Proposed Ratings ?

MissKac

MissKac

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Today my MEB packet got sent to the PEB after an appeal I requested. My appeal was denied (which is alright, I just figured it wouldn't hurt to voice my opinion) and my PEBLO said I should have my unfit memo by the end of the week. I have read on here about "proposed ratings" that people get and was wondering when this is supposed to happen. After reviewing the schedule of ratings I really have no idea what they're going to try and throw at me and a proposed rating would really help ease my mind about not knowing. Any information you have is greatly appreciated. Thanks!
 
If you have a copy of your C&P evaluation, you can match up the conditions vs. the VASRD to see what the proposed ratings should be.
 
I'm in the exact same boat. This is how I understand the process works.........After the MEB, your package goes to the IPEB. If the IPEB finds you unfit, then they request the ratings from the VA. At that point, someone at the VA takes the data from your C&P exams, compares it with the VASRD, and sends the proposed ratings back to the IPEB. The IPEB then matches up the unfitting condition(s) with what the VA ratings say and then they fill out the DA199. This gets sent to your PEBLO, who then shares this info with you.

Where I am in the dark right now is whether the VA also sends a copy of the proposed ratings directly to the service member. On the VA Ebenefits web site, my case has been closed since Feb 5th and it says "decision notification sent" but I've received nothing in the mail so far. Contrast that with my C&P exams, where I had paperwork in my mailbox less than a week after I went in for the exams.

Like gsfowler says, you should be able to match the C&P data up with the VASRD to get an idea where you "should" be ratings-wise. Looking around here and online, though, it's not a sure thing that the person at the VA who does the ratings is going to get it right. I hope in your case (as well as mine) that you are happy with whatever ratings you receive! From what I've seen, it looks like a VARR (VA Ratings Reconsideration?) request will take a long time and prolong the process quite a bit.
 
I got a copy of the VA ratings when i received the IPEB results from the PEBLO.
 
The only rating that I'm unsure about is my back (my unfitting condition) and my PTSD diagnosis. For my ROM for back I got 40 degrees forward flexion the first time and 30 the next times. So that could either be 20% or 40% which is what's confusing. Also, according to my C&P exam, I should fall into the 50% bracket for PTSD but my PEBLO told me without 6 months of consecutive treatment (I have been in and out of "treatment" since September 2013) they might not even rate my PTSD. Anybody have advice?
 
P.s. I got my "unfit" memo today and it, along with my "packet" were forwarded to the VA.
 
Rating should be based off the lowest number.

PTSD is often not unfit until it reaches a permanent status and you have reached maximum medical benefit. Generally its hard to say you've reached maximum medical benefit with less than 6 months of treatment. So unless your doc wrote it up really well it is usually fit in that scenario. That's my understanding, and it doesn't seem completely right from my understanding of the regs, so if its an important rating to you I'd just be mentally prepared for an appeal. Treatment usually speaks to how much its bothering you, but there are other ways to show its limitations. I'm of the opinion that for many the treatment is worse than the condition, especially considering how great a simple over the counter med helps (alcohol).

As far as getting a VA rating, I can personally attest that it can happen with less than 6 months of total treatment.
 
Yeah my PTSD was found fitting which I appealed. Appeal was denied and that's fine with me. I just wanted my opinion voiced that it's still an issue for me.

So initial ROM for my back was 40 degrees but after the "3 repetition test" it was 30 degrees. You're saying they should go off the 30 degree figure?
 
Why wouldn't they just take one measurement and go with it? Well, for some problems its through repeated use that things become worse. You're not gonna get a job that asks you to bend over once a day and it be a part of your job that matters. But they aren't gonna ask you to bend over for an hour to find out your disability level, that's just silly. So if they can see that after 3 movements it becomes worse, usually due to instinctive guarding tendencies, they can see that is close to your actual disability. Why they rate off where the pain starts not where the movement ends. There are ways to justify higher ratings from functional loss, but they take more paperwork and history than the C&P exam has time for.

I believe it comes out of a court case, DeLuca v Brown, that said VA has to take in account repetitive use in deciding their claims. Now the RO is supposed to get an overall picture of your disability, from C&P exams and medical notes. So there is some room for them to say the 40 degrees is a more accurate picture if that is the measurement that showed up more often, I've heard of that. I'd say that would be good for a VA appeal though.

Here's a snippet I found from a GOA report going over the VA's compliance with DeLuca:
Under VA’s quality review standards, a joint or spine exam report satisfies the DeLuca “repetitive use” criteria if the exam report indicates the extent, if any, and the number of degrees, if possible, to which range of motion is additionally limited by pain, fatigue, weakness, or lack of endurance following repetitive use. The additional functional loss may be stated in terms of either degrees of loss of motion or the additional percentage of loss of motion.
 
It's documented that my pain starts at 20 degrees though. So I can see how they would rate me at 20% and I can see how they would rate me at 40%. I'm just hoping for the latter.
 
Haha "should" right. Thanks for the help!
 
MissKac said:
Haha "should" right. Thanks for the help!
Click to expand...

My lower back was rated at 40% due to ROM numbers input on C&P paperwork. My C&P Doc did NOT use a goniometer - just eyeballed me - which is not the correct way to measure the lower back - but that's what he did. And he only had me attempt this "eyeballed" ROM test one time.

I had so many radiology reports & other evidence from those three years prior to my C&Ps, I handed the C&P Doc photocopies of all of them. He accepted all my documents (copies) & came up with numbers that were eventually rated 40%.

As I understand it, they are supposed to use a goniometer and have you do the ROM measurement test 3 X. It sounds to me like you are likely to receive 40% based on your 3 tries, your ROM numbers, and experiencing diminished results ROM numbers by the third try.

Let's hope they get this right for a change.

nwlivewire
 
I was in the same situation with the back ROM. Got my ratings last week and got 40%
 
Thanks! I got my Unfit memo and the VA received my final claim and packet on the 24th. I spoke with my MSC and he said since my initial claim was filed over 120 days ago that I am in an "expedited queue" for ratings and should have them back in 2-3 weeks at most. Keeping my fingers crossed for speedy (and accurate) ratings!
 
So here how it goes, I just recieved my proposed ratings yesterday afternoon. DOD 70% and VA is 90%, thats great great right? Now, I am a little confused on this and disorientated because, my DOD retirement pay is higher than my VA pay. Now the question is: Which one should I choose? And if I select the VA will my family still be covered under tricare? Can some one please help thanks..
 
elvinlaureano29 said:
So here how it goes, I just recieved my proposed ratings yesterday afternoon. DOD 70% and VA is 90%, thats great great right? Now, I am a little confused on this and disorientated because, my DOD retirement pay is higher than my VA pay. Now the question is: Which one should I choose? And if I select the VA will my family still be covered under tricare? Can some one please help thanks..
Click to expand...

If your DOD-unfitting injuries/conditions are not combat-related and you have less than 20 years of active service, then you will receive your full VA check and the difference above that amount in DOD pay. For simplicity's sake, you get $1000 VA and are supposed to get $1500 on DOD. You'll get $1000 from the VA and $500 from the DOD. This is a good thing, as the VA pay is non-taxable.

If your DOD-unfitting conditions are combat related and/or you have greater than 20 years of active service, then you may be able to get both full VA and full DOD at the same time (concurrent receipt) via CRSC or CRDP. There are a lot of good discussions on these forums about that.

As for Tricare, yes you and your family would still be covered.
 
No choice to make. You get both with the VA offsetting DoD disability retirement dollar for dollar. Some of the offset can be restored if CRSC eligible which you must file to receive.

Mike
 
Chuckie said:
If your DOD-unfitting injuries/conditions are not combat-related and you have less than 20 years of active service, then you will receive your full VA check and the difference above that amount in DOD pay. For simplicity's sake, you get $1000 VA and are supposed to get $1500 on DOD. You'll get $1000 from the VA and $500 from the DOD. This is a good thing, as the VA pay is non-taxable.

If your DOD-unfitting conditions are combat related and/or you have greater than 20 years of active service, then you may be able to get both full VA and full DOD at the same time (concurrent receipt) via CRSC or CRDP. There are a lot of good discussions on these forums about that.

As for Tricare, yes you and your family would still be covered.
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Chuck thanks for the reply. Sorry but I just want to make sure I have all the coorect information before I sign anything. I have to select which retirement I want. So, here is the break down:
DOD 70% $2,666 tax free.
VA 90% $1,745 w/o dep. however, I do have dep. so the amount should add up to approx $2,000 tax free.

I also qualify for CRSC. I guess to clarify my question if I select VA% will my family still get the dep. id for DOD due service connected of 30% or more.

Sorry I don't want to sound stupid I am just confused.
 
Unless your DOD is combat-related, it would be taxable.

So let's say you are at $2000 on the VA, $2666 on the DOD. You wouldn't "choose" either one, you would automatically get a $2000 tax-free check from the VA and a $666 taxable check from the DOD. And yes your family is still covered, you get all of the retired benefits on the DOD side.
 
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