What is the Criteria for 70% TBI Disability Rating?
What is the Criteria for 70% TBI Disability Rating? After VA grants service connection for Traumatic Brain Injury (TBI disability), VA must determine the correct rating percentage. As a result, the rating percentage determines how much money VA must pay to the veteran. Rather than assign percentages subjectively, VA uses criteria in the Schedule of Ratings.
VA Schedule of Rating Criteria for 70% TBI Disability Rating
The VA Schedule of Ratings breaks down disabilities into different categories. Firstly, each category contains groups of medical problems. Secondly, each group contains a list of disabilities, and each disability has its own diagnostic code. Thirdly, every diagnostic code specifies the symptoms required for various ratings. For example, the 8045 diagnostic code covers residuals of Traumatic Brain Injury (TBI).
How is a TBI disability rated?
The VA divides the rating criteria for TBI disability into 10 categories.
Veterans are rated based on the level of severity and impairment in each of these areas:
1. Memory, attention, concentration, and executive functions, including goal setting, planning, self-monitoring, and flexibility in changing actions when they are not productive.
2. Judgment: a veteran’s ability to make reasonable decisions.
3. Social interaction: how often a veteran acts appropriately in social situations.
4. Orientation: a veteran’s awareness of who, where, and when he is.
5. Motor activities: a veteran’s ability to perform previously learned motor activities (such as riding a bike).
6. Visual-spatial orientation: A veteran gets lost, even in familiar surroundings, or cannot point at or name their own body parts.
7. Subjective symptoms: symptoms that cannot be measured with objective tests, such as panic attacks and thoughts of suicide.
8. Neurobehavioral effects: examples include lack of motivation, verbal aggression, physical aggression, and lack of empathy.
9. Ability to communicate: Can the veteran communicate either by spoken or written language or communicate basic needs?
10. Consciousness: Is the veteran in a coma or a vegetative state?
Traumatic Brain Injury (TBI) residual scale
VA rates TBI residuals on a scale of 0, 1, 2, 3, or total. Each increment corresponds to a disability rating:
0 = 0% (normal functioning)
1 = 10% (mild)
2 = 40% (moderate)
3 = 70% (severe)
Total = 100%
The VA will award a 100% TBI disability rating if any residuals of TBI are rated “total”. Conversely, the VA will assign a percentage based on the highest-rated residual if no residual is rated “total”. For example, let’s say a veteran has TBI residuals in 3 out of the 10 categories. Therefore, he has a 1 for Judgment, a 3 for the ability to communicate, and a 2 for orientation. In this example, VA will award 70% because 3 is the highest residual rating.
70% TBI Disability Rating Varies
Across the 10 residual categories, the criteria for a 70% rating varies. For example, a Neurobehavioral residual must interfere with or preclude workplace interaction, social interaction, or both on most days. By contrast, VA assigns a 3 if Motor activities are moderately decreased due to apraxia. When in doubt, one should consult diagnostic code 8045 and the associated tables.
The following examples would yield a 70% disability rating for TBI:
A 50 year-old veteran who is often disoriented in time and place.
A 35 year-old veteran whose social interaction is inappropriate most of the time.
A 70 year-old veteran who is unable to communicate either by spoken or written language about half of the time.
Special Monthly Compensation
A veteran may receive special monthly compensation, in addition to a 70% rating, for Traumatic Brain Injury (TBI). As a result, the question is simple: Does your 70% rated TBI disability render you so helpless that you require the regular aid and attendance of another person?
Disability Help Group Case Study
Disability Help Group represented a veteran of the Army who had TBI at 10%. After increasing his rating to 70% for Traumatic Brain Injury, we continued fighting for him to receive special monthly compensation. We were able to prove that he could not care for himself, because the local VA hospital appointed his mother as his VA caregiver. Among other duties, she assisted with medication management, personal hygiene, reminding him of and taking him to appointments, and paying his bill. Therefore, we proved the veteran had a permanent need for regular aid and attendance due to his TBI.
As a result, VA granted Special Monthly Compensation at the (r)(2) rate, increasing monthly payment from $264.02 to $8,343.91.
Do you believe you meet the criteria for a 70% rating for TBI disability? Be sure you start your claim the right way and apply for all the benefits you deserve. Call our team of experts today at (800) 800-3332 or contact us here for your FREE consultation!
Does your anxiety prevent you from working? Anxiety can cause feelings of worry or nervousness. These disorders are the most common emotional disorders. If you have an anxiety disorder, you may qualify for Social Security disability benefits.
Anxiety symptoms
Anxiety disorders have many symptoms. Frequently, these disorders can cause excessive worry or fear. They can also cause you to avoid certain places, activities, or people.
For example, symptoms may include:
Restlessness
Difficulty concentrating
Problems sleeping or fatigue
Obsessions or compulsions
Panic attacks, constant thoughts or fears about safety, or physical complaints
Types of Anxiety That Prevent Working
Anxiety disorders include several different types, these include:
Generalized anxiety disorder – six months or more of a constant state of tension or worry, not related to any specific event
Panic disorder – repeated attacks of anxiety that last up to ten minutes without any specific cause
Social anxiety disorder: fear, self-consciousness, and/or embarrassment with everyday social interactions
Agoraphobia: fear of places and situations that might cause panic, helplessness, or embarrassment. Typically, it can cause difficulty leaving your home or a particular location
Obsessive-compulsive disorder: recurrent and persistent thoughts or impulses that may make you feel can be controlled by performing repetitive behaviors
What if my anxiety prevents me from working?
You may qualify for Social Security disability benefits for your anxiety disorder. However, you must show that your symptoms are severe. They must cause problems doing normal, daily activities. Also, they must keep you from working for at least 12 months.
Social Security’s Listing for Anxiety Disorders
Social Security provides a listing of impairments. This is known as the “Blue Book.” The Blue Book provides specific conditions that you must meet to qualify for disability benefits. Social Security looks at anxiety disorders under Listing 12.06.
Meeting the listing for anxiety disorders that prevent work
First, you must have medical records that show three or more anxiety symptoms.
Specifically, you must show:
Restlessness, easily fatigued, or difficulty concentrating
Irritability, muscle tension, or problems sleeping
Second, you must show that your symptoms cause a serious problem in your functioning. Generally, you must have an extreme limitation in at least one area. Alternatively, you can have a marked limitation in at least two areas.
These areas of functioning include:
Understanding, remembering, or applying information (understanding instructions, learning new tasks, applying new knowledge to tasks, and using judgment in decisions)
Interacting with others (the ability to use socially appropriate behaviors)
Concentrating, persisting, or maintaining pace in performing tasks (staying focused and/or completing tasks)
Adapting or managing oneself (the ability to perform daily activities such as paying bills, cooking, shopping, dressing, and keeping good hygiene)
Social Security definitions of marked and extreme
Firstly, “Marked” means having a serious limitation in that area of functioning. Secondly, “Extreme” means not being able to function in that area at all. Thirdly, a Social Security psychiatrist or psychologist looks at your medical records. and decide if your anxiety disorder causes marked or extreme limitations.
Anxiety and the “C” Criteria
On the other hand, you may also meet the criteria under the listing if your anxiety disorder has been:
Medically documented as serious and persistent for at least two years and
Required to keep a highly structured setting to reduce your symptoms, such as an intensive outpatient or partial hospitalization program, or have minimal capacity to adapt to demands that are not already part of your daily life or changes to your environment
Getting disability if you don’t meet the listing
You can still qualify for disability benefits if you do not meet Social Security’s listing because Social Security looks at how your anxiety symptoms impact your ability to work. Particularly, they consider your ability to carry out simple instructions, make simple work-related decisions, respond appropriately to supervision and co-workers, handle changes in a routine, and show up to work consistently, arrive on time, or leave early.
Example 1: Anxiety prevents you from working
As an example, Joan suffers from anxiety and panic attacks, Her panic attacks happen unexpectedly, she receives medication from her psychiatrist and she also sees a therapist regularly. However, she still suffers from panic attacks many times during the day. She has even had to go to the emergency room during her panic attacks. Her panic attacks make it hard for her to finish things she starts. At times, her panic attacks keep her from leaving the house. Social Security finds that Joan would miss work a lot due to her panic attacks. Therefore, Joan qualifies for disability benefits.
What evidence do I need if my anxiety prevents me from working?
Social Security requests medical records from your doctors. As a rule, it is best to get treatment from a psychiatrist or psychologist. It is important to see your doctors regularly. Equally important, you should tell them about all the symptoms you have. Additionally, your doctor can complete a residual functional capacity form.
Getting help with your disability claim for anxiety
It can be difficult to win disability benefits for anxiety disorders. However, an experienced disability advocate can help guide you through the process. An experienced advocate can also help gather your records to help support your case. Additionally, they can provide you with forms for your doctors and answer all your questions.
Be sure you start your claim the right way and apply for all the benefits you deserve. If you have already applied for SSI or SSDI, contact our team immediately to make sure your case is still pending and was filed correctly. You may be entitled to significant compensation. Call us today at (800) 800-3332 or contact us here for your free consultation.
Can I get A 100% VA Rating for PTSD due to Military Sexual Trauma?
Post Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is a mental disability triggered by a traumatic event. When the average person thinks of a traumatic military event, they often think of combat. However, some military threats come from within our own ranks. Military Sexual Trauma, or MST, refers to experiences of sexual assault or sexual harassment during military service. According to national data provided by the VA, 1 in 3 women and 1 in 50 men say that they experienced military sexual trauma (MST) when screened by their VA provider.
Military Sexual Trauma (MST)
Military Sexual Trauma includes any sexual activity where a service member is involved against his or her will. He or she may have been pressured into sexual activities (for example, with threats of negative consequences for refusing to be sexually cooperative or with implied better treatment in exchange for sex), or may have been physically forced into sexual activities.
Other MST experiences include unwanted sexual touching or grabbing; threatening, offensive remarks about a person’s body or sexual activities; and threatening and unwelcome sexual advances.
PTSD is the most common mental health diagnosis related to MST. You may be eligible for VA 100% if your PTSD is due to MST.
Service Connection PTSD due to MST
Before VA will assign a 100% rating for PTSD due to MST, they must first determine whether it is related to service. In other words, VA must first grant service connection before it will assign a rating.
There are 4 requirements to prove service-connection PTSD due to MST
Current diagnosis,
In-service event, disease or injury,
Medical nexus between the first 2 elements, and
Credible supporting evidence that the claimed in-service stressor occurred.
The challenge of Proving Military Sexual Trauma (MST)
Most victims are not eager to report MST to their superiors. This is especially true if a superior has committed the MST, the VA is well aware of this. Absent an official law enforcement record, how does one prove PTSD due to MST?
The VA looks for credible supporting evidence.
Credible supporting evidence of MST can include:
In-service pregnancy tests or tests for sexually transmitted diseases,
Statements from clergy, family members, roommates, or
Evidence of behavior changes following the claimed assault.
Rating PTSD due to MST
After the VA grants service connection for PTSD due to MST, it must determine the correct rating. To do so, the VA consults the Schedule of Ratings.
The Schedule of Ratings breaks down disabilities into different categories. Each category contains groups of medical problems. For example, PTSD due to MST is found in the General Rating Formula for Mental Disorders. Depending on the symptoms, a veteran may receive either 0%, 10%, 30%, 50%, 70%, or 100%.
100% Rating: Total occupational and social impairment from PTSD due to MST
Gross impairment in thought processes or communication
Persistent delusions or hallucinations; grossly inappropriate behavior
The 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
Memory loss for names of close relatives, own occupation, or own name
70% Rating: Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood
Suicidal ideation
Obsessional rituals which interfere with routine activities
Speech intermittently illogical, obscure, or irrelevant
Near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively
Impaired impulse control (such as unprovoked irritability with periods of violence)
Spatial disorientation
Neglect of personal appearance and hygiene
Difficulty in adapting to stressful circumstances (including work or a work-like setting
Inability to establish and maintain effective relationships
50% Rating: Occupational and social impairment with reduced reliability and productivity
Flattened affect
Circumstantial, circumlocutory, or stereotyped speech
Panic attacks more than once a week
Difficulty in understanding complex commands
Impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks)
Impaired judgment
Impaired abstract thinking
Disturbances of motivation and mood
Difficulty in establishing and maintaining effective work and social relationships
30% Rating: Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal)
Depressed mood
Anxiety
Suspiciousness
Panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, and recent events)
10% = Occupational and social impairment due to mild or transient symptoms
Decrease work efficiency and ability to perform occupational tasks only during periods of significant stress
Symptoms controlled by continuous medication
0% Rating: A mental condition has been formally diagnosed
Symptoms are not severe enough either to interfere with occupational and social functioning
Require continuous medication
You May Be Entitled to VA 100% PTSD due to MST
The type, severity, and duration of a veteran’s symptoms will vary based on a number of factors. For example, race, religion, and sexual orientation can affect the impact of MST. Whether the MST happened once or was repeated over time may affect how long the symptoms last.
If your PTSD due to MST has caused any of the symptoms in the 100% range, then you may be entitled to VA 100%.
Call Disability Help Group for a FREE Case Review! If you have more questions about getting a 100% rating for PTSD due to MST, please fill out our information form here or call us at (800) 800-3332. We offer a 100% guaranteed free case review. We will be happy to answer your questions.
Traumatic brain injury (TBI) usually happens when you suffer an injury to the brain. Usually, this can be caused by different events. The most common include falls, car accidents or sports injuries. Most people recover well from symptoms caused by the injury. However, sometimes symptoms can last much longer.
Symptoms of traumatic brain injury
Traumatic brain injuries can cause many different symptoms. These can include difficulty thinking, feeling slowed down or difficulty concentrating. Traumatic brain injuries can cause physical symptoms. These include headaches, nausea or vomiting or feeling tired. Traumatic brain injuries can also cause mood symptoms. Mood symptoms include irritability, sadness or anxiety. Traumatic brain injuries can also interfere with sleep.
Social Security disability benefits for traumatic brain injury
You can apply for Social Security disability if you have a TBI. However, you must meet certain requirements to receive benefits. Generally, your condition must interfere with your normal daily activities. Additionally, your symptoms must keep you from working for at least 12 months. To qualify for Social Security disability insurance benefits (SSDI) you also must have worked a certain number of years recently.
Social Security definition of traumatic brain injury
Social Security provides a listing of impairments, known as the “Blue Book”. The Blue Book provides specific conditions you must meet to qualify for disability benefits. Typically, the listings consider the most extreme severity of symptoms. Social Security considers traumatic brain injury under listing 11.18.
Listing 11.18 traumatic brain injury
Social Security considers traumatic brain injury as brain damage caused by skull fracture, a closed head injury or penetration by an object into the brain tissue. To qualify under the listing you must show:
The inability to control the movement of at least two extremities (either an arm and a leg or two arms or two legs AND
Extreme difficulty in balancing when standing or walking, standing up from a seated position or using the arms OR
“Marked” physical problems and a “marked” limitation (for at least 3 months post-injury) in any one of the following:
Thinking
Interacting with others
Finishing tasks
Regulating emotions and controlling your behavior
Meeting the listing for traumatic brain injury
Social Security defines marked as more than moderate but not extreme. “Marked” means having a serious limitation in that area of functioning. “Extreme” means not being able to function in that area at all.
What if my traumatic brain injury doesn’t meet the listing?
Many people will not meet the listing for traumatic brain injury. However, you can still get disability benefits. Specifically, you need to show that your traumatic brain injury limits your functioning and keeps you from working. If you don’t meet the listing, Social Security considers your residual functional capacity (RFC). Your RFC includes the most you can do despite your conditions.
Example 1: traumatic brain injury and Social Security disability
For example, Donald had a car accident and hit his head. He lost consciousness when he hit his head. Following his accident, Donald started having frequent headaches. He started having problems with his balance. Donald also started having trouble remembering things and concentrating. He became irritable easily. Social Security found that Donald’s symptoms would cause him to miss work frequently. They also found that he would not be able to stay focused throughout a work day. Therefore, Social Security approved his case.
Medical evidence for traumatic brain injury
Social Security needs evidence showing that your symptoms cause severe problems. Therefore, you must provide medical evidence related to your traumatic brain injury. Generally, medical evidence includes your doctor’s notes, test results and imaging. Your doctor should document:
Any physical problems using your arms or legs
Difficulty with balance or coordination
The frequency and severity of ongoing symptoms such as headaches or blurred vision
Behavioral changes in your mood or personality
Problems with focus or concentration
Side effects from medications
RFC forms for traumatic brain injury
Frequently, traumatic brain injuries cause both physical and mental symptoms. An RFC form can help explain how your condition impacts your functioning. It should be very detailed. It should include all of your symptoms and treatment. Your doctor should include both your physical and mental limitations. An experienced disability advocate can provide these forms to you.
Social Security grid rules
Social Security uses a chart called the Medical-Vocational guidelines, known as the “grid rules”. They use this chart to help evaluate your disability claim. These grid rules make it easier for people over 50 to win their disability case. The grid rules make it even easier for people over 55. The grid rules allow Social Security to approve your case if you can’t do your past work, even if you can do other types of less physical work.
Example 2: grid rules over 50
For example, Paula, 53, suffered a TBI. Her symptoms included frequent headaches, poor sleep and difficulty concentrating. Paula previously worked as a cashier and warehouse worker. Social Security found that Paula could not stand or walk for long periods. They also found she could only perform simple and routine tasks. She was not able do either of her past jobs. Social Security found she could do simple, seated jobs. However, under the grid rules, Paula was approved for benefits.
Example 3: grid rules over 55
In another example, Bob worked as a mail carrier. He suffered from a TBI. Following his injury, he started having seizures. He also suffered from weakness in his arms and legs and mood swings. Social Security found that Bob could not return to his job as a mail carrier. Social Security found that he could do other less physical jobs. However, since Bob was 57 years old, the grid rules applied. Social Security approved his disability claim.
Call Now for a Free Case Review, 800-700-0652
Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
You can receive both VA disability and Social Security disability benefits. Frequently, disabled veterans apply for both benefits. Receiving Social Security disability doesn’t provide extra VA disability benefits. However, it can help increase your VA disability rating.
VA disability vs. Social Security disability
The VA offers disability benefits for disabilities connected to your service. You can get partial disability benefits from the VA. VA disability compensation rates range from 10% to 100% in 10% increments. Social Security offers two types of benefits. You must have worked to apply for Social Security disability insurance benefits (SSDI). You must meet certain financial conditions for Supplemental Security Income benefits (SSI). Under both SSDI and SSI, your medical conditions must keep you from working for at least 12 months. Unlike the VA, Social Security doesn’t offer partial disability.
VA disability benefits
The VA requires that you meet certain conditions for disability benefits. Most importantly, you must show that your medical conditions are service-connected. You must also show a medical nexus or connection between your condition and in-service incurrence. Service-connected means:
Your condition was directly caused by military service
A condition was caused by conditions that are service-connected
VA disability: TDUI
It can be hard to get a 100% disability rating when you have more than one disabling condition. Fortunately, the VA provides an alternate way to total disability. You can receive VA total disability under total disability individual unemployability (TDUI). You meet the conditions for a TDUI rating if your disabilities prevent you from working and have a single service-connected rating or have a combined disability rating of 70%
Increasing your VA disability rating
Social Security recipients can use their decision to help increase their VA rating. Social Security hearing decisions provide detailed reasons for approval. You can use your Social Security decision to:
Help establish your diagnosis, establish service-connection or establish severity
Using your Social Security decision to establish a diagnosis
Social Security looks at your medically determinable impairments (MDI). An MDI includes any conditions that have more than a slight impact on your functioning. Your Social Security hearing decision lists all of your disabilities. Therefore, your Social Security approval helps determine your diagnosis.
Example 1: establishing a diagnosis
For example, Sam applied for Social Security benefits for both physical and mental conditions. In Sam’s decision, the judge listed all of the conditions he considered when deciding disability. The judge also included specific medical evidence that supported his diagnoses. Sam was able to use his hearing decision to help establish his diagnoses.
Using your Social Security decision to establish service-connection
During a Social Security disability hearing, judges ask a lot of questions about your disabilities. Frequently, you have to provide detailed explanations about your conditions. Often, this includes when your conditions started. A Social Security hearing decision includes a summary of what you said during your hearing. Therefore, your Social Security hearing decision can help establish service-connection.
Example 2: establishing service-connection
In another example, Paul applied for Social Security disability benefits for degenerative disc disease and spinal stenosis. During the hearing, he testified that he injured his back while on active duty. Paul’s testimony included specific details how his injury occurred. The judge’s decision included Paul’s testimony. Paul was able to use his Social Security hearing decision to help establish that his back condition was connected to his service.
Using your Social Security decision to establish severity
Social Security has very difficult conditions to meet for disability benefits. You must show that your medical conditions prevent you from working in any job. A judge’s decision explains why a case meets the conditions for disability. Specifically, the decision explains how significantly medical conditions impact your functioning. Therefore, a Social Security disability decision can help explain the severity of your conditions.
Example 3: establishing severity
For instance, John applied for disability benefits for PTSD. During his hearing, he testified that he often had flashbacks and nightmares as a result of his service. John also testified that he would become paranoid. His paranoia made it difficult to be around others. He had difficulty concentrating because of his poor sleep. In the hearing decision, the judge explained that John’s PTSD symptoms caused severe problems concentrating. The judge also explained that John’s symptoms would cause him to miss work a lot, making him unlikely to keep a job. John provided the VA a copy of his decision, helping him qualify for TDUI.
Using your Social Security disability evidence to support your VA disability
Many times, veterans receive treatment from both the VA and civilian doctors. Social Security disability claims need a lot of medical evidence. Therefore, your Social Security disability file should include most of your medical records. You can use your Social Security disability file to help support your VA disability claim or appeal.
Call Now for a Free Case Review, 800-700-0652
Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
