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Attn: Harleyman

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Philip Rogers

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  • HadIt.com Elder

When you have the time, maybe you can answer this for us. What does the VA do when a claimant is already rated 100% scheduler and they have additional ratings that "add" up to 60% (ie: 20%,10%,10%,10% and 10%)?? Do they continue to use the combined ratings table(CRT), even tho the claimant is already 100% and therefore they shouldn't be using the CRT, as the claimant is already completely disabled and should have a value of "0"?? This has to do with an SMC "s" award. Thanks ahead of time!

pr

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Its all about the VA's interpretation of:

Has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems.

This really sounds to me like "additional" suggests "adding" not "combining", noting the plural form of "disabilities". I did not locate a CAVC case addressing this. However, when there are 2 ways of interpreting a regulation, VA regs require the more favorable way is required. The reg does not state they are combined using VA fuzzy math. If you apply VA fuzzy math to everything, then paying employees would go like this:

If you worked 40 hours, then you "combine" the days like so:

8 hours monday

8hours tuesday...you have already "used up 8 hours" of your 40, so you get 8times 32/40 or 6.4 hours rounded to 6

8 hours Wednesday...you have already used up 14 hours of your 40, so you get 8 times 26/40 or 5.2 hours rounded to 5

8 hours Thursday..you have already used up 19 of your 40, so you get 21/40 times 8 or 4 hours

8 hours Friday...you have used up 23/40 hours, so you get 8 times 17/40 or 3 hours.

So, your combined hours are 26 hours for 40 hours work. I bet that would not go well.

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(s) If the veteran has a service-connected disability rated as total, and

(1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or,
(2) by reason of such veteran’s service-connected disability or disabilities, is permanently housebound, then the monthly compensation shall be $2,993. For the purpose of this subsection, the requirement of “permanently housebound” will be considered to have been met when the veteran is substantially confined to such veteran’s house (ward or clinical areas, if institutionalized) or immediate premises due to a service-connected disability or disabilities which it is reasonably certain will remain throughout such veteran’s lifetime.
VA loves obfuscation but there is one and only one ratings table and method for "adding" them up. I applied for SMC-S by virtue of being "housebound in fact" with a number of disabilities (colostomy, 40 lb. weigh loss. 9 months in hospital- the usual stuff). VA turned me down even with my 40% (DC7815-7704) and 10% (DC 6260). Their words- "your independently ratable disabilities add up to 50% and you do not qualify for 'S'. You seem to get to your VA appointments okay so we see no evidence you are housebound."
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I agree, with the Hadit members. I don't think too kindly of the combined rating table especially once a Veteran is parselled out on the combined rating table trying to get the 100% or the IU 100%.. And once you have a person at 100% how can you parsel the person out any more. To me after 100%..., disabilities should compound rather than using the VA combinator of diminishing wellness. If you are 100% there doesn't seem to be any wellness left. In fact, you are not well. -imo

But, I work there and that's how we are directed to determine disability. I am sorry, Maybe someone can take it to court and fight the battle.

Edited by harleyman
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  • HadIt.com Elder

Its all about the VA's interpretation of:

Has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems.

This really sounds to me like "additional" suggests "adding" not "combining", noting the plural form of "disabilities". I did not locate a CAVC case addressing this. However, when there are 2 ways of interpreting a regulation, VA regs require the more favorable way is required. The reg does not state they are combined using VA fuzzy math. If you apply VA fuzzy math to everything, then paying employees would go like this:

If you worked 40 hours, then you "combine" the days like so:

8 hours monday

8hours tuesday...you have already "used up 8 hours" of your 40, so you get 8times 32/40 or 6.4 hours rounded to 6

8 hours Wednesday...you have already used up 14 hours of your 40, so you get 8 times 26/40 or 5.2 hours rounded to 5

8 hours Thursday..you have already used up 19 of your 40, so you get 21/40 times 8 or 4 hours

8 hours Friday...you have used up 23/40 hours, so you get 8 times 17/40 or 3 hours.

So, your combined hours are 26 hours for 40 hours work. I bet that would not go well.

That was good, bronco!!!!

pr

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  • HadIt.com Elder

(s) If the veteran has a service-connected disability rated as total, and

(1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or,
(2) by reason of such veteran’s service-connected disability or disabilities, is permanently housebound, then the monthly compensation shall be $2,993. For the purpose of this subsection, the requirement of “permanently housebound” will be considered to have been met when the veteran is substantially confined to such veteran’s house (ward or clinical areas, if institutionalized) or immediate premises due to a service-connected disability or disabilities which it is reasonably certain will remain throughout such veteran’s lifetime.
VA loves obfuscation but there is one and only one ratings table and method for "adding" them up. I applied for SMC-S by virtue of being "housebound in fact" with a number of disabilities (colostomy, 40 lb. weigh loss. 9 months in hospital- the usual stuff). VA turned me down even with my 40% (DC7815-7704) and 10% (DC 6260). Their words- "your independently ratable disabilities add up to 50% and you do not qualify for 'S'. You seem to get to your VA appointments okay so we see no evidence you are housebound."

asknod - I think I read yesterday, in one of the links that Harleyman posted, that the VA is not allowed to consider the ability of attending medical appointments to refute the housebound rule. I think it was in M-21-1MR part 5. My point is that using the CRT is illegal once the claimant is 100%, because a person rated 100% has no residuals, they are already worth zero.

pr

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I agree if you are 100% disabled there is no wellness left. The whole idea of the combined rating table is based on the idea that there is a percentage of wellness left from which the next disabling condition is apllied. When you reach 100% disabled there is zero wellness. What wellness is the VA baseing the addtional disabities over 100% on? It does not make sense to me either, nor is it fair.

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