Tricare Benefits if 100% TDRL rating is reduced to lower PDRL rating

What do you guess would be the likely outcome of my TDRL Final Evaluation?

  • PDRL retirement status denied altogether

    Votes: 0 0.0%
  • TDRL status temporarily renewed until regular VA appointments and treatment are re-established

    Votes: 0 0.0%
  • PDRL rating reduction

    Votes: 0 0.0%
  • Loss of Tricare benefit for myself and spouse

    Votes: 0 0.0%

  • Total voters
    0
  • Poll closed .
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Young6162

New Member
Registered Member
I currently am rated 100% by the VA and 100% for TDRL, but I fear that my lack of treatment compliance with regular doctor visits in the last two years will almost certainly reduce my PDRL rating substantially, if they even deem me worthy of PDRL status at all. Accordingly, I have three questions which I would be extremely grateful to have answered from anyone who is thoughtful and generous enough to read them and respond --

1. After moving out of state 2 years ago (where there is not MTF within several hours of me), and experiencing significant hardships largely related to my disability, I never got established with a new doctor and hence never established a regular appointment regime nor received any care whatsoever from the VA in these last two years. Consequently, even though my disability has not improved and has actually worsened, I am terrified that my failure to adhere to the regular treatment expectations will deem me "non-compliant" and unworthy of PDRL retirement status. Can any of you make a guess as to the likelihood of this happening?

2. Even if I were somehow granted PDRL retirement status nonetheless, I assume my PDRL rating would be significantly reduced below 100% due to my compliance failure and lack of medical history for the last two years. If reduced below 100%, does that mean my spouse and I would lose our Tricare benefits? Or can we still retain them as long as my PDRL rating is not reduced below 30%? Any feedback on the likelihood and extent of my PDRL rating reduction as it relates to retaining Tricare benefits would be immensely appreciated!

3. The only thing that has kept me above water is that fact that I have actually been consulting with a foreign doctor who sends my prescriptions from India, since it has been such a feasible and cheap alternative, but I don't know if that information is even helpful to impart at my final TDRL Evaluation. I could imagine two different scenarios in which it is either viewed as a willful effort taken to treat the severity of my disability or otherwise an act of "intentional non-compliance" by choosing my own treatment path rather than simply "unintentional non-adherence" to VA treatment). Please kindly share any opinions you may have, not on the ethics of disclosure, but rather simply whether omitting this information is beneficial or detrimental to my evaluation result!

Thank You sincerely for your time and consideration !!
 

rocky8289

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Yes, definitely your ratings may be lowered due to lack of medical treatment. You may have to explain why stopped seeking for medical treatment while on TDRL status. They may assume that you are recovering from injuries since no medications or treatments were followed after separation from AD, unless there was a good reason why you didn't receive any medical treatment. The Outcome can be: Return to AD service or Separated with severance pay; but, I doubt 30% or higher if your conditions are NOT stable without medications or treatment.
 

jeffb

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
All TDRL cases will receive a permanent rating based only on the VASRD criteria that is in effect at the end of the TDRL period.
 
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