5 Misconceptions Veterans Have About Total Disability VA Ratings

CCK Law: Our Vital Role in Veterans Law

Misunderstanding how the Department of Veterans Affairs (VA) handles total disability VA ratings can cost a veteran real compensation, whether by giving up on a claim too early or missing related benefits like TDIU or Special Monthly Compensation.

This article addresses five common misconceptions surrounding total disability VA ratings, including: how VA rates severity, why ratings do not simply add together, how TDIU works, when a rating can change, and whether 100 percent is truly the highest compensation available.

Key points of this article include:

• What “disability” means — VA generally defines “disability” by functional impairment (e.g., ability to work), unlike traditional definitions of disability that might be more far-reaching.
• VA math — If a veteran appears to qualify for 100 percent disability through multiple ratings, they should be aware that additional ratings are reduced more and more when added together.
• TDIU — Total disability based on individual unemployability can bring a veteran to the 100 percent pay rate without a 100 percent schedular rating.
• SMC — Special Monthly Compensation is an often-overlooked, alternative form of VA disability compensation that — in most cases — pays more than total disability.

Watch CCK Law Partner Emma Peterson discuss misconceptions that often trip up veterans who may be eligible for total disability VA ratings:

Play

1. How Severely Disabled Do I Need to Be to Qualify for a Total Disability VA Rating?

The myth: Many veterans hold the misconception that their condition’s symptoms are not severe enough to qualify for total disability. They may believe they can “tough out” any pain they suffer, or that by pursuing total disability, they might be stealing benefits away from other veterans who need them more.

This is not the case, for multiple reasons.

“VA bases disability rating on what its rules call ‘average impairment in earning capacity,’” says Emma Peterson, a partner at CCK Law. “In plain terms, that’s how much your service-connected conditions would keep a typical person from holding a steady job. It’s about lost earning power, not pain levels.”

With this in mind, veterans should not necessarily base decisions regarding their disabilities on whether they suffer more pain or loss of function than other disabled veterans they know. Instead, they should consider the ways in which their disability inhibits their ability to work.

Something else to keep in mind is that one veteran being awarded disability compensation does not reduce funds available to other veterans. This is because VA disability compensation is a federal entitlement, not a fixed pool of money split among veterans. If a veteran meets the legal criteria for a benefit, VA is required to pay it and Congress is generally compelled to fund it, regardless of how many other veterans are also receiving compensation.

2. Why Don’t My VA Disability Ratings Add Up to 100 Percent?

The myth: The average disabled veteran suffers from over seven service-connected conditions, due to how conditions interconnect. This leads some veterans to believe they can simply add the percentages of their various disabilities together. This is not true, as VA uses a specific mathematical formula to combine a veteran’s disability ratings and calculate their overall disability percentage. This formula is regulated under 38 CFR § 4.25 and is commonly referred to as “VA math.” It reduces the value of each additional rating.

“This happens because each additional rating applies only to the portion of a veteran VA still considers healthy after the prior rating is applied,” says Emma Peterson. “This means that stacking conditions rarely reaches 100 percent the way many veterans expect.”

3. I Cannot Work, But I Do Not Have a 100 Percent VA Rating. Is There Another Way to Receive Total Disability Benefits?

The myth: It is common for veterans to believe that they need either a single condition rated at 100 percent or multiple conditions that combine to 100 percent in order to earn total disability benefits from VA.

This is not true. TDIU, or total disability based on individual unemployability, allows VA to pay a veteran at the full 100 percent rate even when their combined rating is lower. Under 38 CFR § 4.16, a veteran can be awarded TDIU as long as they are unable to secure or maintain substantially gainful employment (i.e., employment above a certain income threshold) due to their service-connected disabilities.

Typically, veterans must also meet the following rating requirements to qualify for TDIU:

• They have one condition rated at 60 percent or more; OR
• They have a combined 70 percent or higher rating, with one of the contributing disabilities rated at 40 percent or more.

However, extraschedular TDIU also exists. “If you fall short of those numbers but still cannot work, VA can consider you on what’s called an extraschedular basis,” says Emma Peterson.

TDIU — particularly extraschedular — is an unusual benefit. Contact CCK Law for a free case evaluation if you believe you may be eligible.

4. Is My Total Disability VA Rating Automatically Permanent?

The myth: Veterans frequently hold the misconception that if they are dubbed totally disabled by VA, then that rating is permanent, and VA cannot reduce it in the future.

In fact, whether a condition is “permanent” and whether it is “total” are actually two separate questions. Some disabilities can be totally disabling and not permanent, while others are less than total but permanent.

“If VA thinks your condition could improve, it may schedule a future exam and reduce the rating later,” says CCK Law Partner Emma Peterson. “When VA decides improvement is not likely, it can label the rating ‘permanent and total,’ and routine reexaminations usually stop.”

In other words, whether VA labels a condition “permanent” depends on the type of condition and its likelihood of ever improving. For example:

• Some conditions that VA may consider permanent include the amputation of limbs, blindness, ALS, or Parkinson’s disease.
• Some conditions that VA is less likely to consider permanent may include depression, cancer undergoing active treatment, or recovery following surgery for a service-connected condition.

In addition to a rating being deemed “permanent,” there are other rating protections in place for veterans who have had their disability for a qualifying amount of time, or who have reached a certain age.

Watch CCK Law Partner Michael Lostritto and VA-Accredited Claims Advocate Dallas Aguiar discuss the difference between TDIU, 100 percent schedular ratings, and Permanent and Total ratings:

Play

5. Is a Total Disability VA Rating the Highest Level of VA Compensation?

The myth: It is a common misconception that a total disability VA rating is the highest level of compensation a disabled veteran can receive. While it is true that this is the highest schedular rating a veteran can receive, there are several types of Special Monthly Compensation for veterans with service-connected conditions or life situations that are especially burdensome.

“For more severe situations, there is Special Monthly Compensation, or SMC,” says Emma Peterson. “Under federal law 38 U.S.C. 1114, SMC pays above the standard 100 percent rate. It covers things like loss or loss of use of a limb, blindness, being housebound, or needing the regular aid and attendance of another person.”

Many veterans who qualify for SMC never realize it, since VA does not always identify entitlement automatically.

Having Difficulty Proving Entitlement to Total Disability? Contact the Team at CCK Law

Frequently Asked Questions

What is the difference between TDIU and a 100 percent schedular rating?

TDIU pays a veteran at the 100 percent rate when service-connected conditions prevent substantially gainful employment, even if the veteran’s combined schedular rating is below 100 percent. A 100 percent schedular rating, by contrast, comes directly from VA’s rating schedule based on the severity of a veteran’s individual conditions.

Can VA reduce a total disability rating based on individual unemployability if I try to work again?

Under 38 CFR § 3.343, VA generally cannot reduce a TDIU rating solely because a veteran returns to work, unless that employment is substantially gainful and continues for 12 consecutive months. Short breaks in employment during that period typically do not count against a veteran.

However, earning more than marginal employment in those 12 months will likely lead to the loss of TDIU.

Does Special Monthly Compensation require a separate application?

Veterans do not always need to file a separate claim for Special Monthly Compensation (SMC), since VA may identify entitlement while processing a related disability claim.

However, veterans who believe they qualify should still raise SMC directly with VA rather than relying on VA to catch it. And if veterans realize in retrospect that they should have been offered SMC, or if a veteran’s condition worsens over time until they are eligible for SMC, they should file a claim.

SMC claims can be demanding. CCK Law recommends that anyone overlooked or newly eligible for SMC should request a free case evaluation.

What happens if a veteran cannot work but does not meet the percentage requirements for TDIU?

A veteran who does not meet the standard percentage thresholds for TDIU under 38 CFR § 4.16(a) may still qualify through extraschedular consideration, in which VA’s Director of Compensation Service reviews whether the veteran’s service-connected disabilities alone prevent substantially gainful employment.