Sleep is required to function. Sleep Apnea is a condition where someone briefly and repeatedly stops and starts breathing. This can severely disrupt someone’s sleeping patterns affecting their mental, emotional, and physical health.
Service Connection
For the VA to assign a 100% rating for Sleep Apnea, the VA must first determine that the condition is related to service.
Generally, VA will grant service connection if the following are met:
Proof of a current diagnosis,
Proof of an in-service event, disease, or injury, and
Proof of a medical nexus between the first 2
elements.
VA Schedule of Rating
After the VA grants service connection, it must determine the correct rating. To do so, VA consults the Schedule of Ratings. The ratings should reflect how much that specific disability impairs your ability to work.
To get a 100% rating for sleep apnea, it must be so severe that it prevents gainful employment.
Requirements Specific to Sleep Apnea
The Schedule of Ratings breaks down disabilities into different categories. Each category contains groups of medical problems. For example, Sleep Apnea is found in the Respiratory System category. Each group contains a list of disabilities, each with its own diagnostic code. In turn, each diagnostic code specifies the symptoms required for various ratings. For example, the 6847 code applies to Sleep Apnea. See 38 C.F.R. § 4.97.
A 100% VA rating for Sleep Apnea requires:
Chronic respiratory failure with carbon dioxide
retention or cor pulmonale, or
The condition requires a tracheostomy.
Chronic Respiratory Failure
Chronic respiratory failure usually happens when the airways that carry air to your lungs become narrow and damaged. In other words, less oxygen gets in and less carbon dioxide goes out. A tracheostomy is a surgically made hole in the front of your neck where a breathing tube is connected to your windpipe to help you breathe. Naturally, a veteran with these extreme symptoms deserves a 100% VA rating for Sleep Apnea.
Medical Evidence
Only medical evidence can satisfy these requirements. It is not enough for the veteran to say “I cannot work because of my sleep apnea.” Fortunately, the VA provides rating tools such as Disability Benefits Questionnaires (“DBQs”) on their website. Specifically, VA provides a Sleep Apnea DBQ that focuses on the symptoms described in the Schedule. Veterans seeking a higher rating for sleep apnea should have their doctors complete the DBQ. The VA will likely grant the rating if the DBQ includes the criteria for a 100% rating for Sleep Apnea.
Disability Benefits Questionnaire
A doctor who treats the disability in question should fill out a Disability Benefits Questionnaire. For example, an orthopedic specialist who is treating a foot condition should not complete a DBQ for PTSD.
Watch out for Pyramiding
When seeking a 100% rating for Sleep Apnea, one must consider every rule and exception related to VA ratings. Under the VA rating system, a veteran should be compensated for each service-connected disability. However, there is one big exception. VA cannot pay a veteran more than once for the same disability or same manifestation. For example, Asthma and Sleep Apnea have nearly identical manifestations. They both involve airway impairment, share symptoms such as daytime fatigue and are under the same category in the Schedule of Ratings. A veteran who is service connected for both will only receive a rating for one of them. In that circumstance, the VA must assign the higher of the 2 possible ratings.
How We Can Help
Many variables come into play when trying to get 100% VA disability for Sleep Apnea. The first step is to not give up. Our team of experts are here to support you the entire way through. Whether you are struggling to secure your VA disability or need help with your denied SSD claims, we’re only a phone call away. To learn more about how our team can help you call us today at (800) 800-3332 or contact us here now for a FREE consultation.
Social Security has two types of benefits for disabled people. The first is for people who have worked for a certain number of years. These are disability insurance benefits or SSDI benefits. The second is a needs-based benefit. It is for people who meet certain financial requirements. These are Supplemental Security Income or SSI benefits.
Social Security Disability Interview Questions
First, your medical conditions must keep you from working. Second, you must be unable to work for at least twelve months. To file, you must provide certain information.
What Happens During the Social Security Disability Interview?
The claims representative asks you a series of questions. Your interview can take place in person or over the telephone. It generally lasts for about an hour.
Call Disability Help Group, We Can Complete Your Interview.
Specifically, a claims representative will ask you:
Your current name and any past names you have used
Your social security number
About your education
Names and dates of birth of your children under the age of 18 and your spouse
Dates of marriages and divorces
Bank information for Direct Deposit
An alternate contact person in case they can’t reach you
Worker’s compensation information, if applicable
In addition, you must provide your work history. Only the last 15 years are important.
This work history should include:
Last worked Date
The name of your previous employers
Your job title
The dates that you approximately worked for each employer
Your medical information should include:
All of your medical conditions
Your doctor’s information
Emergency Room or Hospitalizations
A list of your medications
Naturally, disability applications require a lot of information. It is best to get this information before your interview. Social Security may send you a form to fill out before your interview. This form helps you put the information together. In any case, it is always best to write this information out clearly.
Applying For SSI? You May Be Asked Additional Questions
These questions could include:
Where you live and who lives with you
Your household expenses
All sources of income for you and your spouse
The amount of your resources
Be Prepared With Documentation
You will also have to provide Social Security with some documents. These are in addition to the information you have given.
The documents include:
Birth certificate
A government-issued picture ID
A medical release Form SSA-827 (Authorization to Disclose Information to the Social Security Administration)
Why You Should Be Prepared
The Social Security disability interview process is crucial to your application. Therefore, providing complete information gives you a better chance of winning your case. Also, you can avoid problems or delays in your application. Missing information can often lead to being denied.
Getting Help with Your Claim
The process for applying for SSDI or SSI can be overwhelming. Hiring an experienced SSDI disability advocate can improve your chances of a successful claim.
An SSDI advocate can:
Help you prepare for your interview
Understand the Social Security disability process
Keep in contact with Social Security to make sure your claim is moving forward
Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
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.
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.
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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.
