VA Permanent and Total Disability (TDIU) for PTSD. The VA will award Permanent and Total disability to veterans whose disabilities are Total (rated 100% disabling by VA) and Permanent (very low likelihood of improvement). Although the terms “Permanent” and “Total” are often discussed together, it is possible to have a permanent disability that is not totally disabling. For example, a veteran may have a permanent disability (such as PTSD) at 70%. Her PTSD is not “Total” because it is less than 100%. Likewise, it is possible to have a total disability that is not permanent. For example, the same veteran’s PTSD may be temporarily rated at 100% during hospitalization for a suicide attempt.
PTSD Rating Schedule for TDIU
Rather than assign percentages at random, VA uses a Schedule of Ratings. The Schedule of Ratings breaks down disabilities into different categories, which contain groups of medical problems, list of disabilities, and diagnostic code. Therefore, every diagnostic code specifies the symptoms required for various ratings. For example, the 9411 code applies to PTSD. VA rates PTSD –along with 36 other mental health conditions – under the General Rating Formula for Mental Disorders. Depending on the symptoms, a veteran may receive either 0%, 10%, 30%, 50%, 70% or 100%.
VA will award Permanent & Total Disability (TDIU) for PTSD
The veteran’s PTSD meets the criteria for a 100% rating, and
Medical evidence shows that the PTSD is not likely to improve during the veteran’s lifetime.
Total PTSD Rating
VA will award a total rating for PTSD if it causes total occupational and social impairment. Per the Schedule of Ratings, the following symptoms merit a 100% rating for PTSD:
gross impairment in thought processes or communication;
persistent delusions or hallucinations; grossly inappropriate behavior;
persistent danger of hurting self or others;
intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene);
disorientation to time or place; or
memory loss for names of close relatives, own occupation, or own name.
VA will only concede these symptoms if they appear in medical records. In other words, VA will not grant Permanent and Total Disability for PTSD based solely on the veteran’s statements.
VA 100% Rating, Permanent and Total Disability (TDIU) for PTSD
A 100% rating for PTSD satisfies the “Total” part of Permanent and Total Disability. Whether a 100% PTSD is “permanent” is a medical question for the veteran’s treating doctor. Will this condition ever improve during the veteran’s lifetime? If the doctor’s answer is no, then the veteran should submit the doctor’s written opinion to VA. VA will likely defer to the medical opinion and award Permanent and Total disability for PTSD.
Case Study 1: Permanent and Total Disability (TDIU) for PTSD
A 40 year-old Gulf War combat veteran filed a claim for PTSD in 2011. In 2012, VA denied the claim despite the Combat Action Ribbon noted on his DD Form 214. After significant development, DHG representatives won the case on appeal. The medical evidence proved that he met the criteria for a 100% rating. His symptoms included unprovoked irritability with periods of violence, impaired impulse control, and audio hallucinations. They were so severe that he could not hold a job. In addition, his doctor wrote that his symptoms would only get worse throughout his lifetime. Consequently, VA awarded a Permanent and Total disability for PTSD.
Case Study: Permanent and Total Disability (TDIU) for PTSD
A 45 year-old Peacetime veteran received a 70% rating for his PTSD. After service, he worked in a Ford Motor Company manufacturing plant for 15 years. After a workplace injury to his back, he was medically retired. A VA medical exam found that his PTSD was unlikely to improve. However, there was no medical evidence to support a 100% rating. But for his workplace accident, he would be able to work. VA decided to keep his rating at 70%, which is less than total. Consequently, he was not entitled to Permanent and Total disability for PTSD.
Case Study: Permanent and Total Disability (TDIU) for PTSD
A 22 year-old Air Force veteran witnessed a deadly parachute accident. It happened 3 months into his active duty service. As a result, he was diagnosed with PTSD and anxiety disorder. Unfortunately, he turned to drugs and alcohol to self-medicate his symptoms. Within 2 years of his discharge, he was homeless. When he filed a PTSD claim, VA denied it for insufficient evidence. At the local VA hospital, he met another veteran who referred him to DHG. DHG then developed medical evidence, a lay statement from the veteran, and legal arguments. In response, VA scheduled a PTSD medical examination. VA’s own examiner recommended a permanent 100% rating. Shortly afterwards, VA awarded a Permanent and Total disability rating for PTSD.
Call for a Free Case Review
When VA awards a Permanent and Total disability rating your rating is protected for the rest of your life. Are you eligible for Permanent & Total disability.
For a FREE CASE REVIEW, Call 800-800-3332 or click here.
Resources related to Permanent and Total Disability (TDIU) for PTSD
What is VA Permanent and Total Disability? The Department of Veterans Affairs (VA) offers 2 disability benefit programs: 1) Compensation; and 2) Pension. Both disability programs provide monthly payments to disabled veterans. There is a major difference in the programs.
VA Pension Total and Permanent
VA Pension is a needs-based program similar to Social Security’s Supplemental Security Income (SSI). Similarly to SSI, to be eligible for pension benefits, a veteran must have wartime service, low income, and a Permanent and Total disability. The Permanent and Total disability does not need to be “connected” to the period of military service. Disabled veterans aged 65 years or older can receive Permanent and Total disability for pension. For further information on Permanent and Total disability you can read our blog, How Can I Get TDIU.
VA Compensation Total and Permanent
VA Compensation is not based on need, income or age. It pays a veteran for disabilities incurred in or aggravated during their active duty service. The monthly payment depend on how much the veteran’s ability to work is impacted.
Eligibility for VA Permanent and Total Disability
A veteran can be eligible for both Pension and Compensation. Generally, Compensation will pay more money per month than Pension. Many veterans seek Permanent & Total disability for Compensation purposes instead of Pension because it pays more money.
Can You Receive Total Disability without Permanent Disability?
VA will award Permanent and Total disability to veterans whose disabilities are rated 100% with a very low likelihood of improvement. Although the terms “Permanent” and “Total” are often discussed together, it is possible to have a permanent disability that is not totally disabling. For example, a veteran may have a PTSD permanent disability at 70%. The PTSD is not “Total” because it is less than 100%.
It is possible to have a total disability that is not permanent. For example, the same veteran’s PTSD may be temporary at 100% during hospitalization for a suicide attempt. To learn more about TDIU and PTSD you can read our posts, Can I get TDIU from PTSD? or VA Permanent and Total Disability for PTSD.
General Rule
Generally, VA will award a Permanent & Total designation
if the following criteria are met:
The veteran has a disability rated at 100%, and
Medical evidence shows that this disability is
not likely to improve during the veteran’s lifetime.
Medical Evidence
Your treating doctor can provide the best medical evidence to prove entitlement to Permanent and Total Disability. Ask your doctor whether your 100% disability is likely to improve during your lifetime. If the answer is no. Ask your doctor to put this opinion in writing. VA will most likely defer to your doctor’s opinion and award Permanent and Total disability.
Exception to the Rule
As with most rules, there are exceptions. Regardless of the percentage, VA will deem certain disabilities Permanent & Total. Examples include the loss or loss of use of both hands, both feet, or sight in both eyes. In addition, VA would probably award Special Monthly Compensation.
Case Studies
The following DHG clients received a Permanent & Total disability rating.
PTSD Permanent and Total Disability
A 50 year-old Gulf War combat veteran filed a claim for PTSD in 2009. In 2010, he was denied despite the Combat Action Ribbon noted on his DD Form 214. After significant development, we won the case on appeal. The medical evidence proved that he met the criteria for a 100% rating. His symptoms included unprovoked irritability with periods of violence, impaired impulse control, audio hallucinations, and panic attacks. They were so severe that he could not hold a job. In addition, his doctor wrote that his symptoms would only get worse throughout his lifetime. VA awarded a Permanent and Total disability for PTSD. You can also work and get TDIU, if you are working you may want to read our post, Can I Work and Get TDIU?
Schizoaffective Disorder
A 57 year-old Air Force veteran lost his wife to a deadly car accident. This happened 3 months into his active duty service. He was never the same after that accident. He was diagnosed with schizoaffective disorder, depressive type. Unfortunately, he turned to drugs and alcohol to self-medicate his symptoms. He was homeless for many years. When he filed a compensation claim, VA branded him a drug addict. At the local VA hospital, he met another veteran who referred him to us. We developed medical evidence, a lay statement from the veteran, and legal arguments. Our represtative also submitted a medical opinion from a private psychiatrist, who recommended a total and permanent rating based on the medical evidence. Shortly afterwards, VA awarded a Permanent and Total disability rating for schizoaffective disorder
Call for a Free Case Review
When VA awards a Permanent and Total disability rating your rating is protected for the rest of your life. Are you eligible for Permanent & Total disability.
For a FREE CASE REVIEW, Call 800-800-3332 or click here.
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How Can I Increase My VA Disability Rating? When discussing VA Disability rates, one must distinguish between the Compensation and Pension rates. Both involve monthly payments from VA, but they have very different requirements. Pension is a needs-based program similar to Supplemental Security Income (SSI). VA will grant pension benefits to veterans with wartime service, low income, and total and permanent disability. The total and permanent disability does not need to be “connected” to their military service.
Maximum VA Pension
VA Pension rates are based on income. The maximum pension rate is an annual amount set by Congress. A veteran’s pension is determined by how much income his family generates.
VA Compensation Rating
VA Compensation is NOT based on need or income. It pays a veteran for disabilities incurred in or aggravated during their active duty service. A veteran may not receive both pension and compensation at the same time. Compensation is generally paid at a much higher rate, most veterans opt for compensation. The following will focus on disability compensation rates.
Increase VA Disability Rating, Schedule of Ratings
Congress directed VA to, “adopt and apply a schedule of ratings of reductions in earning capacity from specific injuries or combination of injuries.” In other words, a veteran’s disability rating must reflect how much that disability impairs the veteran’s ability to work. VA law also requires that the Schedule of Ratings “provide 10 grades of disability and no more.” Under the schedule, VA assigns disability ratings of: 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100%. The higher the disability rating, the higher the monthly compensation VA will pay to the veteran.
Why VA Ratings Differ
Some medical conditions are more disabling than others. How does VA figure out the right disability rating? The Schedule of Ratings breaks down disabilities into different categories based on the affected part of the body. Each category contains groups of medical problems. Each group contains a list of disabilities, and each disability has its own diagnostic code. Every diagnostic code specifies the symptoms required for various ratings. For example, many veterans suffer from a hearing loss disability known as tinnitus. In-service exposure to loud noise – such as on the deck of an aircraft carrier – is a common cause of tinnitus. Under the Disease of the Ear category, tinnitus has the 6260 diagnostic code. Under code 6260, the maximum disability rating is 10%. The rating is the same whether tinnitus affects one or both ears.
VA Diagnostic Codes and Ratings
Understand the VA diagnostic codes to increase your VA disability rating. Not every diagnostic code is as simple as 6260. For example, the 9411 code applies to post-traumatic stress disorder (PTSD). Depending on the symptoms, a veteran may receive either 0%, 10%, 30%, 50%, 70% or 100%. A 100% rating for PTSD reflects total impairment of occupational and social skills. Symptoms in the 100% range include persistent suicide attempts. However, a veteran with very mild PTSD controlled by medication will probably receive 10%. VA is bound by the diagnostic code criteria. If your service-connected disability satisfies the criteria for a higher rating, then VA must grant that rating.
Disability Help Group VA Team
We have helped thousands of veterans win higher VA disability ratings. One veteran in particular came to us with a 50% rating for his PTSD. During development, we discovered that he had more than 10 psychiatric hospitalizations within the past 5 years. He was involuntarily hospitalized under the Baker Act. He required 300 mg of Lithium twice daily to simply maintain a baseline of suicidal ideations. After several years of our advocacy, VA agreed to assign a 100% rating all the way back to his first hospitalization. Thanks to our work, VA paid him a lump-sum of over $200,000.00.
Increase Your VA Disability to 100%
The maximum VA rating permitted by law is 100%. If you have one disability at 70% and another disability at 50% ? Does that mean you really have a 120% overall rating? No. To avoid exceeding the 100% cap, VA uses a Combined Ratings table. A rating is not added to another rating to determine the VA rating. The VA uses the Combined Ratings table to determine the rating VA first considers the most disabling condition – that is, the one with the highest rating – then less disabling conditions in order of severity. This method captures the residual efficiency of a veteran with more than one service-connected condition. The formula will never result in a rating higher than 100%.
Combined VA Rating
If the combined value ends in a number from 5 through 9, VA rounds up to the next highest multiple of 10. When the combined value ends in 1 through 4, VA rounds down to the lower multiple of 10. If the combined value ends in 0, then rounding is unnecessary. For example, a veteran with 70% and 50% rating has a combined value of 85%. An 85% value rounds up to a 90% combined rating. A veteran with a combined value of 84%, rounds down to 80%. A veteran with two separate disabilities rated at 10% each has a combined value of 19%, which rounds up to a 20% combined rating.
Can I Work and Get TDIU? Many veterans are unable to support themselves because of service-connected disabilities. Congress decided to take care of these veterans with a special benefit called TDIU. Also known as Unemployability, TDIU pays the same monthly amount as a 100% disability rating. Under 2019 rates, VA will pay TDIU recipients a minimum of $3,057.13 per month tax free. The whole point of TDIU is to compensate veterans who cannot maintain a full-time job due to service-connected disabilities. In most cases, VA will only award TDIU if the service-connected disabilities combine to at least 70%.
TDIU v Unemployed
The terms “Unemployability” and “Unemployed” look and sound alike, many veterans assume that cannot work to get TDIU. This is a common misconception.
Amount You Can Earn
VA will grant TDIU to a veteran that works if the employment is considered “marginal.” 38 C.F.R. § 4.16(a). VA considers employment “marginal” if the veteran earns LESS than the federal poverty threshold for one person (in 2018, $12,784 per the U.S. Census Bureau).
Sheltered Work Environment
Regardless of your income, you may still be eligible for TDIU if you work in a sheltered environment. Sheltered work environments include self-employment or a family business. If you are your own boss, you can probably take as much time off as your medical conditions require. Similarly, a family business is probably more accommodating to a veteran’s disabilities than the average workplace. Also, your family or yourself would likely pay at a rate higher than you could earn at another job.
Example: Difficult TDIU Work Case
Take the example of a veteran with a 70% rating for PTSD who works as a Financial Advisor. With the help of his doctors, he is able to manage his PTSD symptoms while earning over $100,000 a year. Because he earns above the poverty threshold despite his PTSD, he is not a good candidate for TDIU.
Example: Good TDIU Work Case
A 60 year-old veteran owns a roofing company. He has an 80% overall rating for PTSD, diabetes, and diabetic neuropathy. He lost his last 2 jobs because his PTSD led to angry confrontations with customers and his bosses. This is why he started the roofing business. His PTSD impairs his ability to maintain relationships with friends, clients, and workers. As his diabetes worsened over the years, he hired more workers to handle the physical labor. Over the past 5 years, he hired and fired over 20 workers. During the same period, another 15 workers resigned because of his offensive outbursts. This veteran is eligible for TDIU because he is employed in a sheltered environment.
Are you entitled to work and get TDIU based on marginal employment? Call the experts at Disability Help Group, 1-800-800-3332. Or, click here to request a free evaluation.
If you would like to read more about the regulation on TDIU, click on this link, 38 C.F.R. § 4.16(a).
Call for a Free Case Review
When VA awards a Permanent and Total disability rating your rating is protected for the rest of your life. Are you eligible for Permanent & Total disability.
For a FREE CASE REVIEW, Call 800-800-3332 or click here.
Many veterans are unable to earn a living because of service-connected disabilities. Congress created a special benefit called TDIU to help these veterans live comfortably, also known as Unemployability. TDIU pays the same monthly amount as a 100% disability rating. Under 2019 rates, VA will pay TDIU recipients a minimum of $3,057.13 per month tax free. VA will pay an additional amount for each of the veteran’s dependents.
Ways to Get TDIU
A veteran cannot simply state to the VA, “I cannot work due to disabilities related to service.”
First, cannot earn a living
In order to receive TDIU, a veteran must first show they cannot earn a living because of service-connected disabilities. VA will grant TDIU to an employed veteran if the employment is considered marginal. They do not have to be unemployed. VA considers employment to be marginal if the veteran earns LESS than the federal poverty threshold for one person (in 2018, $12,784.00 per the U.S. Census Bureau).
Second, must meet percentage requirements
If the veteran has only one service-connected disability, it must be rated 60% or higher to receive TDIU. If the veteran has more than one service-connected disability, then at least one must be rated 40% or higher. Also, there must be “sufficient additional disability to bring the combined rating” to 70% or higher. The regulation specifies five circumstances in which multiple disabilities “will be considered as one disability”.
Will You Get TDIU?
Disability Help Group has won TDIU for hundreds of veterans. Here are a few examples:
A divorced, 70-year old Vietnam-era veteran had a 20% rating for diabetes, 20% each for diabetic neuropathy in both legs, and 10% each for diabetic neuropathy in both arms. These combined to a 60% rating. As a result of these conditions, he had not worked in 3 years. Because the disabilities all arose from exposure to Agent Orange, we argued that VA should consider them as one service-connected disability and grant TDIU. VA agreed and granted TDIU. His monthly payment changed from $1,062.67 to $3,057.13.
A married, 35-year old Gulf War veteran asked us to help with an appeal for PTSD. She did not have a VA rating and she just lost her job. We submitted evidence to VA to win the PTSD claim. However, we noticed that she lost her last 2 jobs because of her PTSD. She had daily panic attacks, thoughts of suicide, and was hospitalized for PTSD four times in the last year. We argued that VA should grant her PTSD claim at a 70% rating, and then grant TDIU. VA agreed. Her monthly payment changed from $0 to $3,227.58.
A single, 50-year old veteran had a 60% rating for Meniere’s disease. His symptoms prevented him from working a full-time job, but he worked as an Uber driver. Because he earned less than $12,784.00 per year with Uber, VA granted TDIU. He continued to receive his income from Uber, but his monthly VA payment changed from $1,062.67 to $3,057.13.
