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What Are Unadjudicated Claims And How Do They Affect The Amount Of Retroactive/back Pay Benefits
An unadjudicated claim refers to a claim which remains open due to an oversight in VA system.
This can occur during different stages of a claim. In the past, , claimants would often file a morass of written submissions.
Buried in these submissions might be statements requesting service-connected benefits, constituting informal claims. Overwhelmed by all the busy text, a VA adjudicator might overlook or even ignore these informal claims.
In theory, upon the claimants request, these claims can be activated at any time, with a potential effective date relating back to the filing of the claim.
Unadjudicated claims can also arise during the appellate stage. For instance, a claim will remain unadjudicated if the VA fails to issue a Statement of the Case following the timely filing of a Notice of Disagreement.
Likewise, a claim will remain unadjudicated if the Board of Veterans Appeals fails to adjudicate a claim following the timely filing of a Substantive Appeal.
For effective dates, unadjudicated claims can be gold mines. Recall that effective dates are usually determined by the date of the claim. Therefore, if you find an unadjudicated claim in the file, which has remained dormant for years, maybe even decades, the entitled retroactive/back pay may reach as far back as the filing date of the unadjudicated claim.
What Does 70 Percent Va Disability Get You
70 Percent Disability Compensation Rates
All veterans with a 70 percent disability rating receive at least the minimum VA disability pay of $1,444.71 per month. Veterans receive additional compensation if they have dependent parents, minor children, or other family members who rely on their financial support.
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How To Calculate Your Combined Va Disability Rating
The VA uses the combined ratings table to determine a final disability rating for a veteran with multiple disabilities.
To use this table, you must first list each of your disability ratings in order of severity . Find the first one in the left column, and then find where it intersects with the top column number representing your second highest disability rating. Round to the nearest 10 if those are your only two ratings. If not, put the number from the intersection point in the left column, then find where it intersects with the top row number representing your third-highest percentage.
Repeat this process until you have run the numbers for all disability ratings, then round to the nearest 10.
For example, a veteran rated for a 50% disability and a 30% disability, would receive a combined rating of 65%, which the VA rounds to the nearest 10, so 70%.
In a different example on the VA official site, a veteran rated with two disabilities at 40% and 20% has a combined value of 52%. The VA rounds that number down to 50%.
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Fully Developed Disability Claims
The next fasted option is the Fully Developed Disability Claims program.
The primary difference between the FDDC program and filing a standard claim is the Veteran must provide all evidence upfront and certify there’s no additional evidence needed to make a claim decision.
At a minimum, the Veteran should provide:
- All military personnel records on the condition, and
- All service treatment records on the condition, and
- All private medical records on the condition, and
- All VA health records or supplementary information about related VA health records that the VA can request on your behalf
If the VA requires additional information, the claim typically gets removed from the FDDC program and is processed as a standard claim.
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How The Va Calculates Compensation Rates
When you prepare to retire or separate from military service, starting your VA disability claims process is among the things many must do as you out-process. You can also apply after youve left military service.
When you apply for compensation, the VA reviews your claims and assigns disability percentage ratings in 10% increments. For example, if you have a knee injury, the VA will determine the severity of that injury .
The VA may rate your condition between 10% up to 100% based on how it affects your life. Your rating percentage determines your compensation.
Some veterans may be entitled to more disability pay if certain conditions apply such as:
- The veteran is living with severe disabilities
- The veteran has lost one or more limbs
- The veteran has a spouse, children or dependent parents
- The veteran has a spouse who is experiencing a serious disability.
Many veterans have more than one medical issue, disability or disease. Each issue is rated separately, and you may be awarded a combined VA disability.
Combined totals are not the sum of multiple percentages. In cases where the VA must rate a veteran for more than one medical issue, the VA uses a combined ratings table to determine the final percentage.
For example, if you have a 50% disability rating for one condition and a 60% rating for a different condition does not mean you are entitled to a 110% VA disability combined rating. In fact, by law veterans cannot earn more than a 100% disability rating.
Common Causes Of Tinnitus
- Hearing loss: hearing loss whether age-related or noise induced is often associated with tinnitus and can require hearing aids. A lot of times the person notices the tinnitus but not the hearing loss itself. The brain receives less external stimuli. This process changes around specific frequencies may be a way of the brain filling in the auditory gap. A gap of the sounds and frequencies it has lost due to hearing loss.
- Obstructions of the ear: excessive wax, head congestion, loose hairs from the inner ear canals, and dirt. Often when the obstruction is removed, the tinnitus will stop. However, sometimes it can cause permanent damage.
- Head trauma or neck trauma: trauma can cause nerve damage that can result in tinnitus.
- TMJ: the joint that connects the jaw to the skull is located in front of the ear canal. For this reason, the tightening of the jaw muscles due to conditions such as TMJ can cause tinnitus since the auditory system and the jaw share muscles.
- Sinus pressure and barometric pressure: any type of abnormal pressure on the middle ear can cause tinnitus symptoms diving, flying, head colds concussive explosions and even just blowing your nose.
- TBI: Traumatic brain injuries can lead to tinnitus again for similar reasons as head and neck trauma. The damage caused to the middle ear by concussive shock injures the auditory system. About 60% of all the tinnitus cases that VA diagnoses are due to mild-severe TBI.
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Indemnity Or Offset For Va Waiver
May a state court order a retiree who waives retirement to receive disability to indemnify the former spouse for the reduction in that spouses share of the retirement?
No, according to a unanimous 2017 U.S. Supreme Court decision, Howell v. Howell, 137 S.Ct. 1400 . SCOTUS made clear that states not only cannot divide disability directly , but cannot do it indirectly either by ordering dollar-for-dollar indemnity.
Prior to Howell, federal law had long prevented states from dividing VA disability payments. Mansell v. Mansell, 490 U.S. 581 . Colorado has similarly ruled that divorce courts cannot divide VA disability payments, nor require the servicemember to indemnity the spouse for a VA waiver of retired pay that happened prior to dissolution. In re Marriage of Franz, 831 P.2d 917 .
The majority rule among the states had been that the federal prohibition on dividing VA disability did not preclude a state from ordering the retiree to indemnify the former spouse for the resulting VA waiver, under the theory that once the former spouse has a vested interest in the retirement, the military member cannot unilaterally reduce the other spouse’s share by applying for VA disability. In other words, once the spouses were divorced, if the member then converts a portion of retirement to disability, he/she would owe the former spouse indemnity for any VA waiver.
How Does The Va Qualify Eligibility For Hearing Loss
Hearing issues are very common in the United States, especially among older adults.
Tragically, retirees and veterans of the U.S. Armed Forces traditionally start dealing with hearing loss at a far younger age compared to civilians.
In fact, the VA recently described hearing problems like tinnitus as the most prevalent service-connected disability among American Veterans.
The goal of any VA disability claim is to link the medical condition with a service connection.
In other words, the patient struggling with hearing loss must prove to the VA that the medical condition started or worsen during their time in service in order to receive disability benefits.
Otherwise, the military is not considered at fault for your injuries and therefore you may not receive any form of VA disability.
While VA rating percentages are subject to change, here are some current examples of how you may qualify for VA disability coverage:
- Otosclerosis
- Chronic Suppurative Otitis Media
- Chronic Otitis Externa
- Peripheral Vestibular Disorders
- Loss of Ear
- Menieres Syndrome
- Malignant Neoplasm
Sadly, the U.S. Armed Forces currently do not currently observe Tympanic Membrane Perforation, or a perforated ear, as a hearing impairment.
As a result, patients receive a 0% rating for this medical condition.
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Eligibility Requirements For Concurrent Retirement And Disability Pay
In order to qualify for CRDP, veterans must be eligible for retired pay. If veterans were placed on a disability retirement but would be eligible for military retired pay in the absence of the disability, they may be entitled to receive CRDP. According to VA, veterans may be entitled to CRDP if:
- They are a regular retiree with a VA disability rating of 50 percent or higher
- They are a reserve retiree with 20 qualifying years of service, who have a VA disability rating of 50 percent or higher, and who have reached retirement age*
- They are retired under Temporary Early Retirement Act and have a VA disability rating of 50 percent of higher
- They are a disability retiree who earned entitlement to retired pay under any provision of law other than solely by disability, and they have a VA disability rating of 50 percent or higher
*Note: In most cases the retirement age for reservists is 60, but certain reserve retirees may be eligible before they turn 60. If a veteran is a member of the Ready Reserve, their retirement age can be reduced below age 60 by three months for each 90 days of active service they have performed during a fiscal year.
- A veterans retirement date or
- When the veteran first increased to at least a 50 percent disability rating
*Note: No CRDP is payable for any month prior to January 2004. Prior to 2004, existing laws and regulations prohibited military retirees with service-connected disabilities from receiving both payments.
Va Disability Counts As Income For Child Support & Alimony
VA disability payments count as income for purposes of calculating child support and maintenance – the fact that they are tax-free payments means they are invisible to the IRS, but not invisible to other agencies or for other purposes.
In Rose v. Rose, 481 U.S. 619 , the U.S. Supreme Court found that VA disability payments were intended not just for the veteran, but as the law stated, to provide reasonable and adequate compensation for disabled veterans and their families.
From this, the Court concluded: “Congress clearly intended veterans’ disability benefits to be used, in part, for the support of veterans’ dependents. Although Rose concerned garnishment of VA disability payments, in that case the disability benefits comprised most of the obligor’s income considered by the state court. While the decision did not explicitly address the fact that the state court counted the disability as income, had the Court taken issue with counting it, the justices certainly had the opportunity to correct the state court.
In a 1991 decision, the Colorado Court of Appeals rejected a husbands argument that counting VA disability payments as income was effectively a backdoor, improper division of the disability payments themselves. In re: Marriage of Nevil, 809 P.2d 1122, 1123 . The Courts reasoning was:
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With A Dependent Spouse Or Parent But No 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 your spouse receives Aid and Attendance benefits, be sure to also look at the Added amounts table, and add it to your amount from the Basic rates table.
| Dependent status | 30% disability rating | 40% disability rating | 50% disability rating | 60% disability rating | ||||
|---|---|---|---|---|---|---|---|---|
| Dependent status | 30% disability rating | 467.39 | 40% disability rating | 673.28 | 50% disability rating | 958.44 | 60% disability rating | 1,214.03 |
| With spouse | 30% disability rating | 522.39 | 40% disability rating | 747.28 | 50% disability rating | 1,050.44 | 60% disability rating | 1,325.03 |
| With spouse and 1 parent | 30% disability rating | 566.39 | 40% disability rating | 806.28 | 50% disability rating | 1,124.44 | 60% disability rating | 1,414.03 |
| With spouse and 2 parents | 30% disability rating | 610.39 | 40% disability rating | 865.28 | 50% disability rating | 1,198.44 | 60% disability rating | 1,503.03 |
| With 1 parent | 30% disability rating | 511.39 | 40% disability rating | 732.28 | 50% disability rating | 1,032.44 | 60% disability rating | 1,303.03 |
| With 2 parents | 30% disability rating | 555.39 | 40% disability rating | 791.28 | 50% disability rating | 1,106.44 | 60% disability rating | 1,392.03 |
If your spouse receives Aid and Attendance benefits, be sure to also look at the Added amounts table, and add it to your amount from the Basic rates table.
What Are The Effective Dates For Tdiu Awards
For the longest time, a request for a total disability award based upon individual unemployability was considered its own claim.
That meant the effective date of a TDIU award could be no earlier than the date of a written TDIU request. In an important case, Rice v. Shinseki, the Veterans Court redefined the status of a TDIU request as an issue tied to a claim, but not a claim in itself. Rice said that the service-connected condition upon which the TDIU was based was the claim, and that the TDIU request was a theory or issue in support of the claim to achieve the highest possible rating.
Rice is good news for assigning earlier effective dates for TDIU awards. Effective dates for TDIU awards can now go back to the date of the underlying claim whereas before Rice, the effective date was limited to the filing date of the written request for a TDIU award.
The effective date assigned will depend upon when the medical evidence shows the claimants service-connected disability prevented him/her from obtaining and maintaining substantial gainful employment.
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How Does Va Determine Disability Rating
The VA assigns you a disability rating based on the severity of your disability. This rating is expressed as a percentage, representing how much your disability decreases your overall health and ability to function.
Your disability rating is then used to determine your disability compensation rate, which is how much money youll receive from the VA each month in disability benefits.
Your disability rating is also used to determine your eligibility for other benefits, like VA health care.
What Other Factors Does The Va Take Into Account For Disability
When deciding on a disability claim, the VA looks at your eligibility first. Then, it considers your conditions overall impact on your daily life, activities and employability.
If you think your VA rating is too high or too low, you can file an appeal to try to get the VA to increase your rating. Be sure to include evidence of your conditions impact on your life, like statements from doctors, employers or others close to you.
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Commonly Awarded Disability Compensation Claims
According to a recent Veterans Administration report to Congress, the ten most commonly awarded medical conditions that are getting approved for benefits are as follows:
- Tinnitus
Of these, tinnitus was the runaway winner, with 157,152 newly-awarded claims, according to the 2018-2019 Veterans Benefits Administrations Report to Congress. The runner-up, Limitation of flexion in the knee, accounted for 99,467 new claims while hearing loss resulted in 76,102 new claims during the reporting period.