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Veterans Law

How to Use VA’s Combined Ratings Table for VA Disability

September 3, 2018
combined ratings

Many veterans are familiar with the unusual way in which VA combines multiple disability ratings to come up with the veteran’s combined rating. VA uses a combined ratings table to determine a veteran’s overall rating, which then in turn determines how much monthly compensation the veteran will receive.

How VA Disability Ratings Work

 The VA disability rating process begins with veterans filing claims for service connection if they believe that they have injuries or disabilities that are due to their military service. If those claims are granted that means that service connection is awarded. From there, VA will assign a disability rating between 0 and 100 percent based on the severity of the service-connected condition.  The rating schedule is what VA adjudicators look to when assigning disability ratings.  Within the rating schedule are over 800 diagnostic codes, each relating to a specific medical condition or set of conditions.  Within each diagnostic code are different criteria, which correspond to certain percentage ratings.  For example, a veteran experiencing only symptom A and B may receive a 10 percent rating, whereas a veteran experiencing symptom A, B, C, and D may receive a 60 percent rating.

Each percentage increment corresponds to a dollar amount specified by VA in the VA disability pay chart.  In other words, the higher the veteran’s disability rating, the more compensation they will receive each month.  For example, a veteran without dependents rated at 30 percent in 2020 would receive $435.69 each month, whereas another veteran rated at 50 percent would receive $893.42.  VA has additional rules when it comes to combining multiple disability ratings to determine monthly compensation.

VA Does Not Add Ratings, They Combine Them

The secret to understanding combined ratings is this: VA does not add each of a veteran’s ratings together, it combines them to determine what percentage of the veteran is disabled, and what percentage is not disabled. When a veteran applies for disability benefits, VA considers them 100% not disabled until they assign the veteran a disability rating, or ratings, for their disabilities.

For example, a veteran who is service-connected for post-traumatic stress disorder (PTSD) at 30% would be considered 30% disabled by VA, and 70% not disabled, or “whole.” If the veteran is later service-connected for other conditions, the disability percentages would be taken from the remaining “whole.” Each additional rating will reduce the percentage that the veteran is “whole,” and increase the percentage that the veteran is disabled.

To use a quick example, if a veteran is rated at 50% for an anxiety disorder, VA will consider that veteran 50% disabled, and 50% not disabled. If the veteran is then service-connected for tinnitus at 10%, VA will take that 10% from the percentage of the veteran that is not disabled. So, 10% of 50% is 5%. VA will then add the 5% to the 50% of the veteran that is disabled, coming out to 55%.

If the veteran is later service-connected for another condition at 10% in addition to the 50% for anxiety and 10% for tinnitus, VA will take that other 10% out of the 45% that the veteran is not disabled. So, 10% of 45% is 4.5%, and then the 4.5% will be added to the 55% that the veteran is disabled. The 4.5% and the 55% will then come out to 59.5% and rounded to the nearest increment of 10 for a  combined rating of 60%.

How Does VA Calculate Combined Ratings?

VA uses a calculate a combined rating, VA starts with the veteran’s highest rating, and then works down the list of disabilities, combining them from highest to lowest. The table does not round up to whole numbers in increments of 10, so when VA has combined all of the disabilities, they will round up to the nearest 10 and the veteran will receive compensation at that rate.

Using the example above, if the veteran who is service-connected for PTSD at 30% is later service-connected for headaches at 30% and hearing loss at 10%, their overall rating would not be 70%. Instead, VA would combine the 30% for headaches with the 30% for PTSD, coming out to 51%. It would then combine the 10% for hearing loss with the 51%, which would come out to 56%. VA would then round the 56% to the nearest 10, which would be 60%. The veteran’s overall combined rating would be 60% and he would receive monthly compensation at that 60% rate.

How to Use the Combined Ratings Table

Veterans can use VA’s combined rating table to calculate their overall combined rating. First, it can help if the veteran lists their disability ratings from highest to lowest. As mentioned, start by using the veteran’s highest rating, and then going down the list from the second-highest rating down to the lowest.

The veteran will take their highest rating and identify it in the left column of the chart. Then, the veteran will take their second-highest rating and identify that in the top row of the chart. Where the row and the column intersect is the combined value for those disabilities.

If a veteran has more than two disabilities, they would take the combined value of the first two (which they got from following the above step), and locate that on the left side of the chart (without rounding to the nearest 10). They will then locate their next-highest rating on the top row, and find where the row and the column intersect. That is the combined rating for those three disabilities.

The veteran would repeat this process for every disability they are rated for, following from highest to lowest. Then, when the veteran is finished combining their rating, they will round that final number to the nearest 10. For example, if the veteran’s final combined rating is 56%, they will round that up to 60%. If their final combined rating is 54%, they will round down to 50%. For reference, a 55% would round up to 60%.

The Bilateral Factor and How it Works With Combined Ratings

Before combining ratings, it is important to first look at any bilateral disabilities the veteran has.  Bilateral means affecting both sides, and therefore, bilateral disabilities are two conditions of the upper or lower extremities (e.g., right elbow and left wrist).  According to VA, bilateral disabilities are severely limiting in relation to a veteran’s ability to function.  Considering the bilateral factor in the VA math equation can increase veterans’ combined disability ratings.

To account for bilateral ratings, the two disabilities are combined as usual and then an additional 10 percent of the combined rating is added.  For example, a left shoulder disability rated at 20 percent and a right elbow disability rated at 20 percent are combined to yield a 36 percent rating.  The bilateral factor then adds 3.6 percent to the 36 percent rating, resulting in a 39.6 percent rating, which is then rounded to a 40 percent combined disability rating.

How Can I Get to 100% Using Combined Ratings or VA Math?

When it comes to combined ratings, achieving a combined 100% rating can be extremely difficult. The higher a veteran’s combined rating, the harder it is to achieve that 100% because the percentage that the veteran is “whole” becomes smaller and smaller as the veteran’s overall rating increases. For instance, if a veteran is at an even 90% for their combined disability rating, they will need another rating of at least 50% in order to increase their combined rating to 95%, which would then be rounded up to 100%.

100% Individual Unemployability (TDIU)

Total disability based on individual unemployability (TDIU) represents an alternative pathway for veterans to receive a 100 percent disability rating.  Importantly, TDIU allows for veterans to be compensated at VA’s 100 percent disability rate, even if their combined schedular rating does not equal 100 percent.  TDIU is awarded in circumstances in which veterans are unable to secure and follow substantially gainful employment as a result of their service-connected conditions.  Here, substantially gainful employment refers to whether a veteran’s annual income meets or exceeds the federal poverty threshold for a single person.

VA outlines TDIU regulations under 38 CFR § 4.16, which encompasses subsections (a) and (b).  Each subsection describes the ways in which veterans can meet the eligibility requirements for TDIU.  In order to qualify for TDIU under 38 CFR § 4.16(a), or schedular TDIU, a veteran must have:

  • One service-connected condition rated at 60 percent or higher; or
  • Two or more service-connected conditions, one of which is rated at 40 percent or higher, with a combined disability rating of 70 percent or higher.

Veterans who do not meet the schedular requirements under 38 CFR § 4.16(a) may still be eligible for extraschedular TDIU as outlined under § 4.16(b).

Again, achieving a 100 percent schedular disability rating can be extremely difficult.  As such, veterans may want to consider applying for TDIU benefits depending on their unique circumstances.  To apply for TDIU, veterans must complete and submit VA Form 21-8940 along with supporting evidence (e.g., employment records, income statement, educational history).

100% Temporary Total Ratings

Veterans may also be eligible for 100 percent temporary total VA disability ratings depending on the nature of their service-connected conditions.  Specifically, veterans who are rendered temporarily incapacitated due to a service-connected condition may be entitled to receive temporary, total disability compensation equivalent to a 100 percent VA disability rating.  VA offers three forms of temporary 100 percent disability ratings: prestabilization, hospitalization, and convalescence.  These forms of VA compensation provide benefits for veterans experiencing temporary, severe medical situations related to a service-connected condition.

Prestabilization

A prestabilization rating is a temporary, immediate disability rating assigned to veterans who have recently been discharged from military service with a severely disabling and unstable condition that is expected to continue for an indefinite period of time.  These veterans are considered to be “most likely in need and at least as likely to be self-sufficient.”  Prestabilization ratings are assigned in increments of 50 and 100 percent over a period of 12 months following the veteran’s discharge date.  In order for VA to reduce a veteran’s prestabilization rating, a re-evaluation must be conducted to assess the status of their condition.  These examinations are scheduled between 6- and 12-months following separation from service.

Hospitalization

Temporary hospitalization ratings are assigned to veterans who have been hospitalized for over 21 days as a result of a service-connected condition.  This rating is also assigned to those who remain under hospital observation for more than 21 days at the expense of the Department of Veterans Affairs.  In order to qualify for a temporary hospitalization rating, you must be receiving treatment at a VA medical center or other VA-approved hospital.  The 100 percent  disability rating will continue until the last day of the month in which the veteran stopped receiving treatment for their service-connected condition.

Convalescence

Temporary 100 percent convalescence ratings are assigned to veterans who underwent treatment or surgery for a service-connected disability at a VA medical center or VA-approved facility.  In order to qualify for a temporary and total convalescence rating, the veteran must have:

  • Undergone treatment or surgery with a convalescence time of at least one month; or
  • Experienced severe postoperative residuals that resulted from surgery (e.g. surgical wounds are not completely healed, the veteran is rendered housebound, there is a need for continuous use of crutches or wheelchair); or
  • Experienced the immobilization of one or more major joints “by a cast without surgery.”

The effective date of a convalescence rating is that of hospital admission or outpatient treatment, and can continue for one, two, or three months “from the first day of the month following such hospital discharge or outpatient release.”

Special Monthly Compensation

Special monthly compensation (SMC) represents additional benefits that are reserved for veterans who are typically even more disabled than the 100 percent schedular disability rating contemplates (i.e., accounts for).  In these situations, veterans are usually unable to complete activities of daily living on their own, without the help of others or assistive devices.  If veterans are able to establish that their service-connected conditions require this additional assistance or additional level of accommodation, then SMC may be warranted.

Importantly, SMC involves various levels, such as SMC(l), which is the lowest level.  SMC(l) pays veterans around $3,800 in monthly compensation.  All levels of SMC, except for SMC(k), pay veterans at a distinct rate, one that is higher than that of the 100 percent schedular rating.  However, SMC(k) adds onto the veteran’s schedular 100 percent rating.  That is, SMC(k) awards veterans an additional $100 to $200 per month on top of their traditional monthly compensation amount.