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  • 14 Questions about VA Disability Compensation Benefits Claims

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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading


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wangotango

100% criteria

Question

Posted (edited)

How much of the 100% criteria do you need to receive the rating?

I have some of the conditions such as persistent delusions/hallucinations and one or two others

claim in prep for decision.

50% MDD increase request, examiner diagnosed me as schizoaffective depressive

 

Edit July 11th- I was granted 100%

Edited by wangotango
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That is for the rater to decide they will look at which rating fits your symptoms better. So if it is a 50/50 split the veteran gets the win. 

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The mental health critieria has been posted a few times.  Its all about "occupational and social impairment", where "total occupational and social impairment" is 100 percent.   

For details, see this:

https://www.law.cornell.edu/cfr/text/38/4.130

If you are unable to work, due to sc mental health disorder(s)  you should be at or close to 100 percent.  

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The 100% criteria is shown below (direct links and content directly from the VA is listed further below).

Basically, if you are unable to work and are having major issues otherwise. The symptoms listed are just examples (i.e. "such as") and should be significant enough to fit this picture.

Quote

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.

 

 

§4.130   Schedule of ratings—Mental disorders.

 

Quote

§4.130   Schedule of ratings—Mental disorders.

The nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (see §4.125 for availability information). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in §4.125 through §4.129 and to apply the general rating formula for mental disorders in §4.130. The schedule for rating for mental disorders is set forth as follows:

9201   Schizophrenia

9202   [Removed]

9203   [Removed]

9204   [Removed]

9205   [Removed]

9208   Delusional disorder

9210   Other specified and unspecified schizophrenia spectrum and other psychotic disorders

9211   Schizoaffective disorder

9300   Delirium

9301   Major or mild neurocognitive disorder due to HIV or other infections

9304   Major or mild neurocognitive disorder due to traumatic brain injury

9305   Major or mild vascular neurocognitive disorder

9310   Unspecified neurocognitive disorder

9312   Major or mild neurocognitive disorder due to Alzheimer's disease

9326   Major or mild neurocognitive disorder due to another medical condition or substance/medication-induced major or mild neurocognitive disorder

9327   [Removed]

9400   Generalized anxiety disorder

9403   Specific phobia; social anxiety disorder (social phobia)

9404   Obsessive compulsive disorder

9410   Other specified anxiety disorder

9411   Posttraumatic stress disorder

9412   Panic disorder and/or agoraphobia

9413   Unspecified anxiety disorder

9416   Dissociative amnesia; dissociative identity disorder

9417   Depersonalization/Derealization disorder

9421   Somatic symptom disorder

9422   Other specified somatic symptom and related disorder

9423   Unspecified somatic symptom and related disorder

9424   Conversion disorder (functional neurological symptom disorder)

9425   Illness anxiety disorder

9431   Cyclothymic disorder

9432   Bipolar disorder

9433   Persistent depressive disorder (dysthymia)

9434   Major depressive disorder

9435   Unspecified depressive disorder

9440   Chronic adjustment disorder

General Rating Formula for Mental Disorders

    Rating
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 100
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 70
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 50
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 30
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. 10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. 0

9520   Anorexia nervosa

9521   Bulimia nervosa

Rating Formula for Eating Disorders

    Rating
Self-induced weight loss to less than 80 percent of expected minimum weight, with incapacitating episodes of at least six weeks total duration per year, and requiring hospitalization more than twice a year for parenteral nutrition or tube feeding. 100
Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of six or more weeks total duration per year. 60
Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of more than two but less than six weeks total duration per year. 30
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder and incapacitating episodes of up to two weeks total duration per year. 10
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder but without incapacitating episodes. 0

Note 1: An incapacitating episode is a period during which bed rest and treatment by a physician are required.

Note 2: Ratings under diagnostic codes 9201 to 9440 will be evaluated using the General Rating Formula for Mental Disorders. Ratings under diagnostic codes 9520 and 9521 will be evaluated using the General Rating Formula for Eating Disorders.

(Authority: 38 U.S.C. 1155)

[79 FR 45100, Aug. 4, 2014]

 

 

 

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