I am 100% P&T (mental health), can I start work without concerning of a possible re-eval or reduction?

brohammer

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I am finding very conflicting information on this. I want to work, I have been out of work for 6 months, I had one job after the military and I lost it due to the disability. I feel as if I am in a decent enough place mentally to start work, I recently received a tentative offer for employment for a GS-9 job, however this is a one-year term job. My concern is if I take this job, am able to keep it for the year, this could be used as 'material' evidence that I have improved in my condition(s). I am going through a counselor through the VA and seeing a psychiatrist, if I started work, they would be well aware. So I am worried that since I may be able to keep the job for a year, my rating could be re-evaluated and I could also be unemployed in the same time frame as it is a term job. I understand that even with a permanent rating, the VA can still re-rate your conditions at any time.

I am also 100% DoD PDRL. Ive had both these ratings for a short period of time (about 4 months). I don't want to lose them because, due to my diagnosis and the fact that my security clearance was taken away, I have lost a LOT of job opportunities, particularly jobs that I am interested in, so I feel like I need to be careful when seeking employment. I can't work any job that was related to my military job due to the clearance issue, and many GS jobs that I am interested in require a SEC or above clearance. I also cannot go into firefighting, law enforcement, commercial flying, truck driving, heavy equip, because of my medical background. I am very limited in the jobs that I can and WANT to do. I want to approach this carefully, so I don't shoot myself in the foot. I don't feel as if I have to just take whatever job I can get, because of the conditions that were caused by the military, and potentially lose the compensation.

Lastly, I am curious what 'gainful' employment implies...is a term job considered substantially gainful employment? Since it is limited to one year, am I taking a risk but accepting the job?
 
Not typical especially if you are 100% P&T and not IU. It's that some believe it's unethical because a maxed out MH rating means "total occupational and social impairment" which in the worst case could possibly come up on a CUE if you had long term employment but I have yet to see it happen. Not trying to scare you just letting you know all the possibilities. Substantial gainful employment is usually around 13k a year but that is only for vets getting TDIU if you fall under that and go over annual threshold the VA will send you out a letter for a reduction.
 
Total occupational and social impairment means that you don’t know your own name or profession.... it’s difficult to say that you are 100% for mental health but can somehow miraculously work.


Total occupational and social impairment, due to such symptoms as:
gross impairment in thought processes or communication;
persistent delusions or hallucinations; grossly inappropriate
behavior; persistent danger of hurting self or others; intermittent
inability to perform activities of daily living (including maintenance
of minimal personal hygiene); disorientation to time or place; memory
loss for names of close relatives, own occupation, or own name 100%.
 
Total occupational and social impairment means that you don’t know your own name or profession.... it’s difficult to say that you are 100% for mental health but can somehow miraculously work.


Total occupational and social impairment, due to such symptoms as:
gross impairment in thought processes or communication;
persistent delusions or hallucinations; grossly inappropriate
behavior; persistent danger of hurting self or others; intermittent
inability to perform activities of daily living (including maintenance
of minimal personal hygiene); disorientation to time or place; memory
loss for names of close relatives, own occupation, or own name 100%.



Without going into the full extensive details of how I got such a high rating, I can assure you with 100% certainty that my medical records were over exaggerated by the doctors giving me the diagnosis following my deployment and medevac. I don't believe my diagnosis was correct (to my viewpoint). It felt like it was an agenda to ensure I was kicked out and lose my TS clearance. My NARSUM was written like I was fit for a straight jacket, while only displaying symptoms of a psychotic nature for a period of 5 days, they applied it to make it seem like a lifelong issue and gave me a diagnosis before the proper period of observation had surpassed. I talked to a lawyer and he told me I had no proof to fight the diagnosis, so I just let it be. I was also taken off medication before I got out of the military, because my counselor and pysch thought I may be able to return full duty, despite having a 70% rating.

After my separation, at my first job, I stated having strange behavior occur, details of my deployment and details of my medical record were known amongst my co-workers without me telling anyone. I was harassed daily by everyone, people were attempting to sabatoge my work, there was a lot of mind games, it felt like a military op was occurring to ruin my life and continue interrogating me from what happened during my deployment, I started to have troubles sleeping again, I was threatened by co-workers, I start to lose my ability to function properly and I eventually had a seizure. I was medevaced out to a military hospital, I am not even sure how they knew I had insurance through the military, I did not tell anyone or claim disabilities when applying for the job (it was on an oilfield). I ended up losing the job and I had a re-evaluation not long after.

It came back as 100% p&t and I was surprised. I told the examiner what had happened at my first job and I think they just took it all is if I was hallucinating or having delusions. I know for sure these things happened, but no one believes me. I think a few of the events I misperceived, due to has happened in the past, but most if it actually happened. The only things that I suffer from on a consistant basis is depression and anxiety, I tried to take my life once after getting out, I never told anyone though. I have exp delusions and hallucinations in very short periods, it is not persistant. but that is how they wrote it. I have had only 2 occasions of it occurring and it was no longer than a week each time for delusions, and hallucinations were very short lived when I was ext sleep derprived.

As of now I have no psychotic symptoms that I am aware of, the depression is getting better with some meds, I am starting to feel more confident in myself and my abilities. I sometimes get paranoid that the gov is monitoring me and trying to sabatoge job opportunities, but I have worked through that as well.
 
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Not typical especially if you are 100% P&T and not IU. It's that some believe it's unethical because a maxed out MH rating means "total occupational and social impairment" which in the worst case could possibly come up on a CUE if you had long term employment but I have yet to see it happen. Not trying to scare you just letting you know all the possibilities. Substantial gainful employment is usually around 13k a year but that is only for vets getting TDIU if you fall under that and go over annual threshold the VA will send you out a letter for a reduction.

What is a CUE? What would long term employment be considered, would 1 year be considered long term employment? Is going to school considered unethical as well?
 
I’ve been rated 70% for MH. I’ve had delusions too. I was absolutely certain on two different occasions six months apart that my wife was trying to poison me!! I KNEW it to be the truth... until far later when properly medicated I realized that it was preposterous to think that she was trying to poison me. I get it. MH sometimes seemingly purposely gets it wrong, for me they always seemed to downplay my symptoms and I had to push them very hard for them to take me seriously. Sometimes I GD to get mad and yell at my psychiatrist (because he refused to prescribe sleep meds and I had been going with 0-2 hours sleep per night for months).

It’s great that you are PT! You can now go to civilian psych doctors through tricare. I did and what a relief! They prescribed trintellix since SsrIs only make me much worse. They can prescribe meds that “aren’t in the Va formulary”.

I’d say dump VA for mental health. I did and I am glad I did.
 
I’ve been rated 70% for MH. I’ve had delusions too. I was absolutely certain on two different occasions six months apart that my wife was trying to poison me!! I KNEW it to be the truth... until far later when properly medicated I realized that it was preposterous to think that she was trying to poison me. I get it. MH sometimes seemingly purposely gets it wrong, for me they always seemed to downplay my symptoms and I had to push them very hard for them to take me seriously. Sometimes I GD to get mad and yell at my psychiatrist (because he refused to prescribe sleep meds and I had been going with 0-2 hours sleep per night for months).

It’s great that you are PT! You can now go to civilian psych doctors through tricare. I did and what a relief! They prescribed trintellix since SsrIs only make me much worse. They can prescribe meds that “aren’t in the Va formulary”.

I’d say dump VA for mental health. I did and I am glad I did.


Well that's the thing, I can look back and know what was delusions and what was real. I know that I was harassed and there was an agenda to get rid of me during my hospital stay following my deployment. But there is nothing that can be done now and there is no way I will ever serve again. I did believe I thought I may had been drugged at my second job, because moments before having my seizure I drank something and immediately after started feeling bizarre, feelings of euphoria, having strange thoughts (like jesus was talking to me) and then had a seizure. I can look back and realize that I was unlikely drugged, and it happened due to lack of sleep, stress, not eating well, being hydrated etc. I still believe my co-workers were trying to sabatoge me and the gov was conspiring against me, working with the corp I was working for, monitoring my phone etc. I don't think I will ever think differently about that.

Anyways, do you need Tricare prime to go to a civilian doc? Does the VA get ahold of those records? I have Tricare select right now. I didn't want to see military docs after what happened following my deployment. A civilian doc would be nice.

In your opinion, do you think me taking that term job is a good idea or bad?
 
I don’t see Va docs any longer because they refuse to prescribe me even basic drugs like high blood pressure and cholesterol meds. So I had to go use tricare because my BP was as high as 186/121.... that’s like an imminent stroke waiting to happen!!!

So from what I understand your PT with no future exams scheduled means you can go see whoever the hell you want and it’s highly unlikely that they’ll ever see those records. I have tricare for life but I use tricare prime remote because my wife is still active duty and as a dependent I don’t have any copays.
 
Let me give you some advice on how this works, all you have to do is write the VA VARO where your claim is handled and tell them you want a reduced rating where you feel it is adequate. Trust me, they will be more than happy to reduce it down for you. You just need to give your reasoning why. I agree with the others here at 100% MH nobody should be working, it would be like walking into a random business office and the unkempt filthy employee you speak with is so incoherent and drooling all over themselves and the computer keyboard and yelling at you for no reason. That is basically the translation of that 100% MH rating. Would that person be employed, NO.

Now if you wanted a higher rating, good luck fighting the VA, but they will reduce it. MH ratings upset me because so many people fidged them and are working full time jobs at 100% rate while for example the ratings of spine is soooooo outdated and screwed up that a person who is paralyzed to some extent and in horrendous pain gets maybe 30%. My magic ball see's a crap-load of MH re-evals coming real soon. Where I am rated, is low, for the severity I have but in most cases by the rating rules I can't say that I truly should be much over them, just the next one up. I am an honest person with real service injuries. How the admin clerk got out and is 100% P&T for seeing a dead body in the rear of the rear of the rear, while the grunt who got shot and blown up fights for a 10% rating beats the living poop out of me. The system is F'd for MH. I don't know about you personally, but it sounds like you feel you are overrated.
 
@GUNS'N'STUFF

I really don't see a bunch of evals coming they just amended the rules to reduce re evals and so many vets bitterly fight for P&T status to avoid future evals as well. Just to provide some context here with MH ratings I see serious problems with secondary depression claims to just about ANY physical condition. I have seen what severe back problems do to peoples lives mentally as well as really bad knees but secondary depression from headache, gerd, ibs, ankles, hips, elbows, and fingers is a little excessive IMO. I notice depression is almost primarily used when the service member has no evidence of a MH condition in their service record and since MH ratings can be so high many shoot for it. I would love to see how many depression claims are actually secondaries and not direct in a future report from the VA.
 
I don’t see Va docs any longer because they refuse to prescribe me even basic drugs like high blood pressure and cholesterol meds. So I had to go use tricare because my BP was as high as 186/121.... that’s like an imminent stroke waiting to happen!!!

So from what I understand your PT with no future exams scheduled means you can go see whoever the hell you want and it’s highly unlikely that they’ll ever see those records. I have tricare for life but I use tricare prime remote because my wife is still active duty and as a dependent I don’t have any copays.


Hi Tony- I am very interested in what you are discussing about seeing paychiatrists outside of VA—- but I don’t want to hijack broham’s thread. Can we chat?
 
@GUNS'N'STUFF

I really don't see a bunch of evals coming they just amended the rules to reduce re evals and so many vets bitterly fight for P&T status to avoid future evals as well. Just to provide some context here with MH ratings I see serious problems with secondary depression claims to just about ANY physical condition. I have seen what severe back problems do to peoples lives mentally as well as really bad knees but secondary depression from headache, gerd, ibs, ankles, hips, elbows, and fingers is a little excessive IMO. I notice depression is almost primarily used when the service member has no evidence of a MH condition in their service record and since MH ratings can be so high many shoot for it. I would love to see how many depression claims are actually secondaries and not direct in a future report from the VA.
It is uncertain if this will occur of course, but judging all the hell the VA has put me through I wouldn't trust anything they say or claim to amend, they make their own rules against the rules they have to follow. I am talking about 100% MH and who are working full-time. Several years ago I was even asked that during a rating exam, if I was working. That should be none of their damn business but they now even have access to cross reference screens now with Treasury and SSA to see if someone is working (VARO). I forget the exact term I used when I was working gov't but had access to all of that info. (system interface) But that is very debatable, myself as an example again, my earnings in life were squashed from my injuries and that doesn't mean I am any less capable like the rest of the guys and if I didn't suffer I would be very well financially off, because otherwise very capable. Now, I should be PTSD connected above 50% myself, but for me, I didn't have any guidance to what that even was when I got back from war after 9/11 back when everyone was listed as personality disorder. You can't have depression and PTSD at the same time rated as it is considered one organic body part I understood? I didn't know you could have PTSD and depression together with depression being filed as a secondary? Maybe a little excessive is Concurrent Receipt for BS sleep apnea with a machine at 40%, heck, I have that from service, my wife though I was going to die numerous times while asleep, never rated. Maybe a little excessive is also retirees who slam dunk CRDP, CRSC and VA all at 100% unless they were in combat at the end I don't see how anyone could be eligible, I mean you make it say 19 years and physically qual. for re-up and the last year you are rated like that in an admin job or something. Yes, there could be circumstances, but other than that, BS.

Now, don't get me wrong, like myself, I don't think there should be any rules preventing veterans from working full-time with MH problems, I think it is good for the health. However, I am just pointing out the definitions for the ratings and at 100% for MH, you gotta be pretty much be a vegetable. Like I was saying though, the spine is rated way too low. Why, most SC rated condition (or one of them) = money and by VA terms $ in my opinion will also = MH claim re-evals. Can you also expand with references to your "they just amended the rules to reduce re evals " ?
 
Hi Tony- I am very interested in what you are discussing about seeing paychiatrists outside of VA—- but I don’t want to hijack broham’s thread. Can we chat?
Yes you can PM me
 
Gun'N'Stuff,

Re: "Maybe a little excessive is Concurrent Receipt for BS sleep apnea with a machine at 40%, heck, I have that from service, my wife though I was going to die numerous times while asleep, never rated. Maybe a little excessive is also retirees who slam dunk CRDP, CRSC and VA all at 100% unless they were in combat at the end I don't see how anyone could be eligible, I mean you make it say 19 years and physically qual. for re-up and the last year you are rated like that in an admin job or something. Yes, there could be circumstances, but other than that, BS. "

I wish you success in your claim/application process.

I do think one can make their case for deserved benefits without characterizing the disabilities of others as undeserving for VA compensation, CRDP, and/or CRSC.

In fact, the laws passed by our elected representatives that pertain to CRSC for example, do not require a person to even be in a combat zone when their disability was formed. Additionally, not all those disabilities are present at time of retirement or discharge. They can be first evident years later and if a nexus to their service can be proved, then there is a possibility that service-connection will be approved.

Eligibility
To qualify for CRSC you must:
  • be entitled to and/or receiving military retired pay
  • be rated at least 10 percent by the Department of Veteran’s Affairs (VA)
  • waive your VA pay from your retired pay
  • file a CRSC application with your Branch of Service
Disabilities that may be considered combat related include injuries incurred as a direct result of:
  • Armed Conflict
  • Hazardous Duty
  • An Instrumentality of War
  • Simulated War
Link to combat-related examples and other CRSC information: ------>LINK

Like thousands of other Vietnam veterans, I developed diseases that were presumptively caused by exposure to Agent Orange while serving in Vietnam. Although I was not an 11B PMOS, I spent a year in one of the most heavily sprayed (Agent Orange) areas of Vietnam during the war. Twelve provinces were the most heavily sprayed with Agent Orange during the war. Ten of them cluster around one of the three air bases that became the most contaminate with dioxin: Da Nang, Phu Cat and Bien Hoa.

One of my friends from my hometown in West Texas was killed when when a field cooking stove blew up in Thua Thien Province, RVN.
If my friend who was a cook, had lived, he likely would have qualified for many of the benefits discussed here.

I continue to hope every veteran receives the benefits they deserve, irrespective of MOS or mission.

Regards,
Ron
 
Gun'N'Stuff,

Re: "Maybe a little excessive is Concurrent Receipt for BS sleep apnea with a machine at 40%, heck, I have that from service, my wife though I was going to die numerous times while asleep, never rated. Maybe a little excessive is also retirees who slam dunk CRDP, CRSC and VA all at 100% unless they were in combat at the end I don't see how anyone could be eligible, I mean you make it say 19 years and physically qual. for re-up and the last year you are rated like that in an admin job or something. Yes, there could be circumstances, but other than that, BS. "

I wish you success in your claim/application process.

I do think one can make their case for deserved benefits without characterizing the disabilities of others as undeserving for VA compensation, CRDP, and/or CRSC.

In fact, the laws passed by our elected representatives that pertain to CRSC for example, do not require a person to even be in a combat zone when their disability was formed. Additionally, not all those disabilities are present at time of retirement or discharge. They can be first evident years later and if a nexus to their service can be proved, then there is a possibility that service-connection will be approved.

Eligibility
To qualify for CRSC you must:
  • be entitled to and/or receiving military retired pay
  • be rated at least 10 percent by the Department of Veteran’s Affairs (VA)
  • waive your VA pay from your retired pay
  • file a CRSC application with your Branch of Service
Disabilities that may be considered combat related include injuries incurred as a direct result of:
  • Armed Conflict
  • Hazardous Duty
  • An Instrumentality of War
  • Simulated War
Link to combat-related examples and other CRSC information: ------>LINK

Like thousands of other Vietnam veterans, I developed diseases that were presumptively caused by exposure to Agent Orange while serving in Vietnam. Although I was not an 11B PMOS, I spent a year in one of the most heavily sprayed (Agent Orange) areas of Vietnam during the war. Twelve provinces were the most heavily sprayed with Agent Orange during the war. Ten of them cluster around one of the three air bases that became the most contaminate with dioxin: Da Nang, Phu Cat and Bien Hoa.

One of my friends from my hometown in West Texas was killed when when a field cooking stove blew up in Thua Thien Province, RVN.
If my friend who was a cook, had lived, he likely would have qualified for many of the benefits discussed here.

I continue to hope every veteran receives the benefits they deserve, irrespective of MOS or mission.

Regards,
Ron
I am 100% for everyone getting what they are entitled to after serving. My whole point is that there was a time before CRDP and CRSC where command leadership intentionally would "F" troops and soldiers from healthcare because they would potentially be entitled to VA benefits [potentially] where the lifers would only have retired pay which would be somewhat close in by deduction dollar-for-dollar of what those veterans would receive by VA compensation monthly. You know what, those military types screwed over a lot of people and are the same ones to game the sleep apnea. Things like that which irritate me. And, keep in mind what I mentioned about being physically qualified. I saw so much of these sorts of things done to Marines it would cause most people to jump off a cliff - all because of greed - the mighty dollar. This while the field grunts are getting all screwed up and admin can go into clinic for a paper-cut. You can plead that service connection injuries can show up years after service all you want, good luck trying to prove that to the VA. Agent Orange is one thing.

As far as CRSC, even if you went to medical they wrote hardly anything. So your up against a Goliath of a fight.
 
As I stated, "They can be first evident years later and if a nexus to their service can be proved, then there is a possibility that service-connection will be approved." [emphasis added]

An example would be my case. I became concerned about my heart rate being around 40 bpm while on active duty. One of the few times I went on sick call for for that matter...this was around 1985. I was told that it "might be" due to the fact I was in great shape as the result of running 2,000 miles a year (I was a competitive runner.) In 1996, five years after I retired, my heart rate dropped to 20 bpm and I was not in good shape. I had bradycardia as the result of sick sinus syndrome. My VA claim was approved due to the nexus of its existence while I was on AD.

You mentioned the "lifers" of a certain era. I was not a "lifer" but I was a career soldier 1966-1991. I never observed the type behavior you described as, "...those military types screwed over a lot of people..." Of course, this was the Army not the Marines so I have no knowledge about how the Marines handle matters, except that I am an admirer of the USMC.

My point is that it is better to focus on what we can do to better our chances of receiving a favorable determination in our claims and applications.

Good luck going forward...

Ron
cc: @Jason Perry
 
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Let me give you some advice on how this works, all you have to do is write the VA VARO where your claim is handled and tell them you want a reduced rating where you feel it is adequate. Trust me, they will be more than happy to reduce it down for you. You just need to give your reasoning why. I agree with the others here at 100% MH nobody should be working, it would be like walking into a random business office and the unkempt filthy employee you speak with is so incoherent and drooling all over themselves and the computer keyboard and yelling at you for no reason. That is basically the translation of that 100% MH rating. Would that person be employed, NO.

Now if you wanted a higher rating, good luck fighting the VA, but they will reduce it. MH ratings upset me because so many people fidged them and are working full time jobs at 100% rate while for example the ratings of spine is soooooo outdated and screwed up that a person who is paralyzed to some extent and in horrendous pain gets maybe 30%. My magic ball see's a crap-load of MH re-evals coming real soon. Where I am rated, is low, for the severity I have but in most cases by the rating rules I can't say that I truly should be much over them, just the next one up. I am an honest person with real service injuries. How the admin clerk got out and is 100% P&T for seeing a dead body in the rear of the rear of the rear, while the grunt who got shot and blown up fights for a 10% rating beats the living poop out of me. The system is F'd for MH. I don't know about you personally, but it sounds like you feel you are overrated.


Here is the thing though, they took my security clearance, they took my security clearance, they took my security clearance!!! Only .01% of clearances are taken from a mental health diagnosis.

Given what I did in the military, my career has been completely destroyed outside the military as well and I also can’t get most GS jobs, I can’t work in law enforcement (my undergrad degree was geared towards that) I can’t be a commercial pilot, I can’t be a firefighter, I can’t be an investigator, I can’t be a truck driver or heavy equipment operator. Any job that I want to do, I can’t. My service was highly invalidated between the diagnosis and the my clearance being pulled. You say people with 100% rating shouldn’t be working? Yeah sure, but the government also should not be influencing doctors to conduct malpractice and destroy people’s lives.

Do I think my rating is too high? In a sense, I don’t believe what was written of me by the military docs was accurate and was inflated. There was an obvious agenda to get me kicked out and lose my clearance, military docs, not me, wrote all kinds of falsehoods about my condition. They also gave me a diagnosis before the timeframe of the diagnosis had passed and then held me in the hospital to meet the criteria. The agenda was blatantly obvious. There is no way I’m going to try to reduce my rating, my life has been absolutely destroyed from all of this. Also, I was followed by the gov to my first job, where they leaked information to my co-workers about my deployment and health information which made them harass and sabatoge me. I lost that job because of it.

Either I am actually batshit crazy or the gov did what I thought they did and sabatoged my second career path. In either case I SHOULD be compensated.
 
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I wouldn't worry to much then, if you could only can see what the military unit command did to me and my medical records would make your situation look like small potatoes. In fact, I even tried to post up before on a forum about it and people called me out like I am a liar. Yeah, because it was that bad, it is unbelievable. You are in a situation that can be corrected if you work hard at it as previous advise has pointed out, but that is entirely up to you.
 
As I stated, "They can be first evident years later and if a nexus to their service can be proved, then there is a possibility that service-connection will be approved." [emphasis added]

An example would be my case. I became concerned about my heart rate being around 40 bpm while on active duty. One of the few times I went on sick call for for that matter...this was around 1985. I was told that it "might be" due to the fact I was in great shape as the result of running 2,000 miles a year (I was a competitive runner.) In 1996, five years after I retired, my heart rate dropped to 20 bpm and I was not in good shape. I had bradycardia as the result of sick sinus syndrome. My VA claim was approved due to the nexus of its existence while I was on AD.

You mentioned the "lifers" of a certain era. I was not a "lifer" but I was a career soldier 1966-1991. I never observed the type behavior you described as, "...those military types screwed over a lot of people..." Of course, this was the Army not the Marines so I have no knowledge about how the Marines handle matters, except that I am an admirer of the USMC.

My point is that it is better to focus on what we can do to better our chances of receiving a favorable determination in our claims and applications.

Good luck going forward...

Ron
cc: @Jason Perry
Ok, maybe you can give us all some pointers on how to establish a nexus then.
 
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