How temporary 100% disability is reviewed

Jim,

I think your are Awsome writer! I like the way you tell it like it is ! My question is ; I was recently awarded 100% IU, in my award letter, it says that they would like to set up a future exam to determine if there is any improvement to my disabilities. How soon do you think I could expect such an exam? I was awarded on Dec.1 2011. Thanks you very much for the info!

Reply:

Thanks for your kind words. I'm not sure about "awesome" but I do try to make my point even though some may not like what they hear.

The Total Disability, Individual Unemployability (TDIU) rating you've received is temporary, not permanent. That happens when VA anticipates that there is an opportunity for improvement in the condition.

VA routinely assigns a temporary 100% rating (usually schedular but sometimes TDIU) for conditions like prostate cancer. It's assumed that the veteran with prostate cancer will have a treatment to remove the cancer. Once that happens, he can't be rated for having a cancer and he's reexamined to determine what a more permanent rating will be.

Younger veterans (under age 55) are also likely to receive temporary ratings. The philosophy being that a young veteran is more likely to improve the status of many conditions. The mental health category of conditions often receives temporary 100% ratings because it's thought that intensive treatment plus some time is likely to bring about improvement.

There is a function called the "future calendar" that each disabled vet is assigned. In that calendar is a reminder to the VA Regional Office that the veteran who is awarded a temporary 100% rating must have a C & P exam at a future date.

Depending on the disabling condition, those repeat C & P exams are scheduled from 6 to 18 months ahead.

A problem arises when the VA Regional Office doesn't properly use the Future Calendar. This is a frequent mistake at every VA Regional Office. The veteran with prostate cancer, for example, should be scheduled for reexam about 6 months after he has a definitive treatment such as surgery and/or radiation therapy. I often hear from veterans who have expected to be reexamined and 2 or 3 years have passed with no notice from their VA Regional Office.

The oversight costs VA a lot of money. If the vet is paid the 100% rate for a year or two because of their error, there is no way for VA to recoup the money.

There are cases that are on the record of VA completely forgetting reexaminations for some veterans and they receive their 100% benefit for many years. When VA discovers the error, the benefit may fall to a very low rate and then the fight starts.

Mental health conditions may be reexamined every 18 months or so.

This topic can get complex. The VA office of General Council issued a memo in 2005 to address it, click here to read it www.va.gov/ogc/docs/2005/PREC52005.doc

The temporary 100% rating does not allow some of the benefits that come with a permanent 100% rating. These include eligibility for dependents CHAMPVA and Chapter 35 DEA benefits.

If you feel that your 100% rating should be permanent in nature, you have the right to appeal. Vets should use caution and give some thought to seeking a permanent rating. The VA often replies that rather than awarding a permanent rating that they propose to reduce the existing rating drastically. I've worked with many vets who have a 100% rating that is suddenly proposed to be rated at 30% or even lower.