through it. So please double check everything I write. I'm just trying help as many others have helped me here.
 
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Want to give some points of "anecdotal" evidence.

As of this posting I personally know two individuals with prior VA ratings who, on their DA 199, received the same ratings from the DoD for their referred conditions (found unfitting).
The wording to be "evaluated for DoD purposes only" was used on their VA Form 21-4138. Their VA ratings were not affected.


If/When I receive my paperwork I will follow up with personal experience/data.
 
JakeTrilla said:
Want to give some points of "anecdotal" evidence.

As of this posting I personally know two individuals with prior VA ratings who, on their DA 199, received the same ratings from the DoD for their referred conditions (found unfitting).
The wording to be "evaluated for DoD purposes only" was used on their VA Form 21-4138. Their VA ratings were not affected.


If/When I receive my paperwork I will follow up with personal experience/data.
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The VA honored my request as well. The VA even sent a letter explaining what ratings they would have given me.
 
DaveK said:
The VA honored my request as well. The VA even sent a letter explaining what ratings they would have given me.
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Dave,
I went through an MEB in Dec 2023 and was given 100% P&T. I was then allowed to stay on active duty until I hit my 20 (Aug 2026). When I go through my final MEB this fall, are you saying I can choose LDES and keep my previously awarded 100% P&T?
 
tk87 said:
Dave,
I went through an MEB in Dec 2023 and was given 100% P&T. I was then allowed to stay on active duty until I hit my 20 (Aug 2026). When I go through my final MEB this fall, are you saying I can choose LDES and keep my previously awarded 100% P&T?
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What I was referring to was IDES and keeping ones previously awarded 100 P&T. "Evaluate for DoD purposes only".
 
DaveK said:
What I was referring to was IDES and keeping ones previously awarded 100 P&T. "Evaluate for DoD purposes only".
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Gotcha. So when I go through my final MEB, I’m still going to go through an exam for my referred condition-spine. All other exams that I had from the VA from 2023 (that resulted in 100% PT) are still good and I will not need to redo them.
 
tk87 said:
Gotcha. So when I go through my final MEB, I’m still going to go through an exam for my referred condition-spine. All other exams that I had from the VA from 2023 (that resulted in 100% PT) are still good and I will not need to redo them.
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During your initial interview with the PEBLO you can make a written statement requesting to be evaluated for DoD purposes only. You must inform them of this request at that time. They will likely reevaluate all your conditions regardless unless the original exams are less than one year old. They will then give you an estimate of the percentages you have received had you been evaluated for VA purposes as well.

I was reevaluated for lots of conditions but only the DoD unfitting were used while my original VA was left alone.
 
DaveK said:
During your initial interview with the PEBLO you can make a written statement requesting to be evaluated for DoD purposes only. You must inform them of this request at that time. They will likely reevaluate all your conditions regardless unless the original exams are less than one year old. They will then give you an estimate of the percentages you have received had you been evaluated for VA purposes as well.

I was reevaluated for lots of conditions but only the DoD unfitting were used while my original VA was left alone.
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Yeah, that’s where my hangup is. I read in the adjudication manual that you can make an exception and use DBQ’s and exams that are older than a year as long as you write a statement saying your condition hasn’t changed. Was that your experience?
 
tk87 said:
Yeah, that’s where my hangup is. I read in the adjudication manual that you can make an exception and use DBQ’s and exams that are older than a year as long as you write a statement saying your condition hasn’t changed. Was that your experience?
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Yes, and they said no only after extra months of delay. I even had some less than a year old and they still said no.
 
DaveK said:
Yes, and they said no only after extra months of delay. I even had some less than a year old and they still said no.
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What do you mean “they said no”? As in, was it the VA or DoD that wouldn’t let you reuse your previous exams?
 
tk87 said:
What do you mean “they said no”? As in, was it the VA or DoD that wouldn’t let you reuse your previous exams?
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Yes in that it is a reg. And no, they did not approve the use of any of my previous exams and all it did was cause months of delays.
 
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