Rehabilitation Plan

Hey bigrex, thanks for the advice!! I talked with my CM today and he explained how the vocational assessment works and how it will benefit me for EELB.  It kind of made sense.  Come April, 2019, it will all become a moot point anyway, as you are right, my ELB will shift to IFL.   Well, of course, this all dependant on what actually happens in April, 2019.  He said I really don't have much to worry about since I will turn 65 in 2020.  Holy shit, I can't believe I am actually saying that.   65!!! My earning potential certainly won't be 66 3/4 of my adjusted release salary so I anticipate (hope) that I will receive a favorable decision.

Well, it appears that you have a CM who actually has no clue, about the benefits, or the bureaucracy, that she is supposed to be guiding you through. For example, she seems to be completely unaware that as of Apr 2019, ELB is being replaced with Income Replacement Benefit (IRB) that doesn't end at 65, but is merely reduced to 70% of the overall benefit. So, unless you turn 65 before then, it doesn't apply to you. Also the rehab program isn't designed to see if and when you can return to work. My CM applied for TPI, and the rehab program on the same day. And I do not believe that other Veterans, who have been deemed TPI/DEC for PTSD, needed to undergo any further evaluations, beyond seeing their Psychiatrist/ Psychologist, and the decision is based on their assessment, not just giving their input to a third party. So IMO, I would request a new CM, before getting too far into a prolonged process, if it turns out to be unnecessary . Just tell her, that because of your unique situation, that you would feel more comfortable having a CM, with more experience dealing with PTSD and the DEC process.

"The DEC designation process is a formal VAC process to determine
your capacity for suitable and gainful employment. At this point,
it would seem to me that you haven't been involved in the Rehab
program or Psychological services nearly long enough to know
how treatment may impact your ongoing capacity for suitable/gainful
employment.

Usually the process is initiated by the Case Manager (my role)
when the accumulating evidence suggests DEC needs to be considered.
The veteran (yourself) can also request the process be initiated
and we then discuss it from there on it's merits for timing,
evidence on file and other factors.

Your case is a bit unique for me in terms of timing, as you'll
be 65 in under 2 years and are relatively new to the Rehab Program,
which doesn't give you as much time for treatment to improve
your condition. Also I'm told that Earnings Loss stops once
you reach age 65 no matter where your Rehab program case plan
is at, but you can still be on the Rehab program after age 65
and utilize benefits for social and medical rehabilitation activities,
but again Earnings Loss stops.

One idea I have is for me to make a referral to the National
Vocational rehabilitation contractor to do what's called an EECA
assessment (Employment Earnings Capacity Asssessment) to speed
up the process of assessing your overall capacity to return to
suitable/gainful employment. This would provide 3rd party assessment
of your capacity from a Vocational Rehabilitation specialist,
would include input from your mental heatlh treatment team and
provide additional overall evidence for direction on your case
plan. These EECA assessements can take long periods of time
(i.e. one year or more) or sometimes they're done quickly (months).
Your involvement in the process depends on the need for additional
assessments (i.e. they may refer you for a separate PVA (psych
vocational assessment) to assist in the overall EECA). I have
never referred any veterans for an EECA before in my short time
with VAC, but other case managers have several EECA's in progress
at any given time so they're widely used.

Keep in mind that if the EECA determines that you do have capacity
to return to work with gains made in treatment and further gains
being anticipated, then that would represent a significant body
of evidence that would impact a DEC decision significantly.
However Voc Rehab specialists are not mental health specialists
so they should be consulting with your mental health treatment
provider for input and additional assessments may be requested
(PVA).

Are you in support of me referring you for an EECA at this time.
I think it makes sense to proceed in this way given the circumstances
of your case. "

I don't understand any of this. It would seem because of my age I am discriminated against for benefits.

Just tell your CM, that you have been told that you will be limited as per employment, and they should initiate the DEC paperwork. VAC will contact your Psychiatrist, and get the supporting documents, and you shouldn't need to undergo any further testing, since it's been an ongoing process. If your CM refuses to apply for DEC, then request a new CM, and submit a complaint to the OVO. After all, the CM's are merely there to facilitate you applying for benefits that are available, NOT to decide which ones they believe you are entitled to. If you don't qualify, so be it, but that is not their decision to make.

My story, I was working casual as Security, but when it got to the point where for each shift that I worked, I would be unable to get out of bed for a day or two, I was forced to quit. I called VAC and told them that I was no longer able to work, and was interested in applying for the CIA, (PIA at the time), just to try and cover the loss of income. They sent a CM out to do a home visit. During that first home visit, she applied for ELB, PIA, PIAS, DEC, approved me for VIP housekeeping and Attendance Allowance. A week or two later I had the functionality assessment completed for the DEC, that limited me to 2 hours of work per week. Within a month or so, everything was approved. The rehab program even paid for my wife to go back to school for 2 years, So for me, the best thing I ever did for myself and my family, was to make that call and ask for help. So even though you are anxious, I highly recommend calling, because it could lead to a lot, and do it now, because once you hit 65, it's a lot harder to get additional benefits, especially with the changes that will be happening next year

Thanks propat. Saw my counsellor today with my best friend, caregiver....spouse. I take my spouse to all my appointments so it is easier for me to attend. We talked about next steps. It is likely I will start prolonged exposure therapy. I am more than anxious about that since I can't even talk to my spouse about my experiences and it has been a very long time. I have to move forward!

Bigrex, I am not sure if I can start the process for DEC or if VAC has to start it. I read the DEC policies and I seem to fit, but it also says VAC has to decide that on the basis of my rehabilitation progress/failure (when there is nothing more therapy or meds can do).
The origins of my PTSD date back to 1976, with repeated trauma exposure to 1985 when I finally decided I couldn't do what I was tasked to do any longer. UGH

hey buds EELB is called extended ELB I believe . its the same as ELB in the same amount but goes till you are 65 . the supplement to CIA or CIAS is extra money for you over a thousand a month . that program ends April 2019 so get on that ASAP as well you will be grandfathered if successful .

propat

Hey propat,  not sure what EELB is. Thanks for the advice.  I will give my CM a call to see where things are at and if I need to amend my CIA application.

hey buds I here your concerns . when the rehab ends doesn't mean your ELB ends it all depends on your circumstance . given your restrictions and age id assume no change or a switch from ELB to EELB of the same amount . as for the application call your CM with your intent to apply for DEC and she may be able to amend your current CIA application with an application for the supplement if not already done .

propat

Thanks bigrex. Just not sure how to get things going. I have a career impact allowance application at step three for the past 14 weeks but didn't tick off the box for DEC on advise from my CM. To apply do I resubmit a new CIA application this time checking of the DEC part as well?

I would start the process to be declared DEC tomorrow. It should be rather easy to approve, because they have already identified that your employment would be really limited, and the chance that you would find anything above minimum wage, at your age, is highly unlikely.

I have a question about the rehabilitation program...Once you start your rehabilitation program for complex PTSD, how long can you remain in the program before they terminate it. I started my rehabilitation in April and I have completed CBTm. I willl commence one-on-one counselling this week. I also see a psychiatrist for medication management every three weeks. I will continue to see him until he considers my medication treatment is stable. I am currently receiving ELB and I know this will be paid as long as I am participating in the program. I am 63 years old and unable to work no more than a maximum of about 16 hours a week in a modified work environment due to my PTSD. I am concerned that the rehabilitation plan will end, I then will lose the ELB and would still be unable to work due to my PTSD. Your thoughts would be much appreciated. Thanks XMedic