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Periodic Examination after 4.5 years on TDRL Questions

Baldazzer

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Hello,

I was medically retired (TDRL) July 2016 from the Army after completing IDES and boards. The Army and VA rated my qualifying "unstable" condition at 70% for "major depressive disorder with anxiety disorder" (MEB Dx 1 & 2) (Army) / postraumatic stress disorder with major depressive disorder and alcohol use disorder (VA). My condition was deemed "combat related" and I applied for and receive CRSC. My combined disability rating at the VA was determined at 100%, though not P&T. I was reevaluated in 2017 and my 70% mental health rating was continued. I have not worked since retirement and have been a frequent consumer of VA mental health services and medications for my conditions, with no real improvement.

This January, the VA sent me a decision letter stating that my PTSD/Depression/Alcohol use disorder rating was maintained at 70 percent after a "special review" of my file. The latter also states that my condition is not subject to a future review examination (38 CFR 3.327). The letter also awarded me basic eligibility to Dependents' Educational Assistance and stated this is only awarded for P&T disability. A print of my VA benefits confirmation letter shows I am now 100% P&T as of 5 January, 2021.

Shortly afterwards, the Army Physical Disability Agency contacted me to inform me they are scheduling me for a "periodic examination". I assume this is because my 5 year TDRL limit will arrive July 2021. I have been assigned a PEBLO and we have been corresponding regarding the upcoming, but unscheduled, exam. I mentioned that the VA recently made a decision on my qualifying condition and sent them the letter, hoping it would satisfy their requirements and I would not have to endure another exam, and I provided a copy of the recent decision letter. The PEBLO informed me that the letter was inadequate as it was based upon a "records review" was not the result of an actual exam.

I am concerned that they are not accepting the VA continuation of my rating because there is an agenda to reduce ratings and retirement benefits paid. I simply don't trust the Army to have my interests at heart. I don't believe a 2 page questionnaire and 30 minute phone interview are sufficient for evaluating impacts from my mental health state. I am fearful of a loss of financial resources for my family in this time when my wife has been unemployed for months due to the pandemic. I realize that I have no choice but to cooperate but I am wondering the following:

1: My PEBLO says she is requesting my medical records from the VA since my last exam in 2017. Should I also get copies in case that gets screwed up?

2: Is it recommended to seek outside counsel at this time (pre-exam)? I am concerned about the quality of representation I may receive from the Office of Soldiers' Counsel (although my initial representation at retirement was good). I am also worried that if I wait for findings, it will be too late to mount a proper response.

3: If the Army reduces my rating to a lesser percentage, is it common for the VA to use this as reason to reduce their rating as well? I know that P&T ratings can still be modified.

4: If the Army reduces my rating to a lesser percentage, can that affect the amount of CRSC that I receive? I recall that CRSC amount was based upon my VA rating rather than the Army rating, but I am still concerned.

Thank you for your insights and assistance.
 

RonG

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Hello,

Re:
3: If the Army reduces my rating to a lesser percentage, is it common for the VA to use this as reason to reduce their rating as well? I know that P&T ratings can still be modified.

4: If the Army reduces my rating to a lesser percentage, can that affect the amount of CRSC that I receive? I recall that CRSC amount was based upon my VA rating rather than the Army rating, but I am still concerned.

Comment for 3: No, it is not common. I would not worry about it.

Comment for 4. Actually, it is more complex than what you state.
a. Your retired pay is reduced dollar for dollar in the amount of VA compensation received. It does not appear that the VA amount will change.
b. CRSC replaces some or all of the waived retired pay shown at 4-a. It can not exceed the dollar amount of the longevity portion of retired pay. It also can not exceed the amount of reduction/waiver. And...it cannot exceed the dollar value using the VA comp tables for the CRSC percentage and number of dependents approved by your service.
c. The part in bold likely applies to your case (ref: 4-b)
d. The CRSC may or may not be reduced due to the amount of retired pay you receive in the future. Since we do not know the new DoD percentage, it is impossible to give you a forecase. Other info would be needed. You can look at almost any of the hundreds of CRSC computations on this board to see the info necessary (which you do not have at this time...my inference.

Ron
 

Baldazzer

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Thank you for this. #3 is my biggest worry at this point. The CRSC is certainly complex. My read of your explanation tells me that if my DOD percentage is reduced, then my longevity portion of retired pay would also be reduced and that may result in a reduction of CRSC. I guess I will just have to wait for the process to play out.
 

RonG

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Thank you for this. #3 is my biggest worry at this point. The CRSC is certainly complex. My read of your explanation tells me that if my DOD percentage is reduced, then my longevity portion of retired pay would also be reduced and that may result in a reduction of CRSC. I guess I will just have to wait for the process to play out.
Hello @Baldazzer

Your potential reduction of retired pay will not affect the longevity portion of retired pay UNLESS the new DoD retired pay results in gross pay that is less than the longevity portion of retired pay.

The longevity portion of retired pay is basically static.
Active Duty or Active Duty Equivalent years (& partial yrs/months) x 2.5% = longevity multiplier This multiplier does not change even if you DoD retired pay is reduced.
Average high three base pay x longevity multiplier = longevity portion of retired pay.
Note: The Blended Retirement uses 2% rather than 2.5%.

Good luck,
Ron

Edited to add:
You said: "then my longevity portion of retired pay would also be reduced and that may result in a reduction of CRSC."

No...the retired pay might change but the percentage that is considered "longevity" will not change.

If the longevity multiplier is 31.75% (number picked at random), it is the same percentage regardless whether the Retired Pay is $4000 or $2500.
The formula: Average high three base pay x longevity multiplier = longevity portion of retired pay.
IF the gross retired pay (average high three x DoD disability percentage) becomes less than the longevity formula allows, then that lesser amount becomes one of the ceilings.
There are other ceilings that do not come into play at this time and likely will not be applicable.
 
Last edited:

oddpedestrian

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You have to just wait it out I also retained outside legal counsel because a reduction in my DoD rating was out of the question it was all premature they continued my rating and offered PDRL I accepted. Its really up in the air if the DoD wants to make you go to exam or not they can also do what the VA did and do a records review but its at their discretion I think an actual exam would be better for you overall, just an educated guess.
 

Baldazzer

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Thank you for sharing your experience. Maybe I am worrying too much about this. Despite being told the exam would be in April, my PEBLO left a VM yesterday afternoon asking if I could do the exam (by phone) this morning, or to reschedule soon. I was busy and did not respond yet but it looks like they are hot on it to get me evaluated sooner.
 

chaplaincharlie

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As hard as it sounds, you have to wait out the process. If the the DoD rating is reduced there are appeal mechanisms. Do not agree to a reduction without first consulting legal counsel.
 

Baldazzer

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Thank you. I will complete the exam and review the results. Hopefully there will be no need for appeal.
 
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