Q: What is Permanent and Total disability?
Permanent and Total disability, or P&T, refers to veterans whose disabilities are total (rated 100% disabling by VA) and permanent (zero or close to zero chance of improvement). Though “Permanent and Total” is often used as a single phrase, veterans can have a total disability that’s temporary or a permanent disability rated less than 100 percent. Permanent and total ratings are protected from being reduced and may entitle you or your family to additional VA benefits.
Total. Veterans’ disabilities are rated based on VA’s Schedule of Rating Disabilities. The ratings levels for each type of disability are based on how much the residuals of said disability impair your ability to function in life and at work. A 100% rating indicates that your disability is completely, or “totally,” disabling.
Permanent. VA deems a disability “permanent” when it is reasonably certain, based on medical evidence, that the level of impairment will continue for the rest of the veteran’s life. For this reason, VA is allowed to take age into account when determining whether a disability is permanent and it can be more difficult for younger veterans to be considered permanently disabled.
There are a few combinations of disabilities that are automatically deemed Permanent and Total, including the irreversible loss or loss of use (for example, amputation or paralysis) of:
- Both hands,
- Both feet,
- One hand and one foot,
- Sight of both eyes, or
- Becoming permanently helpless or bedridden.
There are a few scenarios in which a disability is less likely to be rated P&T:
- VA awards temporary total disability (100% rating) to veterans who are hospitalized for more than 21 days for a service-connected condition and for the six months following that hospitalization.
- Some totally disabling mental health disorders and cancers are not considered permanent because, according to VA, they are expected to improve with treatment.
Q: How do I know if my disability rating is permanent?
Take a look at the decision letter VA sent you when granting benefits (your Rating Decision). On some Rating Decisions there is a Permanent and Total box that will be checked if your 100% disability is permanent. On others, there may be language like “Eligibility to dependents Chapter 35 DEA / CHAMPVA are established” or “No future exams are scheduled” – both of which indicate permanence. The exact language may vary with different VA regional offices.
If, however, the letter says that future exams are scheduled, then your total disability ratings is considered temporary by VA.
Q: If I qualify for TDIU does that mean I’m P&T?
Not necessarily. TDIU (or simply IU) stands for Total Disability based on Individual Unemployability. If you receive TDIU, you are considered totally (100%) disabled even if your disability rating is less than 100 percent. But TDIU can be permanent or temporary. So it’s important to check your rating decision as discussed above.
Q: Can I ask VA to make my rating permanent? How?
If you believe (and you have evidence showing) that your total 100% disability is unlikely to improve at any point in the future, you can write a letter to your VA Regional Office requesting a permanent rating. With your letter, you should include medical evidence (like treatment records) showing that your medical condition cannot be expected to improve in the future.
Q: Are there any additional benefits available to me or my family if I have a Total and Permanent rating?
Yes! Veterans with Permanent and Total ratings may be eligible for the following benefits:
- CHAMPVA (VA healthcare for your dependents)
- Chapter 35 Dependents Educational Assistance Program (Chapter 35 DEA)
- Dependency and Indemnity Compensation (DIC), often referred to as “death benefits”
- Certain state-level benefits for veterans
Note: Other factors may also be considered in determining eligibility for these benefits.
Dependency and Indemnity Compensation: Both CHAMPVA and Chapter 35 DEA require the veteran to be P&T (permanent and totally – 100% – disabled). For DIC, however, eligibility depends on how long you were considered P&T.
- If the veteran’s condition was rated P&T for 10 years immediately prior to his/her death, his/her dependents will be eligible for DIC.
- If the veteran’s condition was rated P&T for less than 10 years prior to his/her death, his/her dependents will only be eligible for DIC if the veteran died from a service-connected condition.
State benefits: Many states have special benefits for veterans who are permanently and totally disabled. Check out this website to find out which benefits your state offers.