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4 Best Ways to 100% VA Disability Rating

4 Best Ways to 100% VA Disability Rating

Video Transcription

Alyse Phillips: Hello everyone and welcome to today’s CCK Live. My name is Alyse Phillips, and I’m an attorney with CCK.  I’m joined here today with Matt Fusco, he’s an accredited claims agent with the firm, and Alec Saxe, another attorney with the firm. Today we’ll be talking about ways to obtain a 100% rating for your VA disability.

So, these 100% ratings are absolutely beneficial to obtain. They are technically the highest scheduler compensation that you can get apart from obtaining special monthly compensation. So, they’re certainly beneficial and it will be a good topic for us to discuss today.

So Alec, why don’t you get us started and talk a little bit about what a 100% rating for disability means?

Alec: Sure. So, VA disability ratings are meant to compensate veterans for the average impairment in their earning capacity that are caused by their service-connected conditions. So, generally the more severe disability, the higher VA will rate that disability and the more compensation you can expect to receive from VA. So, a 100% rating is the highest monthly compensation rate.  Based on the 5.9% cost-of-living adjustment increase for 2022, veterans with 100% and no dependents can expect to receive $3,332.06 per month starting December 31, 2021.

Alyse: Great. So, we’ve outlined four major ways to obtain a 100% rating. The first way we’re going to discuss is just regular general direct service connection. So, this means that you file a claim for service connection and you actually obtain a rating of 100%.

Now, three things to know about service connection, or three elements rather, are first, you have a current, diagnosed condition. There are some exceptions to the diagnosis, but it is definitely easier to have a diagnosis than to not have a diagnosis to get service connection. Second, you’ll have an in-service event injury or illness. And third, you’ll have that connection between the two, what we call a medical nexus.

Here, it’s also definitely beneficial to have a doctor that’s connecting the two. Although there are some exceptions where you don’t need to have a medical examination. In direct service connection cases, evidence that are going to help your case are going to be personnel records, lay statements, opinions from doctors, any of those sort of things can all be submitted to help show that you have a condition that’s directly related to your service.

Once something is service connected, then you will be rated on a scale from 0 to 100 depending on what the actual condition is. You could receive a 100% rating for a single condition or you could receive a 100% rating as a combined rating of all of your different conditions combined. If you have a 100% rating, whether it’s just based on one condition or multiple conditions, it’s still going to be that same compensation that Alec just told us about. Again, with that exception of special monthly compensation.

To file for direct service connection, what you’re going to do is file a VA Form 21-526EZ, and that’s going to be VA’s application for disability compensation related to compensation benefits. You can do this online through the e-benefits portal, in your local regional office, or with the help of an accredited veteran’s advocate or an attorney.

So Matt, why don’t you tell us a little bit about secondary service connection and aggravation?

Matt: Sure. So, secondary service-connected disability is a disability that resulted from a condition that is already service-connected. And similarly, aggravation is when a pre-existing condition was made worse or aggravated by military service. In these claims proving a nexus is especially important. And as Alyse previously mentioned, a nexus is a medical opinion that, in cases of secondary service connection, links veterans’ secondary disability to their disability that’s already service-connected.

The link between those disabilities must be clearly established in order to be granted secondary service connection for the secondary disability. And some common examples of secondary service-connected conditions include things like: peripheral neuropathy secondary to diabetes mellitus type 2; radiculopathy secondary to back or lumbar spine disabilities; depression secondary to things like Parkinson’s disease or cancer; and depression and anxiety secondary to orthopedic pain or orthopedic conditions that are service-connected.

Filing a secondary VA claim for service connection involves the same process as filing any other initial claim. So, if you are granted service connection, the secondary condition will be rated in the same manner as any other service-connected conditions. Once again, VA math will be used to determine the overall combined rating, and in and of itself may be another way for veterans to reach a 100% disability rating.

Alyse: Great. Alec, why don’t you tell us a little bit about TDIU?

Alec: Sure. So, total disability based on individual unemployability, or TDIU for short, is a benefit that allows veterans to be compensated at the 100% level even if their combined disability rating is less than that. So, this is an alternative path to receiving the maximum benefits and it’s awarded in circumstances in which veterans are unable to either secure and follow substantially gainful employment as a result of their service-connected disabilities.

There are two basic ways to achieve TDIU on a schedular or extraschedular basis. It falls under regulation 38 CFR § 4.16a and b, respectively. And for schedular TDIU, the veteran must have one service-connected condition rated at 60% or higher, or two or more service-connected conditions, one rated at 40% or higher with a combined rating of 70% or higher. So, one at 40 and one or more other disabilities that through VA math will get you to 70% or higher.

Veterans who don’t meet the schedule requirements for TDIU schedular under 4.16a may still be considered for extraschedular TDIU under 4.16b. And extraschedular TDIU doesn’t have any rating requirement, instead it simply looks at the veteran’s inability to secure and follow substantially gainful employment, like scheduler.

And we have several CCK Lives as well as articles on our website that talk about TDIU, what it requires, what are the best ways to go about obtaining those benefits.  So, I encourage you to check those out.

Alyse: Excellent. Yeah, I like to think of TDIU as a different road to get to the same destination of a 100%.

All right. So, the final way we’re going to talk about today is increased rating claims. Matt, you want to take that one for us?

Matt: Sure. So, the disability rating that VA assigns in its initial rating decision might be satisfactory at that time, but it’s certainly realistic that your condition or your disability may worsen years down the road. So, if you’re outside of that one-year period to file an appeal with VA’s decision, you will likely have to file a new claim for an increased rating. VA is going to treat this as any other claim and issue a rating decision in response.

You as a veteran can submit any new documentation or evidence you have supporting that your service-connected condition has worsened. And in the legacy appeal system, the evidence that you’re submitting must be new and material, whereas under AMA, it must be new and relevant.

Veterans should be mindful of the applicable rating criteria for the service-connected condition for which they are seeking an increase because this can importantly determine how their symptomatology lines up. And you can also have a private doctor or your treatment specialists opine on the severity of your service-connected conditions in relation to what is listed on the actual rating criteria.

Alyse: Excellent. Thank you so much. So, that’s going to wrap up the four main ways to reach a 100% rating, but we do want to hit on some other tips before we let you go today.

So, one tip is that we would like you to use lay evidence, such as buddy statements, statements from family, friends to bolster your claim. The reason for this is this really fills the gap that some of those VA exams or medical records are going to miss. You can really explain, or your friends, family that have seen how this disability impacts you, can really explain in a better way more precisely why your disability is preventing you from either working or how it’s more severe than maybe a strict check box type of exam might show.

But with that said, our next tip is to attend those C&P exams. VA can deny your claims if you don’t attend the exams. While they’re not always perfect you absolutely should be attending them. You should be honest during them. And if there is an exam that isn’t favorable, you can always introduce your own medical evidence or make your own challenges to those exams.

But one thing is, if you don’t attend the exams, then you can’t challenge them, and we’ve seen that happen to a lot of veterans and it’s an unfortunate situation. So, you definitely want to attend them.

When you are denied a claim, if you’re denied a claim, make sure that you’re looking for the reasons that VA denied your claim when you’re trying to spot any error. So, if, for example, they’re denying your claim for lack of medical nexus then what you’re going to need is a medical nexus. It’s not going to help if you continue to show that you have a current disability, just as an example.

And if you believe your rating is too low, continue your appeal. And one thing that’s definitely going to help you out, Alec is going to touch on, but it’s going to be seeking the assistance of an accredited rep or attorney.

Alec: Yeah, definitely. We know it can be challenging and confusing the whole VA benefits process filing for increased rating claims, multiple claims, or TDIU. So, it’s just that it’s helpful seeking assistance from accredited representatives, an accredited attorney, or a representative, perhaps from a veteran’s service organization, to guide you through VA’s complex processes and help fight for that highest possible rating.

Alyse: Thank you so much. So, that was a pretty general overview of some ways to obtain a 100% rating. We do have specific blog post on things we talked about, like TDIU, special monthly compensation, increased rating claims, direct service connection, and secondary service connection. So, please feel free to check those out. And also, please remember to subscribe to our channel. Thank you.