Who Is Entitled To Va Compensation For Medical Issues
Veterans who apply for VA disability compensation must have medical conditions that are the result of an injury or disease that was incurred or aggravated while on active duty or active duty for training or from injury, heart attack or stroke that occurred during inactive duty training, according to the VA.
Such disabilities may apply to medical conditions such as Lou Gherigs Disease, mental health issues including post-traumatic stress disorder , and more, according to the VAs guidelines.
What Are Va Disability Retro Benefits
VA typically pays a veteran from the date that he filed a claim. Most of the time that is months or years before the veteran wins. Once he does win he receives his new rate every month going forward. But the VA must also pay that back paythe retro paymentto the date of the claim. To calculate an estimate of your retro benefits,
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What Does Each Rating Pay
A 0% rating doesn’t pay any disability compensation but is important because it may qualify you for priority health care and other VA benefits.
The monthly payment for ratings of 10% or higher will vary based on whether the veteran has any dependents, and if so, how many.
If you are a single veteran with no dependents, in 2017 you’ll receive a monthly benefit of:
- $409 for a 30% rating
- $839 for a 50% rating, or
- $1,556 for an 80% rating
If you are married with one dependent child, in 2017 your monthly payment rate will be:
- $493 for a 30% rating
- $979 for a 50% rating, or
- $1,781 for an 80% rating
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Permanent And Total Va Ratings
Permanent and total ratings are 100 percent ratings that are protected from being reduced because the condition has been found not likely to improve. Permanent and total disability ratings are combined using VA Math to reach a schedular 100% rating. Veterans can find whether their rating is considered to be permanent and total in their decision letter, sometimes on the back in what is referred to as the code sheet but the area in which this is indicated can vary per regional office. Here, permanent and total status can be indicated specifically as permanent and total or as entitlement to chapter 35 dependents educational systems benefits. Note: Not all 100 percent ratings are permanent.
What If I Got A Zero Percent Rating For My Condition
A 0% VA disability rating is by law considered non-compensable and therefore does not result in monthly compensation. The VA acknowledges that your condition exists, but the symptoms are not severe enough to warrant a higher rating.
There are certain benefits with 0% ratings.
First, you are eligible for no-cost VA healthcare and travel reimbursement for the condition.
Second, a 0% rating for a condition means the VA has granted service connection for the condition, which is often half the battle. A non-compensable rating can open the door for:
- Filing a claim for an increased rating as the non-compensable impairment worsens
- Appealing the decision because the condition should be rated at a higher percentage.
Many factors will come into play here, and a good veterans claim attorney can help you through them.
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Va Claims Rating / Va Math
One of the most confusing aspects of filing for service-connected disability compensation is figuring out how the Department of Veterans Affairs establishes a rating. Below we will show you how VA calculates disability ratings so you can be better informed when discussing and making decisions about your claim.
How does VA decide a rating?
If VA rates a single condition, your rating is the rating for that single condition, but most veterans are rated for multiple conditions. This rating for multiple conditions is called a combined rating.
One of the major misconceptions is that combined simply means added together, which is not true as the VA uses what is known as a combined ratings table. This means that a persons efficiency is determined first by the most disablingor highest individually rated conditionand then by less disabling conditions ranked in order of severity.
A veteran may receive a letter from VA notifying them that they have two service-connected disabilities, TBI and a back injury, rated at 50% each. Normally, 50% plus 50% would equal 100%, but this veterans total disability rating is listed as 80%.
This is how the combined ratings table works.
In this case, the VA takes 100 and subtracts the highest individually rated condition . This means the veteran is initially considered 50% disabled and 50% efficient.
100% whole efficient person 50% = 50%
50% remaining efficient person 50% = 25%
So only 25% is added to the first 50% .
What If My Disability Got Worse While I Was Waiting For The Va To Award Benefits
You can ask the VA to assign you different ratings for different periods of time while your application was pending. This is called “staged ratings.” You can ask the VA to look at the medical evidence and assign you a higher rating for the period during which your symptoms worsened and met the criteria for a diagnostic code with a higher rating. Staged ratings can help you get a higher retroactive benefit payment when it has taken years for your claim to get awarded.
Continue reading to find out about advanced ratings, such as special monthly compensation, 100% TDIU ratings, and 100% disability ratings, and special rules for TBIs and muscle injuries.
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Schedule For Rating Disabilities
The Rating assigned to your impairments is often the most confusing part of the decision.
The VA created the Schedule for Rating Disabilities to identify what % should be applied to each impairment. This schedule is intended to reflect the loss in earnings that you may experience because of your impairments. Ratings range from 0% to 100%.
The Schedule for Rating Disabilities lists impairments by body parts affected and conditions/issues. Each diagnosis within the group of issues has a list of symptoms that the VA Rater will compare to your symptoms and the evidence in your medical record, including your C& P exam. Your symptoms are then rated according to the requirements listed in the Schedule. The more severe your impairment is, the higher the disability rating will be.
For example, if you were experiencing symptoms of post-traumatic stress disorder as a result of your time in the service, you would find the section titled Mental Disorders, which includes PTSD, Depression, Anxiety, and MST. The table for PTSD indicates that if you have occupational and social impairment in most areas resulting from symptoms such as spatial disorientation and suicidal ideation, you would receive a 70% rating for this impairment. If you have reduced reliability and productivity as a result of occupational and social impairment, you would receive a 50% disability rating, and occasional decreases in work efficiency would equal a 30% disability rating.
Va Disability Rates For Conditions Are Scaled From 0% To 100%
Each impairment is given a disability rating as a percentage. Ratings are scaled from 0%100% in terms of severity. VA disability percentages climb in 10% increments to represent how much each condition affects your overall health and ability to function. The degrees of disability are considered proportionate to your loss of working capacity.
For example, you suffer service-connected ulcerative colitis. The VARSD lists this condition under the main category The Digestive System, and subcategory Colitis, ulcerative which uses Diagnostic Code 7323.
Diagnostic Code 7323 rating rules are as follows:
|7323 Colitis, ulcerative||Rating|
|Moderate with infrequent exacerbations||10%|
As you can see, there is a wide percentage difference in VA disability rates for this one condition.
Even the difference between a 10% and 30% rating can be crucial. A veteran who is rated below 30% for all conditions may only collect benefits as a single veteran with no dependents . Only at the 30% disability rating does a veteran get additional compensation with dependents.
Another example is tinnitus, one of several conditions where VA disability rates are limited, in this case only up to 10 percent. Tinnitus is one of the most claimed disabilities by veterans.
The VASRD lists this impairment under the main category Diseases of the Ear, and subcategory Tinnitus, recurrent which uses Diagnostic Code 6260. Note the VA examiner is instructed to take both ears into account in the rating.
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How Va Math Affects Your Disability Rating
It is important to note that the VA uses whats referred to as whole person theory or VA math to calculate ratings for veterans with more than one disability. Since a person can never be more than 100% disabled, this means you cant simply add ratings together to get your total disability rating. Your highest percentage disability is subtracted from the starting 100% that represents your whole body, and then each additional percentage is subtracted in decreasing order.
For example, consider a veteran who has three disabilities rated at 30%, 20%, and 10%. You would subtract 30 from 100 to get 70, subtract 14 from 70 to get 56, and then subtract 5.6 from 56 to get 50.4. The veteran would be 50.4% not disabled. Subtract 50.4 from 100 to get a 49.6% disability ratingwhich is rounded to 50%.
How Can I Be Sure They Rate My Disability Accurately
The best way to ensure that you receive the proper rating for your disability is to file a well-detailed claim backed up with solid evidence. Experts advise that when you apply, focus less on naming your condition than on listing all of your symptoms. The VA is obligated to follow-up on each symptom listed, and those symptoms may point to more or different conditions than you were aware of. This will help them assign the most accurate rating for your disability.
Also, be aware that if you are receiving compensation for a disability and that condition worsens, you can apply to have your claim evaluated for an increase in the disability rate. The VA emphasizes the importance of fully developing your claim.
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What Are The Most Common Va Disability Claims
Veterans seek VA benefits for a large variety of service-connected disabilities. The most common disabilities range from musculoskeletal conditions to mental health disorders.
These are some of the most common conditions veterans file claims for:
- Limitation of Flexion of the Knee
- Lumbar and Cervical Strains
- Paralysis of the Sciatic Nerve
- Limitation of Motion of the Ankle
- Limitation of Motion of the Arm
Va Combined Ratings Table
The math can be a bit confusing if you try to do it manually thats where this combined ratings table may be helpful.
Lets try the same example with the table below.
We start with the 30% disability. Look at the combined ratings table and scroll down the left column until you find the number 30.
Then go to the right column until you find the 20. The 30 and 20 combine for 44. If those are your only two ratings, you would have a 44% VA service-connected disability rating, which would round down to 40%. But, were not done. We still have to add two 10% ratings.
Start on the left column again. This time, you will look for the 44 in the left column. Then find the intersection point with the 44 and 10. Your new rating is 50%.
Repeat this one more time, starting with 50, and meeting up with 10. Your new combined rating is 55%, which rounds up to 60%.
Table Instructions: List all disabilities in descending order. Start with the highest disability rating, find it in the left column, and find the intersecting point with the next highest disability rating. This is your combined rating for these two disabilities. If these are your only two disabilities, you can round to the nearest number divisible by 10 .
Repeat this process until you have run the numbers for all disability ratings.
Source: 38 CFR 4.25 Combined ratings table. Downloadable PDF: You can download this table here .
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How Does Va Math Work
Each condition is a percentage of the disability of the service member. When combined together, however, each percentage is not a percentage of the entire service member but a percentage of what is left after other percentages have been subtracted. Definitely follow along with our examples to fully understand this concept.
About The Va Disability Rating System
Veterans with a disability that developed or worsened while serving in the military or due to military service may be eligible for Service-Connected disability pay.
Conditions covered by these benefits typically include:
- Physical disabilities including hearing loss, chronic back pain, asthma and cancers caused by contact with toxic chemicals.
- Mental disabilities including anxiety, post-traumatic stress disorder , depression and traumatic brain injury .
Find a complete list of covered conditions here.
For every disability claim, the Department of Veterans Affairs assigns a severity rating ranging from 0-100%. This rating moves in 10% increments, is based on service treatment records, VA medical records, and private medical records directly relating to the disability.
For Veterans with more than one disability, the VA uses the combined rating table to calculate your disability percentage.
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With Dependents Including Children
Find the dependent status in the left column that best describes you. Then look for your disability rating in the top row. Your monthly basic rate is where your dependent status and disability rating meet.
If you have more than one child or your spouse receives Aid and Attendance benefits, be sure to also look at the Added amounts table, and add these to your amount from the Basic rates table.
|Dependent status||30% disability rating||40% disability rating||50% disability rating||60% disability rating|
|Dependent status||Veteran with 1 child only||30% disability rating||504.39||40% disability rating||722.28||50% disability rating||1020.44||60% disability rating||1,288.03|
|With 1 child and spouse||30% disability rating||563.39||40% disability rating||801.28||50% disability rating||1,118.44||60% disability rating||1,407.03|
|With 1 child, spouse, and 1 parent||30% disability rating||607.39||40% disability rating||860.28||50% disability rating||1,192.44||60% disability rating||1,496.03|
|With 1 child, spouse, and 2 parents||30% disability rating||651.39||40% disability rating||919.28||50% disability rating||1,266.44||60% disability rating||1,585.03|
|With 1 child and 1 parent||30% disability rating||548.39||40% disability rating||781.28||50% disability rating||1,094.44||60% disability rating||1,377.03|
|With 1 child and 2 parents||30% disability rating||592.39||40% disability rating||840.28||50% disability rating||1,168.44||60% disability rating||1,466.03|
Calculate Combined Disability Ratings Using Va Math
The VA uses a descending efficiency scale for its calculations. The VA will give each injury or illness a numerical rating.
When it comes time to determine the overall rating, the VA will start with the highest rating, then work its way down. You will always begin with an efficiency rating of 100. Each new disability gives you a new baseline.
We start by racking and stacking the disabilities. In the example above, we have ratings of 30%, 20%, 10% and 10%. We start with the 30%, then factor in the 20%, the 10% then the final 10%.
Again, we arent subtracting here were doing VA math.
You start with your efficiency rate of 100, multiply it by your disability rating, then subtract the result from your original rating.
In this case, you would multiply 30% times 100 and get 30. You subtract that from 100 and come up with 70.
Your new efficiency rating is 70, and your disability rating is 30.
This is the starting point for the next calculation. You repeat the process for the next rating. You take 20%, multiply it by 70, and come up with 14. You subtract 14 from 70, and you get 56.
Your new efficiency rating is 56, and your disability rating is 44. You repeat the process for each additional disability rating.
Caption: The VA rounds final ratings to the nearest 10 . Approximately symbols in the example above indicate rounding to the nearest whole number.
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How To Apply For Va Disability
Veterans should apply for VA disability compensation via their eBenefits account. If you do not have one, apply for an eBenefits account online. You will need the following documentation:
- Discharge or separation papers such as DD214 or Guard/Reserve equivalent.
- Medical evidence including military medical records, civilian treatment records, etc.
- Vital records such as marriage and dependent birth certificates.
You can also apply via regular mail by filling out VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits. Call VA at 1-800-827-1000 to have the form sent to you.