How Does VA Rate PTSD?
Post-traumatic stress disorder (PTSD) is a common psychiatric condition experienced by many veterans as a result of their military service. VA rates PTSD under 38 CFR § 4.130, Diagnostic Code 9411. Specifically, VA assigns a disability rating ranging from 0 to 100 percent based on the level of social and occupational impairment a veteran experiences, and the frequency, duration, and severity of symptoms it uses to characterize that impairment. Importantly, if your PTSD significantly impairs your ability to work, you may be eligible for a total disability rating based on individual unemployability.
TDIU and PTSD
Total disability based on individual unemployability (TDIU) is a VA benefit that allows veterans to receive benefits at the 100 percent rate if their service-connected condition(s) prevent them from securing and maintaining substantially gainful employment. There are two ways veterans can qualify for TDIU under VA’s regulation 38 CFR § 4.16: schedular and extraschedular. In order to be eligible for schedular TDIU:
- You must have one condition (e.g. PTSD) rated at 60 percent or higher on its own; or
- You must have a combined rating of 70 percent or higher when your PTSD is taken together with other service-connected conditions and at least one of those conditions is rated at 40 percent or higher on its own
If you do not meet the eligibility requirements listed above, but you are unemployable due to your PTSD, you may qualify for TDIU on an extraschedular basis. In both cases, you must show that your PTSD (along with your other service-connected conditions, if applicable) contribute to your inability to work.
How to Demonstrate Your PTSD Impacts Your Ability to Work
In order to be eligible for VA individual unemployability based on your PTSD, you must demonstrate that your PTSD prevents you from securing and maintaining substantially gainful employment. While Compensation and Pension (C&P) examinations intend to help VA determine the severity of your symptomatology, it may be helpful to submit additional evidence as well. For example, lay statements can be very useful. Lay statements are written statements from a veteran or someone who has witnessed the limitations the veteran faces every day, such as a spouse, family member, or co-worker. In this case, lay statements should address the extent of your PTSD and the impact it has on your daily life, specifically in regards to employment. This type of evidence provides valuable insight about your disability that is not always conveyed through other objective evidence.
It may also be helpful to obtain a private medical opinion, or an expert opinion, to substantiate your claim. Additionally, switching jobs on a frequent basis, receiving complaints about your work performance, or getting fired from jobs are all good indicators that your PTSD contributes to your inability to work.
In some situations, employers may make accommodations that allow veterans to maintain employment. It is important to note that under these circumstances, you may still qualify for TDIU based on your PTSD.
Protected Work Environment and TDIU: Accommodations for Your PTSD
If your employer makes special (and significant) accommodations for you based on your PTSD, without reducing your earnings or benefits, VA should find that you are employed within a protected work environment. Protected work environments cannot be considered substantially gainful employment. As a result, you are still eligible for TDIU. An example of this may involve the following: a veteran who is suffering from PTSD struggles with social interaction. As a result, he is allowed to take multiple breaks throughout the day, and does not have to handle as many customers, but his employer does not reduce his pay or penalize him for being less productive than other employees.
100% PTSD Disability Rating vs. TDIU
In general, neither the 100 percent schedular rating nor TDIU is better than the other, as they both provide VA disability compensation at the 100 percent rating amount. However, depending on the circumstances, one of these options might be more beneficial to pursue. The major differences between the two involve the qualifying criteria and the work restrictions. There are not any work restrictions when receiving a 100 percent PTSD disability rating. TDIU allows you to receive compensation at the 100 percent level when you are unable to work and your PTSD and other service-connected conditions do not meet the 100 percent rating criteria. A schedular 100 percent disability rating for PTSD is often difficult to obtain because it requires a veteran’s symptoms to be so severe that he or she is totally impaired and unable to function in everyday life.
Call Chisholm Chisholm & Kilpatrick LTD for a Free Case Evaluation
If you are suffering from PTSD as a result of your military service, Chisholm Chisholm & Kilpatrick LTD may be able to help you receive the VA disability benefits that you deserve. To speak with a member of our staff about a free case evaluation, please call 800-544-9144.