TDRL Re-Evaluation below 30% Lumbar Need Help/Advice

puppolo

PEB Forum Regular Member
Registered Member
I just received my TDRL re-evaluation results back and I got rated at 20% for DDD. Just some quick background, my original PEB rated me at 20% for DDD and left off my right and left sciatica as an unfitting condition. I then appealed and they approved and added them bringing me up to 30%. Now, they took off sciatica again even though during my TDRL re-eval both the Neurology doctor and the Pain Management doctor both wrote that I had significant bilateral radicular pain . In addition my ROM tests were significantly worse than the ones from when I went through the PEB process 2 years ago. I had flexion 20 degrees, extension 10 degrees. Which from looking at the VA tables would have given me 40%. I understand that the PEB probably will not go back and utilize these to give me a better rating, they would most likely only use them as evidence if they got better.

Anyways, does anyone have experience with this that can give me some advice on what I would need to get the board to grant me a higher percentage. I did have a EKG done in between my original PEB and FPEB when I was still in the Navy, that is how I got the Sciatica originally added.

Thank you in advance for your help!
 

Warrior644

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I just received my TDRL re-evaluation results back and I got rated at 20% for DDD. Just some quick background, my original PEB rated me at 20% for DDD and left off my right and left sciatica as an unfitting condition. I then appealed and they approved and added them bringing me up to 30%. Now, they took off sciatica again even though during my TDRL re-eval both the Neurology doctor and the Pain Management doctor both wrote that I had significant bilateral radicular pain . In addition my ROM tests were significantly worse than the ones from when I went through the PEB process 2 years ago. I had flexion 20 degrees, extension 10 degrees. Which from looking at the VA tables would have given me 40%. I understand that the PEB probably will not go back and utilize these to give me a better rating, they would most likely only use them as evidence if they got better.

Anyways, does anyone have experience with this that can give me some advice on what I would need to get the board to grant me a higher percentage. I did have a EKG done in between my original PEB and FPEB when I was still in the Navy, that is how I got the Sciatica originally added.

Thank you in advance for your help!
In my lengthy experienced opinion with DoD TDRL (Army) re-evaluations spanning 4 years and 17 days prior to an official placement onto the DoD military PDRL, you will definitely need to fight (e.g., appeal) the DoD LDES PEB (Navy) findings at this point in time via requesting a FPEB hearing.

Hmm, do the results from the current TDRL medical re-examination exactly show ROM measurements in accordance with 38 CFR VASRD Schedule of rating criteria for the spine at a 40% rating? If so then the LDES PEB (Navy) may revise their findings accordingly (e.g., grant a DoD 40% rating for Lumbar DDD) without the need to schedule a FPEB hearing for direct resolution.

Moreover, do you have medical evidence and/or medical documentation while on TDRL from any medical provider (e.g., Neurology, Pain Management, etc.) documenting that you still have "significant bilateral radicular pain" at this particular point in time? If yes then you have a stronger case which proves that your bilateral sciatica is still an unfitting condition for the LDES FPEB hearing.

Bottom line is that you will need to fight the LDES PEB (Navy) findings produced from the current TDRL re-evaluation. With the assistance of a FPEB attorney either provided by the Navy or at your own expense, he/she shall ensure that all medical evidence and/or medical documentation are available for presentation to the FPEB hearing. In some instances, the medical evidence and/or medical documentation may be strong enough for the PEB to change their original findings resulting in a favorable resolution without the need for a FPEB hearing.

Nonetheless, never default acceptance to any injustices; fight then continue to fight some more until receipt of your desired expectations supportive via all available medical evidence and/or medical documentation! I hope for a successful outcome from your current TDRL re-evaluation. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

chaplaincharlie

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You have appeal options. You may want to exercise that option. Many people do not realize it, but TriCare is actually pretty good insurance. Getting back to 30% means TriCare!
 

puppolo

PEB Forum Regular Member
Registered Member
In my lengthy experienced opinion with DoD TDRL (Army) re-evaluations spanning 4 years and 17 days prior to an official placement onto the DoD military PDRL, you will definitely need to fight (e.g., appeal) the DoD LDES PEB (Navy) findings at this point in time via requesting a FPEB hearing.

Hmm, do the results from the current TDRL medical re-examination exactly show ROM measurements in accordance with 38 CFR VASRD Schedule of rating criteria for the spine at a 40% rating? If so then the LDES PEB (Navy) may revise their findings accordingly (e.g., grant a DoD 40% rating for Lumbar DDD) without the need to schedule a FPEB hearing for direct resolution.

Moreover, do you have medical evidence and/or medical documentation while on TDRL from any medical provider (e.g., Neurology, Pain Management, etc.) documenting that you still have "significant bilateral radicular pain" at this particular point in time? If yes then you have a stronger case which proves that your bilateral sciatica is still an unfitting condition for the LDES FPEB hearing.

Bottom line is that you will need to fight the LDES PEB (Navy) findings produced from the current TDRL re-evaluation. With the assistance of a FPEB attorney either provided by the Navy or at your own expense, he/she shall ensure that all medical evidence and/or medical documentation are available for presentation to the FPEB hearing. In some instances, the medical evidence and/or medical documentation may be strong enough for the PEB to change their original findings resulting in a favorable resolution without the need for a FPEB hearing.

Nonetheless, never default acceptance to any injustices; fight then continue to fight some more until receipt of your desired expectations supportive via all available medical evidence and/or medical documentation! I hope for a successful outcome from your current TDRL re-evaluation. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
Thank you for your assistance. I am going to appeal it, but I wanted to see if anyone had similar experience and what they provided for the reconsideration/FPEB. I had an EMG done in 2017 to get me to the 30% status where they added sciatica to my unfitting conditions. All of the doctors that did my re-evaluation indicated I had the same things, but they never actually conducted any nerve studies. I have been on medication to manage the pain for both my back and the sciatica, but I have not had any additional tests done to prove that it still exists. My ROM for flexion was 20 and for extension was 10, which from looking at the regulation does appear it should have given me a 40% rating by itself. I could be wrong though.

Thank you again for your response!
 

puppolo

PEB Forum Regular Member
Registered Member
You have appeal options. You may want to exercise that option. Many people do not realize it, but TriCare is actually pretty good insurance. Getting back to 30% means TriCare!
Thank you for your response. Yes, I know that $ wise being medically retired will not change because with the VA my % is 70%, so even if I did get permanently retired or not I would still get the same amount of money. However, like you said my thing lies with Tricare. I understand how important that is to me and for my health, it benefits me a lot so that is why I am going to appeal. I am just trying to get people's inputs that have gone through it so that I can have a strong case and not look dumb.
 

chaplaincharlie

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I would search for known secondary conditions. By secondary, I mean they are known to be connected to an unfitting condition.
 

Warrior644

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Thank you for your assistance. I am going to appeal it, but I wanted to see if anyone had similar experience and what they provided for the reconsideration/FPEB. I had an EMG done in 2017 to get me to the 30% status where they added sciatica to my unfitting conditions. All of the doctors that did my re-evaluation indicated I had the same things, but they never actually conducted any nerve studies. I have been on medication to manage the pain for both my back and the sciatica, but I have not had any additional tests done to prove that it still exists. My ROM for flexion was 20 and for extension was 10, which from looking at the regulation does appear it should have given me a 40% rating by itself. I could be wrong though.

Thank you again for your response!
Indeed, you are quite welcome!

In retrospect while on DoD military TDRL, I requested a FPEB hearing for PTSD albeit it was ultimately unsuccessful; therefore, I was continued onto the TDRL for an additional 12 months at that particular point in time. It would seem that your current TDRL case has a different medical condition so I am not able to offer any detailed sound insightful feedback other than you will need to fight the LDES PEB (Navy) findings produced from the current TDRL re-evaluation for sure.

Again, nonetheless, never default acceptance to any injustices; fight then continue to fight some more until receipt of your desired expectations supportive via all available medical evidence and/or medical documentation! I hope for a successful outcome from your current TDRL re-evaluation. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

puppolo

PEB Forum Regular Member
Registered Member
Thank you all for your assistance and recommendations. I had my Formal Hearing yesterday and my attorney thought it went very well. Due to the Navy's system of processing, I will not know anything for another month or so.

One thing that caught me off guard was the board presented "new" evidence. I quote new because it was my TDRL Re-Evaluation. I found this very interesting that they were presenting this as new evidence, when it was my assumption that that was what they were supposed to be looking when my TDRL package got sent to them for a decision. Has anyone else had this issue with the PEB? I just found it pretty odd that that was what they were supposed to be using to rate me, yet they did not add it to evidence until the day of my Formal Board. It also made me look like I was hiding things because me and my attorney did not include it with our new evidence.

Thank you all again for your help!
 

bluemoon

PEB Forum Regular Member
Registered Member
I actually had the same exact experience this week, I appealed the first findings of the TDRL PEB going from 70% to 10%. I just got news that they re-evaluated and offered 30%, it still seems like a bit of a lowball offer, but Idk if I am going to accept or appeal again to the PEB or go for a formal board. I dont think they had access to any of my VA records and I think in my case all they had was my TDRL eval. I would say keep your hopes up man, I hope that it all goes well for you.
 

puppolo

PEB Forum Regular Member
Registered Member
Just an update received my formal board results....no change to my findings. My Formal Board attorney said the board got it wrong with their justification because the regulation says ratings can change if it is to the benefit of the service member. Therefore, he suggested that I continue the appeal up the chain, which I just sent in today. Here is to more hurry up and waiting.
 
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