How to Get 100% Permanent and Total VA Rating

Video Transcription

Kayla D’Onofrio: Welcome to CCK Live. My name is Kayla D’Onofrio, and I’m joined today by my colleagues Matthew Fusco and Brandon Paiva, and today, we’re going to be explaining how to get a 100% Permanent and Total VA disability rating. So first, we’ll just start with the basics, what is a Permanent and Total rating?

Basically, Permanent and Total Disability, or P&T, refers to veterans whose disabilities are rated as total, meaning that they’re at 100%, or they have TDIU and permanent, meaning that there is zero or close to zero chance of improvement. For the purpose of just defining these terms, a total rating would be 100% rating or TDIU, like I said, which would indicate that you are completely or totally disabled for the purpose of VA benefits. A permanent rating is when VA deemed the disability is permanent, making it reasonably certain based on medical evidence that the level of impairment will continue for the rest of the veteran’s life. So, there is really no chance that that condition is going to improve.

It’s important to point out that since permanent means a veteran will be disabled for the rest of their life, VA is allowed to take into account the veteran’s age when determining whether that disability is permanent, which can mean that it can be a little bit more difficult for younger veterans to get that permanent determination just because VA will sort of factor that into making that decision. And just a final note on this topic, although Permanent and Total is often used as a single phrase, veterans can have a total rating that is temporary, so it’s not going to be a permanent finding for VA purposes, or they can have a permanent disability that’s not rated at 100%. It just means that VA has found that that condition is not likely to improve.

So, Brandon, how would one go about getting a Permanent and Total rating?

Brandon Paiva: That’s a good question, Kayla. In order for VA to consider granting a 100% Permanent and Total disability rating, the veteran will need to show two things. The first is they need to show evidence of a service-connected disability. Veterans wishing to obtain Permanent and Total status with VA, in order to get those ratings, they need to first prove that they actually have a service-connected disability. So, first and foremost, you need to have a disability that is deemed to be service-connected.

The second thing that the veteran or the claimant will need to show is they will need to show proof that their conditions will not improve. This may include medical reports from doctors, psychologists, cardiologists, oncologists, and even other medical professionals. So, sometimes obtaining an opinion in these circumstances is somewhat necessary.

Now, these reports in these circumstances can and should detail why the veteran’s condition is not expected to improve, i.e., those reports need to show why or how these conditions are going to be the same essentially throughout the veteran’s life. So essentially, a veteran needs to have a report from a medical professional, so to speak, that shows that this condition will not or at least is not expected to improve.

So, how does a veteran actually go about asking VA to rate them as permanent and totally disabled? If we believe or the veteran believes and they have evidence showing that their disability is unlikely to improve at any point in the future, you can go ahead and submit a claim to VA requesting a permanent rating. Now, with your claim, you definitely want to be sure to include medical evidence, treatment records, and those doctors’ opinions or reports showing that the condition cannot be expected to improve in the future. So, oftentimes having medical evidence in these circumstances, if you are seeking that Permanent and Total rating, is not only recommended, in most circumstances that is required to show VA that not only you have a service-connected disability, but that service-connected disability is not expected to improve.

Kayla: Great. Thank you. And Matt, how do you know if your condition is permanent?

Matthew Fusco: Sure. So, some combinations of disabilities are automatically deemed Permanent and Total, including the irreversible loss or loss of use of both hands, both feet, one hand and one foot, sight in both eyes, or becoming permanently helpless or bedridden. When VA decides a veteran’s service-connected condition is permanent in nature, it importantly no longer requires veterans to attend reexaminations. According to 38 CFR § 3.327, you are exempt from future examinations when your condition is static or unchanging; when your condition has persisted without material improvement for a period of five years or more, which is referred to as stabilized rating; when your disability is permanent in character or of such nature that there is no likelihood of improvement when you are over 55 years of age, although some exceptions may apply to this specific criteria; or if the rating you received is prescribed minimum rating or if a lower rating would not affect your combined disability rating. All of those qualifications no longer require veterans to attend reexaminations when determining the Permanent and Total status of their disability.

Kayla: Great. Thank you. To determine if you are rated as Permanent and Total, take a look at your VA decision letter or your rating decision. There should be some language in there that would indicate that they have made the Permanent and Total finding. This language will vary depending on the regional office so you’ll likely see one of the following. One is that they’ll explicitly check off a box that says Permanent and Total if you have been granted the 100% rating or TDIU.

You may also see language like eligibility to Chapter 35 Dependents’ Educational Assistance, or that CHAMPVA has been established. Or you may also see something like no future examinations are scheduled. Like Matt was saying, any of those phrases or any of that language would indicate that they have made a finding of permanence. If the letter said anything to the extent that a future examination could be scheduled or future examination will be scheduled, then your disability is not considered permanent by VA.

So, now looking at whether VA can reduce a Permanent and Total rating. The short answer is that no, VA cannot reduce your Permanent and Total rating. They are protected from being reduced and they may entitle you and your family to additional benefits.

In cases involving Dependency and Indemnity Compensation, or DIC, the spouse will need to have been married to the veteran for at least 10 years prior to the veteran’s death. Otherwise, the benefits will stop upon the veteran’s death, even if they were rated as Permanent and Total.

According to regulation 38 CFR § 3.105e, a rating reduction may only take place in cases where VA has received the veteran’s entire medical history; the veteran undergoes a thorough examination that is adequate for rating purposes, meaning that there is really nothing wrong with the examiner’s reasoning; and VA finds sustained improvement in the veteran’s ability to function under the ordinary conditions of life, including employment. So here, a sustained improvement is considered to have been demonstrated when significant evidence shows a lessening of service-connected symptoms that have persisted consistently over time across situations and under the ordinary conditions of life, which really just means that there is a sustained improvement, there’s no circumstantial factors or mitigating factors that are attributed to that improvement that has been found on that single exam.

One thing that I do want to note for this is that once you’ve been found Permanent and Total, if you do not file new claims, the VA will not schedule you for new exams. That’s just part of the regulation like Matt was talking about. If you do file a new claim, that can potentially open the door to VA looking at your conditions again and potentially reducing those ratings. So, just something to keep in mind as a potential risk once you have been found Permanent and Total if you are interested in filing a new claim at that point.

Matt, are there any additional benefits for veterans with 100% Permanent and Total ratings?

Matt: Yes, there are additional benefits that veterans with Permanent and Total ratings may be eligible for. Some of those include, which was mentioned earlier, CHAMPVA health care benefits, which is VA health care for your dependents. Veterans who are Permanent and Total may also be entitled to Chapter 35 Dependents’ Educational Assistance programs. They may also be entitled to Dependency and Indemnity Compensation, which is often referred to as death benefits. And many individual states also have special benefits for veterans who are permanently and totally disabled. So, if you have attained that status before VA due to your service-connected conditions, take a look at what your states may offer in terms of special benefits because they do vary by state and specific states may entitle you to additional benefits up to and including the one’s that we just mentioned.

Kayla: Great. And if you’re not sure what benefits you might be eligible for, definitely reach out to local VA offices as well, or veteran service organizations or other representatives. They may be able to point you in the right direction and let you know what other benefits you might be eligible for.

And with that, I think that’s a good place for us to close out today. Thank you all so much for tuning in. For more information on this topic and other VA disability topics, you can check out our blog at CCK-law.com. And also, be sure to subscribe to our YouTube channel to catch our future videos.