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HOW DOES THE VA DETERMINE YOUR DISABILITY PERCENTAGE?

paul-2-300x199One topic in military law important to many veterans is Veterans Affairs (VA) disability. Federal law established the US Department of Veterans Affairs with several important missions to serve our veterans.[i] One of those missions is to provide disability benefits to eligible veterans who are disabled due to injuries or illnesses that have been caused by or made worse through the veteran’s military service.[ii]

What Is VA Disability Compensation?

The VA defines disability compensation as “a tax free monetary benefit paid to Veterans with disabilities that are the result of a disease or injury incurred or aggravated during active military service. Compensation may also be paid for post-service disabilities that are considered related or secondary to disabilities occurring in service and for disabilities presumed to be related to circumstances of military service, even though they may arise after service.”[iii] The VA also provides additional compensation benefits such as dependency and indemnity compensation, special monthly compensation, adapted housing grants, service-disabled veterans’ insurance, and veterans’ mortgage life insurance.

How Do I Begin the VA Disability Process?

The first step in the VA disability process is to find out if you are eligible. This may be more complex than it sounds due to the myriad of rules that apply. For example, if you are a veteran who received an other than honorable discharge, bad conduct discharge, or dishonorable discharge, you are not eligible for VA disability benefits.[iv] (In that case, you might consider applying for a discharge upgrade, and if granted, you may then be eligible)[v]  Another common issue that could arise is whether you were on an active duty or training status at the origination of the injury or illness. The simplest way to determine your eligibility is to review the information on the VA website to see if you meet the criteria.[vi]

Who Determines If I Am Eligible For Disability Benefits?

Applicants apply to the VA for a disability determination. The VA will then review the application. Once the VA has made their decision, they will mail a disability claim decision letter to the applicant.[vii] This is not the end of the process as the applicant may submit additional evidence, submit a new request for disability later, or may appeal the VA’s determination. Appeals go to the Board of Veterans Appeals and then the US Court of Appeals for Veterans’ Claims.[viii]

How Much Will I Be Awarded For My Injury?

The VA awards disability ratings for each service-connected illness or injury from 0% to 100%. 100% means that the veteran is completely and totally disabled based on the illness or injury and is therefore unable to work. 0% means the VA has determined this injury or illness does not cause problems for the applicant that would prevent the applicant from being able to work. The percentage awarded for each injury or illness is based on the percentage range for that injury or illness in the federal code of regulation that defines that specific injury or illness.[ix] The VA uses a 4 digit diagnostic code to categorize every injury or illness.

It is easy to determine the correct percentage of some injuries as they are clearly specified in the CFR. The following are examples:

  • Tinnitus, recurrent code 6260: The VA awards 10% disability for tinnitus, “whether the sound is perceived in one ear, both ears, or in the head.”[x] Although this example could be made more complicated if combined with another hearing loss evaluation.
  • Cartilage, semilunar, removal of, symptomatic 5259: 10%.[xi]

Other injuries have a wide range of possible disability percentages and may require persuasive arguments supported by medical records on behalf of the applicant. Examples of these include:

  • Sinusitis, sephenoid, chronic 6514: ranges from a rating of 0%, 10%, 30%, or 50%.[xii]
  • Fibromyalgia 5025: ranges from 10%, 20% or 40%.[xiii]
  • Ankle, limited motion of 5271: moderate=10% marked=20%.[xiv]
  • Open-angle glaucoma 6013: “Evaluate under the General Rating Formula for Diseases of the Eye. Minimum evaluation if continuous medication is required 10%”[xv]

What If I Suffer From Multiple Disabilities Related to Military Service?

When a veteran has multiple disabilities, they must be combined into the combined disability rating. This rating is in increments of the nearest 10% from 0% to 100%.

Do not assume that you just add the disabilities together. For example, if a knee injury makes the applicant 30% disabled and post traumatic stress disorder makes the applicant 20% disabled, it appears that the applicant would be 50% disabled, right? No, that is wrong. The VA has made it a bit more complicated. There is a combined disability rating calculator on their website that may be helpful.[xvi] The actual combined disability percentage of 30% and 20% is 44%, which will then be rounded to the nearest 10% to 40%. Mathematically this is justified by the VA’s position that no one can be more than 100% able bodied.

This calculation gets more complicated based on how many disability ratings there are. For example, a veteran that has ratings of 30%, 20%, 20%, 10%, 10%, 10% is 70% disabled.[xvii] (not 100% as it would be if you added them all together).

There are many rules and concepts that apply to VA disability law that are difficult to understand.  If you are interested in applying for VA benefits, we can help. Just call our office at 615-490-6020 to set up a consultation with Military Law Attorney Paul Tennison at Cole Law Group in Brentwood, TN. Our firm offers either in-person meetings or video conferencing.

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[i] For more information about the US Department of Veterans Affairs, I encourage you to visit their website at https://www.va.gov

[ii] See https://www.va.gov/disability/eligibility

[iii] https://www.benefits.va.gov/compensation

[iv] See https://www.va.gov/disability/eligibility

[v] To learn more about military discharge upgrade reviews: https://www.colelawgrouppc.com/blog/how-do-i-request-a-military-discharge-upgrade

[vi] Id.

[vii] To learn more about the VA disability claim decision letter: https://www.colelawgrouppc.com/blog/how-to-read-and-understand-your-va-disability-claim-decision-letter

[viii] See http://m.uscourts.cavc.gov

[ix] 38 CFR §4.1 Essentials of evaluative rating explains the percentage ratings: “represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and their residual conditions in civil occupations.”

[x] 38 CFR §4.87.

[xi] 38 CFR §4.71.

[xii] 38 CFR §4.97.

[xiii] 38 CFR §4.71.

[xiv] Id.

[xv] 38 CFR §4.79.

[xvi] https://www.va.gov/disability/about-disability-ratings

[xvii] Id.

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