Complex claim process, currently at 90%


Hello Jim, Thank you for providing us veterans with the information we need to understand the VA processes. Currently, I'm SC at 90%, and have been for over 3 years. (70% PTSD , 50% Sleep Apnea, 30% IBS and 20% hemorrhoids). I only work 15 days a month and I have a pending claim for headaches secondary to PTSD . I have submitted all of the treatments for my headaches over the years along with what I think to be decent notes from my wife, neuro doctor, VA treatment facilities and a headache diary.  My current pending has went from GOE to PFD back to to GOE and then PFD and so forth for over 8 months. I had a exam with QTC doctor about six weeks ago for my frequent headaches and today I see this notice on my ebenefits:

"You may be entitled to compensation at the 100 percent rate if you are unable to secure and follow a substantially gainful occupation because of your service-connected disabilities. If you believe you qualify, complete, sign, and return the enclosed VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability."

As of today, I'm back to the GOE stage! I don't want to apply for TDIU yet bc Im eligible for retirement in the next two years and I'm only scheduled to work 15 days a month. I was never offered to apply for TDIU with my 70% PTSD rating 3 years ago. My goal is to get better with treatment, however TDIU comes with much paperwork, re-certifying each year and everything else the VA does to cancel out vets pays. In my opinion, It's just too much of a hassle for me to request for TDIU!

1) Could this be a "sign" that I'm getting a new rating for my "pending" headaches condition (50%) that may take me to 100% schedular rating?
2) Secondly, If I don't complete the TDIU form, will my entire claim may be denied or have a negative impact on my pending claim?

Jim's Reply:

My reply:

(1) No, VA doesn't give signs or hints. We never try to read between their lines.
(2) No, but depending on what your current earnings are at your 1/2 time schedule, you may well be eligible for the TDIU benefit. If you earn less than the federal poverty rate, you're likely eligible.

Keep in mind that the benefits says "unemployability", it doesn't say, "wait until I retire and apply to supplement my retirement income benefit". If you are able to work and earn more than the poverty wage, you are not eligible for the TDIU benefit. Retiring from a career isn't the same as not being able to work because of service connected disabling conditions and VA will often hang you up on that. If you aren't able to show that you've been denied gainful employment because of service connected disabling conditions, VA may deny TDIU.