VA RATINGS–AM I 100% OR NOT?


I get queries about 3 times a month to diagnose a Veteran’s rating. Apparently VA is not as clear as we would like and uses all manner of acronyms in an attempt to throw us off. So, too, do they obfuscate and fail to state in concise English that we are permanently and totally rated-i.e. P&T. Let’s clear the air and explain it in JohnnyVetspeak.

The 100% Schedular Rating

First, let’s analyze what a true, 100% schedular rating is. This simply means your rating is at the top of the schedule for your disease or disability.  DC 7354 Hepatitis C is an example. If your symptoms are “near-constant and debilitating”, this entitles you to 100%-the highest rating. If it were not near constantly debilitating but at least more than 6 weeks of the year, you would get a 60% schedular rating. That, in and of itself, might or might not entitle you to TDIU. Some diseases or injuries top out at 60% and have no higher schedular rating. This, in most instances, would prevent you from reaching 100% without some help or other ratings adding up to 100%.

The 100% Combined Rating

The next version of 100% can be attained by adding up a number of disabilities and arriving at 100%. This is called a “combined 100%” rating. It pays at 100% and feels like it, too. If you cannot work, you will eventually be awarded a Permanent and Total  rating-usually after a 2-5 year period to determine if you may improve and fall below 100%. In certain instances, a 100% combined rating will be inferior for Special Monthly Compensation awards above SMC L.

TDIU

Finally, let’s analyze what TDIU is. TDIU stands for Total Disability (due to) Individual Unemployability. In simple terms, this means you have an employment “handicap” that prevents you from working. The problem is that you do not have a 100% total  rating and can never get there. Let’s say you have a mega-bad back and have maxed out at 60% on the L5-S1 juncture from jumping out of perfectly good airplanes with about 90 extra lbs. of shit attached to you more than 25 times. You have a couple of smaller ratings such as DM II from too much Agent Orange that gets you 20%, maybe tinnitus for 10% and flat feet from all those hard landings for 10%.  60 + 20 = 68%. 68 + 10 = 71% and finally 71 + 10 = 74%. Bummer. It rounds down to 70%  but you still can’t work. VA has made a special “extraschedular” consideration (see comments below) for these situations and usually grants you TDIU. TDIU is, for all intents and circumstances, a 100% rating for pay purposes. If you have it for more than five years, you’ll probably get P&T eventually. If you do not, you need to apply for it. VA is fond of telling you that you can still make $12,000 a month selling Vacation Time Shares in Hawaii and will deny TDIU. Don’t give up. Appeal it unless you have a degree in telemarketing.

The bare minimum to get your foot in the TDIU door is a single 60% rating. If you cannot rustle that up, VA has an alternative. If you have a single 40% or more rating , and others adding up to 70% combined using the table in §4.25, you are also eligible. If you are not considered for it, you should be. With that said, you probably will not get TDIU if you have 40% for DM II, 10% each (bilaterally in all four quadrants) for peripheral neuropathy, tinnitus for 10%, flat feet for 10% and hemorrhoids for 10%. While it might add up to 70%, the combination is not so debilitating as to keep you out of gainful employment in VA’s eyes. I’m currently fighting for Ed who is 70% for PTSD, 60% for IHD from AO, 10% for a B 40 122cm RPG rocket that hit him in the shoulder but didn’t explode and 10% for Tinnitus. He’s 90% and VA seems to think he has that marketing BA degree in Time Share 401. Not. He has a 20-year degree in LA County Sheriff Lieutenant. That isn’t very useful when you hit 70 unless you’re seeking employment as a rent-a-cop security guard at Boeing in the Bitch Booth for $7.25/hr.

Permanent and Total

Last but not least, you will always know when you are Permanent and Total. At the end of a rating or on your Confirmed Ratings Decision, you will see the “Entitlement to Chapter 35 DEA (Dependents Educational Allowance)” announcement. That is the giveaway that you are not going to have to pay for the kids’ college. Unfortunately, most of us get here about 10 years after the kids have graduated so the only one who can benefit is the wife. Not very many wives relish the idea of chasing a degree in anything by the time they hit 55. In fact, being 55 or more hits them pretty hard when you think about it.

My son lucked out. Surprise, surprise, surprise. The vasectomy failed (I got the second one free) and Buckwheat junior was born when I was 35. I got P&T in 2008 when I hit 56. He decided to use the 4 years in three and did Law school and a Masters in CPA at the same time so it didn’t go to waste. By law, the rug rats can’t be over 26 to use it up unless you get it way late in life. They have one year to file for it at that point or it evaporates.

It’s easy to see the confusion when you start getting a check for $3,277.00 and you’re only 70% rated. It’s even more confusing to see you are now entitled to Chapter 35 DEA and you ‘re trying to figure out how the Drug Enforcement Agency got dragged into this discussion. Most Vets think they got promoted to 100% schedular when they get the TDIU. This really begins to cause problems when they think they have 60% (or more) in extra ratings and are entitled to the first tier of Special Monthly Compensation “S”. VA is many things but they are not fast and loose with their money. I’ve discovered VA can be 100% pure asshole with someone like Ed who is 90% but will give another guy with 60% TDIU. I’m sure there’s a rhyme or reason to it but it eludes me. It’s a VA thing. You wouldn’t understand.

So, that today’s teaching moment in 100% ratings. Today’s blog is brought to you by letters P and T.

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Below, find my latest treasure trove of great Sunday Morning cartoons.

 

About asknod

VA claims blogger
This entry was posted in 100% ratings, KP Veterans, SMC, TDIU, VA Agents, Veterans Law and tagged , , , , , , , , , , , , , . Bookmark the permalink.

9 Responses to VA RATINGS–AM I 100% OR NOT?

  1. tamanuoil says:

    I was service connected in 2013 with 70%PTSD(personal trauma) 40% bladder hypertensionality and 10% severe anxiety. I have not worked since 2011. I submitted a review for TDIU in may 2019. I was impatient and clicked the button to decide my case now not realizing it meant they could not ask me for anything else they needed. I was denied. I hired a lawyer wanting to make no more mistakes. The lawyer filed a nod(im guessing all ebennies said was privacy act) on 4Oct19. On 12Oct19 it moved to evidence gathering and has been sitting there since. What are your thoughts on me receiving extraschedular? my C and P doctors said they found me deficient in the areas looked at for unemployability and the VA has not requested any more appointments. Also, would my EDD go back to the 2013 claim if there is no increase?

  2. Poopsy Woopsy says:

    I’m seriously trying to be “Lawyer”ISH” and get some much needed reading done as your info is always stellar BUT, your jokes and jargon keep getting in the way when I would rather “Laugh” than get down to business.. Thanks for keeping it “Light and Hearty” whith undertones of “Whoop-Ass information..

  3. T Robins says:

    Alex, I was able to receive pension in 2015 while on Comp appeal to BVA for “chronic liver” damage from HCV. I talked to pension and was told my rating was 10% but with Unemployability was rated 100%. I had to stop work in 1999 with the nightmare of ribavarin and interferon which failed, then ribavarin and pegulated interferon failed and epic failed and finally in 2014 virus was eradicated with Sofosbuvir. Through the years and battles with ascites, portal hypertension and gastrophy, and esophageal varicies, … everything but the cancer which I am screened for frequently. Anyway, I had my BVA hearing and think I will have a win.
    Will my 100% rating stay the same with TDIU?

    • asknod says:

      If your ratings combine to 100% or more using §4.25, then you would be assigned a 100% rating. This would moot a TDIU rating and supplant it with a 100% combined rating. It also would allow you to work if you wanted to whereas you would be forbidden to work if you were TDIU. I do hope you filed for ascites/varices as secondary to the hep. Usually, VA would give you a 100% for the HCV if you got that ill or try to do a split between DC 7312 (cirrhosis) and HCV under DC 7354. That way they’d screw you out of a 100% rating for just the HCV. VA is famous for that trick.

      • T Robins says:

        I had claimed HCV and stated in claim that to progressed to Cirrhosis (biopsy in 1999 was stage IV of IV), Portal hypertension, Ascites, and Esophageal Varices. So all of those are listed. Also, my Dr has rendered a nexus on connection to the inoculations.
        I’m saddened that hours on the phone and internet do not render answers for the Veteran.
        My appeal is prioritized- what is the timeline when VLJ finishes for back pay to be processed? I guess that keeping this old man in a maize will result in death before help.
        Thanks for your time.

        • asknod says:

          You said your doctor has written you a nexus. If he did not mention he had reviewed your medical records from the service, you probably will not win. If that happens, let me know and I’ll help you obtain real legal counsel. VSOs do not know how to do this. Look at the top of the blog under Nexus Bible and read it.

  4. Holly R Hardy says:

    Great info. Thank you.

  5. JOEL F HINES says:

    You forget the 38cfr 4.16(b) method

    • asknod says:

      Well, if you mean I didn’t cite to §4.16(b) specifically, yes. Nevertheless, you will note my use of the term “extraschedular” which is what §4.16(b) references. I’m sorry I neglected to specifically mention the controlling regulation . But I amply described how most, if not all, Veterans attain TDIU. To be sure, all Veterans are automatically considered for TDIU locally. For those who are “iffy”, the Regional Office transfers the Vet’s file to the Director, Compensation and Pension in DC and allows them to review it for sufficiency. The process is fairly open but yes-mistakes happen. My client Ed mentioned above is more than eligible for TDIU but the raters focused myopically on just the IHD and neglected to look at the 70% for PTSD. Additionally, if denied at the Director C&P’s office, a Vet can appeal to the BVA and the reviewing Judge is authorized to override that denial and grant TDIU if the Veteran is otherwise eligible.

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