TDRL Expiration

CParker

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Good afternoon, and apologies if this is in the wrong section.

I am a medically retired Personnel Specialist (Navy). I was diagnosed with Ulcerative Colitis roughly 6 months after developing symptoms while deployed. I was initially offered a permanent retirement at a high percentage, but I decided to appeal the decision after being told that it's possible I could remain on AD with a permanent attachment to PSD/Shore-based commands. I was advised that this decision would be made based on my medical checkups and my PRT scores, and after a lot of experimenting, I came up with a meal plan that wouldn't aggravate my condition and would allow me to be at 75-80% most days.

Despite scoring within the top 5 of my base for 3 consecutive PRTs, becoming LPO of my respective department as an E-4, and performing numerous hours of volunteer work, it was determined that I would not be allowed to continue my career in the Navy, and that I was potentially facing an Administrative Separation on the basis of Malingering. I appealed this decision and wound up receiving a "take it or leave it" 30% DoD (TDRL) and 40% VA.

I did as I was told regarding consistent appointments and filled out all necessary paperwork for the initial 2 years after separating. Right around the halfway mark, my wife and I decided to move back to our hometown. My dad was taking a 2-month vacation at the time and needed someone to watch his dogs, so we opted to forward our mail to his address and stay there (keeping our stuff in storage) while looking for a home for ourselves. During this time, I have since discovered that a Certified letter was mailed to our old address, and since it required a signature, it was never forwarded to us. Because the forms contained within were never filled out and returned, my 30% DoD pay was stopped and I was told that I had been removed from the TDRL. I only discovered this after my Delta Dental was no longer being paid for, and as a hockey player, that's pretty important to me. It wasn't initially a huge concern because I already had another dental insurance provider, and the 30% DoD pay was practically peanuts.

I returned to DOD as a civilian contractor this week, and while my new CAC was being processed, the clerk asked if I wanted to have my retiree ID renewed. I was under the impression that I was no longer eligible to have one, so I said sure out of curiosity. The ID printed with an expiration date of May 2019, exactly 5 years after my EAOS. This wasn't an issue until I did a bit of research and came to the realization that my TRICARE isn't a part of my VA coverage, but a benefit from being on the TDRL. Ulcerative Colitis is currently incurable, but I have heard absolutely nothing regarding me being transferred to the PDRL and any POCs I reach out to result in being left on hold for hours on end until the line is disconnected.

Is there any way I can find out if I'm being transferred to the PDRL? With roughly 6 weeks left on my TDRL, should I have heard something by now? My wife and I are expecting our first child at the end of the year, and we picked our hospital based on them accepting TRICARE, so I need to know if I should be shopping for a new insurance provider, or if I can count on TRICARE still being available to me. My new job will not be providing medical insurance until October, and the baby is due in September.

Any/all help is greatly appreciated. I've been told by recruiters that even if I'm dropped from the TDRL, I won't be eligible to reenlist due to my UC and I can't wrap my head around that. As brief as it was, I loved my time in the Navy and would love nothing more than to serve again.


V/r,

Cody
 

PEBMember2017

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Cody,

You've gotten a pretty bad shake there, and based primarily off of what you are relating, it looks at though you may still be in quite of a bind.

The certified letter that you received was more than likely a notice for you to attend a mandatory 18 month re-evaluation for your conditions. Because it was not acknowledged or signed, you were effectively held in non-compliance and your TDRL was terminated. This means you lost both your 30% TDRL rating and Tricare, and you will not be placed on PDRL.

If PSD res-issued your Retirement ID, it had to have been done so out of error. Who else have you contacted or been in touch with that your TDRL is still active? How are you even sure you have Tricare? Have you been in touch with Humana Military?

Not to sound alarmist, but you could be in serious trouble here if you are simply assuming you still have these benefits. This simply can not be the case.
 

RonG

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You might consider contacting the military personnel office at your last duty station.

There should be important telephone numbers in your discharge packet.

You could call DEERS to determine what info they show.
DMDC/DEERS Support Office (DSO)
Toll-free: 1-800-538-9552

Ron
 

PEBMember2017

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The level of importance of being in constant contact with your PEBLO and TDRL while on TDRL can not be stressed enough. All phone number, address, and condition changes must be updated to all parties (PEBLO, TDRL, DEERS) and you should have been specifically told and directed to do this by your PEBLO when you signed your findings.

I've been seeing quite a few of these posts lately of TDRL members who essentially cut ties with the TDRL process thinking it will automatically resolve itself or that placement on the PDRL is somehow automatic. This IS NOT the case.

You MUST maintain contact, your appointments, and continue recommended treatments/medications while on TDRL or you will effectively be held in non-compliance and terminated from TDRL, which suspends all DOD benefits!
 

CParker

PEB Forum Regular Member
Registered Member
Cody,

You've gotten a pretty bad shake there, and based primarily off of what you are relating, it looks at though you may still be in quite of a bind.

The certified letter that you received was more than likely a notice for you to attend a mandatory 18 month re-evaluation for your conditions. Because it was not acknowledged or signed, you were effectively held in non-compliance and your TDRL was terminated. This means you lost both your 30% TDRL rating and Tricare, and you will not be placed on PDRL.

If PSD res-issued your Retirement ID, it had to have been done so out of error. Who else have you contacted or been in touch with that your TDRL is still active? How are you even sure you have Tricare? Have you been in touch with Humana Military?

Not to sound alarmist, but you could be in serious trouble here if you are simply assuming you still have these benefits. This simply can not be the case.
MilConnect shows:

Coverage: TRICARE
Retired Sponsors and Family Members
Coverage End Date: 2019-05-28
Coverage End Reason: Projected end of eligibility

I haven't heard of Humana Military but I'll look into it. My wife has been using TRICARE for all of her appointments and they've been paying, so the entire situation has left me very confused.
 

PEBMember2017

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@CParker I re-read your post and there is an additional possibility.

If (and you didn't state this) you did attend a TDRL re-evaluation, they may have came to a decision and mailed you that decision requiring a signature of the actual decision form (not just a delivery signature needed by the USPS). Did you attend a TDRL re-evaluation?

1. If, again, the decision was to move you to PDRL, there is a very remote possibility that you not sending the decision letter back caused the PEB to believe you automatically accepted the findings, ONLY if the decision was to move you from TDRL to PDRL, HOWEVER, you would NOT be on TDRL right now, but rather PDRL.

2. If you were terminated from TDRL, you should not be receiving these benefits, and eventually they will figure this out and terminate them, OR, you are not receiving them at all.

Also, it would be even more difficult to prove compliance because you moved/re-located and did not tell anyone.

But, even still, you should have been made aware of this. I find it simply stunning that you have not called your MTF, your PEBLO, TDRL or anyone else. No one has emailed you? Was this information not given to you? And even if it wasn't, why have you not been in contact with them with these questions? This is your livelihood and benefits, and with a family and child on the way, it's extremely important you get this clarified.
 
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PEBMember2017

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MilConnect shows:

Coverage: TRICARE
Retired Sponsors and Family Members
Coverage End Date: 2019-05-28
Coverage End Reason: Projected end of eligibility

I haven't heard of Humana Military but I'll look into it. My wife has been using TRICARE for all of her appointments and they've been paying, so the entire situation has left me very confused.
Cody, can you clarify? Was your wife military, because these could be HER benefits.

Again, you need to take the reigns on this and figure out where in the process you are and what your specific coverages are.
 

CParker

PEB Forum Regular Member
Registered Member
The last time I reached out for information regarding the TDRL, they told me that the determination would be made without me (since the package was never returned) and that I would likely be automatically transferred to the PDRL without any input. I had full coverage at my last job, so we've had no need for TRICARE until I was laid off last year.

I'm the sponsor; she has no military affiliation. I'm unsure about the evaluations as there was a time in which I was attending appointments multiple times a week. If the retirement is off the table, I'm fine with that, I'm just having a hard time understanding how the process has gotten to this point. I've sat on hold for hours attempting to get answers, and I'm honestly fed up.
 

PEBMember2017

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The last time I reached out for information regarding the TDRL, they told me that the determination would be made without me (since the package was never returned) and that I would likely be automatically transferred to the PDRL without any input. I had full coverage at my last job, so we've had no need for TRICARE until I was laid off last year.
I'm not sure who told you this, but as far as the Navy side is concerned, this is entirely inaccurate.

Unless something has drastically changed that I haven't heard about, there is simply no way for the PEB to adjudicate a TDRL member without a mandatory 18 month re-evaluation, especially now that TDRL is adjudicated either at the 18 month or 3 year mark.

The sole purpose of TDRL is to allow the PEB to re-evaluate your conditions for stability. I'd even go so far as to say they wouldn't even legally be capable of adjudicating your case without any further medical input.

Simply said, this just isn't even possible. "No re-evaluation" would mean they would have put you on PDRL from the beginning. There is something very amiss here.

I'm the sponsor; she has no military affiliation. I'm unsure about the evaluations as there was a time in which I was attending appointments multiple times a week. If the retirement is off the table, I'm fine with that, I'm just having a hard time understanding how the process has gotten to this point. I've sat on hold for hours attempting to get answers, and I'm honestly fed up.
Attending appointments with a primary care provider or VA? Did you ever go back to your Medical Treatment Facility for the specific purpose of a TDRL re-evaluation?
 

PEBMember2017

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Also, you state you are 40% VA. On TDRL, you are paid at 50% even if you are assigned 30%.

Were you not paid by DOD? Was your VA compensation higher? I would think you would have noticed the loss in pay if your DOD paycheck stopped/changed and the VA pay kicked in...?

Cody, it almost sounds to me your entire case may have been mishandled on top of the fact that your erred in a few of the steps in the process, but I'm not sure as we are missing some key details.

As @RonG stated, you should reach out to your PEBLO/MTF first thing tomorrow morning (immediately). Numbers and contact information has to be in your discharge packet. I am simply at a loss as to how they wouldn't be.
 
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CParker

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Registered Member
I was attending VA appointments for months, multiple times per week prior to the missed certified letter.

The ratings were 30% DOD and 40% VA when I was separated. DOD was paying me, but the Delta Dental was absorbing the majority of it. I wound up seeing roughly $15 after, so I hadn't noticed the pay had stopped.

Who would be the best POC to find out what's going on? Every time I call to get answers, I'm transferred multiple times before being put on hold until the call disconnects. No one seems to know what's going on.

I greatly appreciate your advice; it's good to finally talk to someone who knows about the system.
 

PEBMember2017

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I was attending VA appointments for months, multiple times per week prior to the missed certified letter.

The ratings were 30% DOD and 40% VA when I was separated. DOD was paying me, but the Delta Dental was absorbing the majority of it. I wound up seeing roughly $15 after, so I hadn't noticed the pay had stopped.
Okay, this is making some sense now. This tells me you were removed from TDRL. You are not on PDRL, nor can you be placed on to it; if you were, this pay would have continued. Also, you would be receiving Tricare and an ID card in error. This is uncommon, but it does happen.

Also, on January 1 this year, Delta Dental coverage fell off and it is up to the beneficiary to elect new dental insurance.

Who would be the best POC to find out what's going on? Every time I call to get answers, I'm transferred multiple times before being put on hold until the call disconnects. No one seems to know what's going on.
In your discharge paperwork, along with your signed findings, there SHOULD have been a number to the PEB themselves, from the President all the way down to your PEBLO. You should contact the very medical office on base you utilized during your MEDBOARD process, who can put you in touch with the MEDBOARD/TDRL office there. You should do this as soon as humanly possible.

I greatly appreciate your advice; it's good to finally talk to someone who knows about the system.
We are here to help you. I don't mean to sound like I am scolding, but when healthcare and compensation are involved, it is essential you find answers to this for the sake of yourself and your family. I wish you the best and congrats on the new one!
 

RonG

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I agree that you are receiving excellent advice from PEBmember2017.

I can only add that to be successful in resolving this matter, you must be proactive and assume it will not be fixed without your direct
involvement.

Ron
 

CParker

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Registered Member
I'll dig up the paperwork tonight and give them a call tomorrow. I'll update the post ASAP, thank you all again for your help!
 

johnbgately

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Simple answer- Here is Tonjua Howard's contact info- the TDRL Coordinator at the PEB:
(202) 685- 6431, Fax: 685-6429, E-mail: [email protected]

Tonjua can tell you whether a decision was made in absentia to put you on the PDRL or whether you were dropped from the rolls for failure to appear at an exam. However, if no one signed for the certified letter and it was returned, you will have to show that you notified PERS of your pending move and updated your mailing address. Otherwise, they will likely tell you that the case was finalized and indexed to PERS. If this proves to be the case, then you will likely have to go to the BCNR to attempt to correct it. If this proves to be the case, this will take between 12-18 months on average. If this is necessary, you should ask her for a copy of your entire TRIM file to assist you in this matter. FYI, TRIM is the acronym for the Navy PEB in-house case file.
 

PEBMember2017

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PEB Forum Veteran
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Simple answer- Here is Tonjua Howard's contact info- the TDRL Coordinator at the PEB:
(202) 685- 6431, Fax: 685-6429, E-mail: [email protected]

Tonjua can tell you whether a decision was made in absentia to put you on the PDRL or whether you were dropped from the rolls for failure to appear at an exam. However, if no one signed for the certified letter and it was returned, you will have to show that you notified PERS of your pending move and updated your mailing address. Otherwise, they will likely tell you that the case was finalized and indexed to PERS. If this proves to be the case, then you will likely have to go to the BCNR to attempt to correct it. If this proves to be the case, this will take between 12-18 months on average. If this is necessary, you should ask her for a copy of your entire TRIM file to assist you in this matter. FYI, TRIM is the acronym for the Navy PEB in-house case file.
@CParker Ms. Howard would be able to give you a disposition of the case, and you will have to follow up with either DFAS/PERS and rectify whatever is happening with TRICARE, also.
 

CParker

PEB Forum Regular Member
Registered Member
Update: Tonjua Howard put me in contact with Service Headquarters, who assigned a TDRL coordinator to me and scheduled my final evaluation. Evaluation was completed 13May2019 and I was told I'd hear something within 4-8 weeks. Today marks 9 weeks, my coordinator is no longer answering me, and I'm unsure if I'm just being antsy or if I should be lighting some fires to figure out what's going on. My assumption is that the 4-8 week timeline doesn't begin until they receive the findings so the current stress could just be a result of my own impatience.

For what it's worth, Doc at Bethesda couldn't believe I wasn't immediately put on the PDRL after reviewing my medical record, so hopefully that's a sign of things to come.

As for TRICARE, I was told that I'm still covered and will remain covered unless they take me off of the TDRL and do not put me on the PDRL. I have no idea how that works, so hopefully they're right.
 
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