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80% disabilities now I am trying to get to 100%

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Timothy L. Gess

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Here is a good explanation of VA math for rating disabilities.  No one can explain it better.  This information is from a veterans attorney website.

How Does the VA Rate Disabilities?

"When it comes to service connected compensation claims, the VA takes the view that it should not add whole numbers together to get your rating but, instead, the VA takes percentages of percentages.  It is as if the VA says if you are 10% disabled then you are 90% healthy.  Therefore, the next rating is not added but is used to take a percentage of the ‘healthy’ 90%.  So for a veteran with two 10 ratings the first ten percent rating would be 10% of 100, which is 10%.  The second ten percent rating would be 10% of the 90% (again the ‘healthy’ percent of the veteran), which is 9%.  So the combined rating would be 19%.  The percentages are all rounded up or down to the nearest ten percent.  Here, the rating would be rounded to 20%.

The combined rating system starts to work against a veteran when he gets closer to 100%.  It gets harder and harder to get that higher rating, especially once a veteran is over 50%.  For instance, if a veteran has a ratings of 50% for PTSD, 50% for Sleep Apnea, a rating of 20% for diabetes and 20% for a back problem the combined rating is 80%.  So even though 50+50+20+20 equals 140 in real math; it is only 80 in VA math.

The difference that it leads to in compensation is huge.  According to the VA compensation rating table, a veteran, with no dependents, rated at 80% would receive $1,877.43 per month.  A single veteran rated at 100%, on the other hand, would receive $3,456.30 per month.  This veteran receiving a rating of 100%, which is only 20% greater than the 80% rating, gets almost 100% more money a month!"

_________________________________________________________________________

The sometimes easier and faster to get a 100% rating and pay is to claim your 80% disability/s render you unemployable and unable to work due only to your VA service connected disability.  You do this by filing a IU or TDIU claim on the proper form and submitting solid medical evidence to support your unemployability and TDIU claim.

You must not be working at a gainful employment income level and should not be working at all and receiving earned income.  Also at least one of your disabilities must be rated at 40% and the others combined to add up to  60% or more to receive the TDIU rating.  Also a doctor's nexus opinion letter stating in great detail why your disabilities render you unemployable. Title 38 CFR 4.16 of the VA CFR regulation covers the minimum requirements you must meet for TDIU.

As an example.  In 1998 I was rated TDIU due to a single 70% PTSD rating and in 2000 this was made permanent.  I met all of the above requirements and the VA C&P Psychologist examiner agreed my PTSD rendered me unemployable.  I did not need a separate doctor's medical IMO opinion or nexus letter due to my long term PTSD ratings starting in 85 and combat awards to include the PH.  Extensive long term VA medical treatment records for PTSD was a big plus for my TDIU claim.

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

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Edited by Dustoff1970
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1 hour ago, Dustoff1970 said:

The sometimes easier and faster to get a 100% rating and pay is to claim your 80% disability/s render you unemployable and unable to work due only to your VA service connected disability.  You do this by filing a IU or TDIU claim on the proper form and submitting solid medical evidence to support your unemployability and TDIU claim.

You must not be working at a gainful employment income level and should not be working at all and receiving earned income.  Also at least one of your disabilities must be rated at 40% and the others combined to add up to  60% or more to receive the TDIU rating.  Also a doctor's nexus opinion letter stating in great detail why your disabilities render you unemployable. Title 38 CFR 4.16 of the VA CFR regulation covers the minimum requirements you must meet for TDIU.

The above statement is a little off because it only addresses 38 CFR 4.16(A) and not 38 CFR 4.16(B). “Which states that a particular rating percentage is not needed.”

“(b) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue.” Keep in mind that unemployability and TDIU are the same benefit, and the only difference is unemployability does not have the TD for Total Disability part.    

 

Now it is hard, but it is not impossible. I did it but not knowing your current rating percentages, it is hard to say. Yes, you are going to need a bunch of separate and different rating percentages, but you only need to hit 95% where the VA would then round up to 100% schedular. I was rated as 90% on the VA math scale 38 CFR 4.25 and the VA granted/awarded me 100% schedular when my final ratings came in as a separate 40% and 30% which tip me above the 95% and I was rated as 100% schedular P & T. Yes, a veteran could go the route of filing for TDIU but that is something the veteran should decide. What are your current breakdown rating percentages? 

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According to former senior DRO achieving an extra-scheduler TDIU rating is extremely rare and in his 30 years with VA claims adjudication he recalls only a few times a vet received the extra-scheduler rating under 4.16B.  Of course he could be lying.  You are one of the rare ones evidently. Congratulations!!!!.

By the way Title 38 4.16 includes both subsections  (A) AND (B).  Just saying.  No off at all.

One time overseas a fellow airman wanted to argue how many angels could dance on a pin head.  I said don't waste my time.

Edited by Dustoff1970
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First things first, I don’t care what a former Senior DRO said or say because they are bias and not veteran friendly.  Second and finally, if you take the time to read and reread my post, your post mentions the rating percentage a veteran must have the 40% and the 60% 38 CFR 4.16(A) and nothing else. It does not mention 38 CFR 4.16(B).

The VA loves to quote 38 CFR 4.16(A), but they rarely address or even mention 38 CFR 4.16(B). Just because something is hard does not mean that it is impossible. I was informed that I would never get to 100% schedular but I did it and I never listen to anyone that says it is impossible without knowing my record and evidence. Of course, it is possible because I did it. It is your right if you choose to listen to anyone but when you spread their opinion then it should be checked and corrected. I not only won my 100% schedular rating. I won two separate early effective dates, and I was told that would never happen.

The bottom line is there is absolutely no standard in the VA and no one employee or former employee can speak for an entire agency or entity and be spot on all the time. My record speaks for itself, and I will call out any misleading information I see. Heck with all the changes the VA is going through even I may be off but this time your post if off and that is it. You can think otherwise but it is off and let’s agree that our opinions are different and move on.

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You need to chill out.  Many years ago when I researched my possibility of applying for TDIU I read in many veterans resources such as the Veterans Advocate, Nexis Lexis VA disability Claims Reference books, Paralyzed Veterans SOAR newsletters for their attorneys and VSOs plus many other expert sources that said extra scheduler ratings were in fact rarely awarded by the Director of Compensation for VBA.  This was the case even when VA adjudicators themselves submitted a request to the Director for awarding extra scheduler to a vet claimant.  This was why I did not mention subsection (B) in my first comment.

So like you I do not rely only on the word of a single VA rater based upon my many years filing claims and appeals with the VA and all were eventually successful.  Take a chill pill and call me in the morning.  The following ratings I handled myself pro se due to poor representation from DAV VSO.   So I do my homework starting in 85 to present.  Sorry you were so easily offended.  I did offer you my sincere congratulations but you were eager to jump on me. My comment was in no way misleading and you know it.  In some of my other posts I have given you great credit for your accurate advice you have give to others but no more.  Too hot tempered.

Like others on the forum I now list my disabilities for the record.

 

1998 70% PTSD and TDIU, 

2000 P&T TDIU, 

2017 AO Heart Disease 30%,

2019 OSA Sleep Apnea 50%,

2019 BVA Appeal and 60% Heart Disease,

2022 GERD 60%, Tinnitus 10% and Hypertension at 0%.

2022 Awarded 100% P&T plus SMC-S backdated to 2017.

1985 PTSD at 50%

Edited by Dustoff1970
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The truth of the matter is all this means absolutely nothing. Both your opinion and mine means nothing. I did not attack you, so don’t take it personally. Facts are facts and there are situations that we don’t and cannot see when a veteran files his/her claims. There are times depending on the evidence of record when a veteran file claims that the VA has the authority to grant them maximum benefits which means that a veteran can be granted TDIU, and the record may not meet the minimum 40% with a combined 60% but the VA raises one or more of their disabilities to meet that criteria and that would or could settle the problem. There is absolutely no way that a generic or blanket statement that state it is not possible or worth it, makes any sense, it is misleading, and you can’t change that. Once again, we have no idea what it is the veteran’s records and for the veteran to make a good decision, he/she should be given all or every option to decide to how to go forward.

I was not offended, your information is off and misleading, by not giving all the information/options can lead to a missed opportunity for the veteran.

 

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