What is the Criteria for 70% TBI Disability Rating?

What is the Criteria for 70% TBI Disability Rating?

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!

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Can I get A 100% VA Rating for PTSD due to Military Sexual Trauma?

Can I get A 100% VA Rating for PTSD due to Military Sexual Trauma?

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

  1. Current diagnosis,
  2. In-service event, disease or injury,
  3. Medical nexus between the first 2 elements, and
  4. 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.

Resource for PTSD due to MST

How Can I Receive VA Compensation for Burn Pit Exposure?

How Can I Receive VA Compensation for Burn Pit Exposure?

What is a Burn Pit?

A burn pit is an area devoted to open-air burning of trash and you can receive VA Compensation for burn pit exposure. During U.S. operations in countries such as Kuwait, Iraq and Afghanistan, the military commonly used burn pits for waste disposal. It was a very efficient way to get rid of large amounts of waste. The largest pit was about 20 acres long .

These burn pits disposed of various materials, such as:

  • Human waste
  • Body parts
  • Medical waste
  • Unexploded ordinance
  • Chemicals
  • Plastics and Styrofoam
  • Paints
  • Rubber.

Smoke from these pits contained toxins that may lead to serious health conditions.  This is especially true for those who had prolonged exposure.  This includes service members who personally dumped waste into a burn pit.  In addition, those with pre-existing respiratory conditions were especially sensitive to the smoke.

Basic Eligibility

VA compensation is a monthly payment to veterans for disabilities related to service.  However, VA will not start the process for you.  You must first file a claim.

To win VA compensation, a veteran must satisfy the 3 basic elements of a VA claim:

  1. In-service event, disease or injury,
  2. Current diagnosis of a disability, and
  3. Medical nexus between the first 2 elements.

The first step is to prove you were exposed to burn pits during your active duty service.  If you served in the Southwest Asia Theater of Operations, then your DD Form 214 should confirm this.  Absent official service records, obtain statements from buddies who witnessed your exposure to burn pits.

Second, the veteran must have a current disability.  The time between exposure and diagnosis will vary based on several factors.  For example, the toxins from burned human waste may affect the body differently than those from burned Styrofoam.   

Even so, a short-term adverse reaction to the smoke is not enough.  Shortly after burn pit exposure, many veterans develop medical conditions.  However, many do not develop disabilities until years after discharge. 

Third, VA requires proof that the condition you suffer from today was caused or aggravated during service.  This usually takes the form of a medical nexus letter.  Only a medical professional should write a disability nexus letter.  In limited circumstances, non-doctors such as physician’s assistants and nurse practitioners can write them.  However, VA will find a disability nexus letter more persuasive if written by a doctor in the relevant specialty. 

Does Every Burn Pit Claim Need a Medical Nexus Letter?

Not every burn pit claim needs a nexus letter because in some cases, the link to service is undeniable.  For example, if your service records note a disability you still suffer from today, then VA would probably grant a claim for that disability without a nexus letter.  As of August 2021, VA will concede that burn pit exposure causes certain health conditions.  These are known as burn pit presumptive conditions.

New presumptive conditions, you can receive VA Compensation for burn pit exposure.

On August 5, 2021, VA issued a new rule to remove the medical nexus requirement for 3 conditions:

  • Asthma,
  • Rhinitis, and
  • Sinusitis.

This rule removes the medical nexus requirement for certain veterans.  But that’s not all.  It also makes it easier to prove burn pit exposure.  For veterans with a qualifying period of service, VA no longer requires specific proof of burn pit exposure to burn pits.  If you served in the Gulf War, Iraq, Syria, or Afghanistan, then you qualify.   In those cases, all you need to prove is a current diagnosis.

Why does VA keep denying my burn pit claim?

VA has been slow to recognize the science linking serious conditions to burn pit exposure.  Because the decision-makers don’t see a link, they tend to deny the claims.

The Secretary of Veterans Affairs recently talked about this . He conceded that many vets have come home with ailments that their doctors believe are a result of burn pit exposure. VA has recognized burn pits cause asthma, rhinitis and sinusitis. However, VA has yet to accept the scientific link to many more serious conditions.

Secretary McDonough cited a critical example.  A female veteran was trying to stay healthy in Fallujah, Iraq.  She went running daily around a burn pit.  When she informed her doctor, he said she should get tested early for breast cancer.  It turned out she had stage 4 breast cancer at the age of 38.  The science indicated she was way too young to have such an advanced stage cancer.

When VA denies a claim, the veteran can file an appeal.  However, appeals can take years to win.  With such an advanced cancer, this veteran may not survive before VA decides the appeal.  This is grossly unfair to veterans who served our country with honor.

Are you entitled to VA compensation for burn pit exposure?  The experts at Disability Help Group are standing by.  Contact us for a FREE CONSULTATION.

Disability Help Group, Call Now for a Free Case Review, 800-700-0652.

You can receive VA Compensation for burn pit exposure.

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

Get Help Now

Call, 1-800-700-0652

Because memory deficits are common VA TBI residuals, a veteran should always have an advocate. Disability Help Group specializes in TBI cases and is here to answer your questions now.

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How to Qualify for VA Compensation While Receiving SSI

How to Qualify for VA Compensation While Receiving SSI

How to Qualify for VA Compensation While Receiving SSI. Veterans can receive both VA compensation and SSI.  Both VA compensation and SSI require that you have disabling conditions.  However, the requirements to qualify differ. 

How to Qualify for VA Compensation While Receiving SSI: VA compensation

VA disability compensation offers monthly payments to Veterans who got sick or injured while serving.  You must show that your disabling condition was “incurred or aggravated by your military service.”  The VA does not require total disability.  The VA awards benefits based in proportion to your percentage of disability.  Compensation rates range from 10%-100%, in 10% increments. 

VA pension

The VA also offers benefits for veterans who have non-service disabilities.  VA pension benefits require that you were not dishonorably discharged and you meet certain financial limits.  You must also meet certain service requirements.  Additionally, you show one of the following:

  • You are at least 65 years old
  • Have a permanent and total disability
  • Are a patient in a nursing home for long-term care because of a disability or
  • Are receiving Social Security disability insurance or SSI. The OT and ICS cyber security is what is needed to protect data.

How to Qualify for VA Compensation While Receiving SSI: SSI benefits

Unlike VA compensation, SSI does not offer partial disability.  You must prove that your medical conditions keep you from working in any job.  You must also show that you can’t work for at least 12 months.  SSI also has specific financial requirements.  Specifically, these requirements include:

  • You must have less than $2,000 in assets (or $3,000 for a couple)
  • Have a very limited income
  • Are a US citizen (there are very few exceptions to this)

VA compensation and SSI benefits

Since SSI is a needs-based program, other income affects the amount you receive from SSI.  Therefore, VA compensation will reduce your SSI payments.  Social Security considers VA compensation as “unearned income.”  Social Security deducts unearned income on a dollar for dollar basis with a $20 exclusion.  The SSI federal payment amount for 2021 is $794 per month. 

How to apply for VA compensation

You can apply for veterans benefits online.  You may also apply by using VA Form 21-526, Veterans Application for Compensation and/or Pension.  Once you apply, the VA uses military doctors and other health personnel to evaluate your disability claim.  The VA may ask you to attend a C&P exam to help rate your claim.  The VA assigns a disability rate to each of your conditions.  These rates determine your Total Combined VA disability rating.  The VA then uses this rate to figure out the amount of your benefits. We Can Help You Qualify for VA Compensation While Receiving SSI.

How to apply for SSI

You must contact your local Social Security office to file. Unlike the VA, Social Security doesn’t rate your conditions separately.  Social Security looks at how the combination of your conditions impacts your functioning.  First, they consider if any of your conditions meet certain conditions under their listing of impairments, known as the “Blue Book”.  Most conditions will not meet these strict requirements.  Next, Social Security considers your residual functional capacity or RFC.  Your RFC includes both physical and mental limitations.  If Social Security determines that your conditions keep you from working, they will approve your disability claim.  Like the VA, Social Security may ask you to attend a medical exam to help evaluate your claim. 

Disabled veterans and your age

Social Security has special disability rules the older you are.  They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.”  The grid rules make it easier for older people to win their case.  Social Security considers your age, education and work background.  The older you are, the easier it can be to win your case. 

Can a veteran work and receive both VA and SSI?

If you are working, you may not qualify for SSI.  Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you will not qualify for Social Security disability.  For 2021, SGA is earnings $1,310 per month or more (before taxes).  However, if you earn more than $794 per month, you will not qualify to receive SSI payments.  Unlike Social Security, veterans can work while receiving VA disability benefits unless you receive Total Disability Based on Individual Unemployability (TDIU). We can help you Qualify for VA Compensation While Receiving SSI.

VA and SSI medical benefits

Veterans receiving VA disability automatically receive TRICARE benefits.  TRICARE covers health costs found “medically necessary” for your condition.  SSI recipients receive Medicaid benefits.  If you receive both TRICARE and Medicaid, TRICARE becomes your primary insurance. 

Getting help with your VA compensation and SSI claims

Get help with your case now. Firstly, your advocate helps you with your application and can make sure you provide all necessary information.  Secondly, your advocate walks you through the process and can answer all of your questions. Thirdly, your advocate knows what it takes to get your case approved.

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.

How Receiving Social Security Disability Can Help You Get VA 100%

How Receiving Social Security Disability Can Help You Get VA 100%

How Receiving Social Security Disability Can Help You Get VA 100%. Receiving Social Security disability can help you get a 100% VA rating.  However, receiving Social Security disability doesn’t guarantee a 100% VA rating.  It can be used as powerful evidence for your VA claim.  Although, these decisions only help if you can show your conditions are service-connected. 

VA disability benefits

VA disability benefits require that you meet certain conditions.  You must have a current diagnosis.  That diagnosis must be service-connected.  You must also show a medical nexus or connection between your diagnosis and in-service incurrence.  The VA considers your disability service-connected if your medical condition:

  • Firstly, Was directly caused by military service
  • Secondly, Occurred while in the military
  • Thirdly, Was aggravated by military service or
  • Finally, Caused by conditions that are service-connected

VA disability rating and TDUI

Disability ratings range from 10% to 100%.  Next, it can be hard to earn a 100% disability rating when you have more than one disability.  Fortunately, the VA provides an alternate route to total disability rating based on individual unemployability (TDUI).  The VA considers your ability not only get a job but also to keep a job.  You meet the conditions for a TDUI rating if your disabilities prevent you from working and:

  • You have a single service-connected rating or have a combined disability rating of 70%

Social Security disability helps establish a current diagnosis

Firstly, SSDI looks at your medically determinable impairments (MDI).  Secondly, Social Security considers any condition that has an impact on functioning as an MDI.  Thirdly, a Social Security hearing decision includes a list of your disabilities.  Therefore, your Social Security approval helps determine your diagnoses. Receiving Social Security Disability Can Help You Get VA 100%. Call Now for a Free Case Review.

Social Security disability helps establish service-connection

Frequently, applicants for Social Security disability have to testify at a disability hearing.  During the hearing, the judge asks a lot of questions about your disabilities.  Often, applicants provide detailed explanations about their conditions.  They also explain when conditions started.  A Social Security hearing decision includes a summary of testimony.  Therefore, your Social Security hearing decision helps establish service-connection. 

Example:  Social Security hearing decision helps establish service-connection

Likewise, a veteran applied for disability benefits for PTSD.  During the hearing, he testified that he witnessed a young girl get hit by a vehicle while on patrol during his service.  He also testified that since his service, he started blacking out and became violent.  He testified that he didn’t sleep well, had significant paranoia and was very depressed.  The judge’s decision included the veteran’s testimony, helping to establish that his PTSD was connected to his service. 

Social Security disability helps establish severity

Social Security has a difficult standard to meet for eligibility.  You must show that your medical conditions prevent you from working in any job.  A judge’s decision must explain why a case meets the requirements for disability.  The decision includes specific reasons how significantly medical conditions impact a person’s functioning.  Therefore, a Social Security disability decision can help explain how severe your conditions are. 

Example:  Social Security hearing decision helps establish severity

Hence, a veteran applied for Social Security disability due to a lower back impairment, depression and anxiety.  During the hearing, the veteran testified that he injured his back during his service.  He could no longer perform his duties as a postal worker.  As a result of his chronic pain and limitations, he developed significant depression and anxiety symptoms, requiring medication and therapy.

In his hearing decision, the judge explained that his lower back condition caused significant limitations with standing, walking and sitting.  The judge also explained that his depression and anxiety symptoms caused significant problems concentrating.  The veteran provided the VA a copy of the decision, which helped him qualify for TDUI. 

Example:  Social Security hearing decision helps establish severity

For instance, a veteran applied for Social Security disability due to a traumatic brain injury.  He suffered from episodes of aggression, poor memory and difficulty getting along with others.  In his hearing decision, the judge referred to evidence in his record documenting that he needed a lot of help with his daily activities.  Specifically, he needed help with medication management and reminders to take care of his personal hygiene. 

His mother took him to all of his medical appointments and helped manage his bills.  His medical records documented that he could become very aggressive often.  The Social Security judge determined that the veteran would not be capable of maintaining any job.  The decision helped increase the veteran’s VA disability rating. 

Getting help with your Social Security and VA disability claims

Both Social Security and VA have complicated application processes.  The process can be even tougher when Social Security or the VA issues a decision that completely ignores the evidence.  Working with an experienced advocate helps increase your chances of getting approved.  They know how to turn a loss into a win.  An experienced advocate can analyze your case and help you receive maximum benefits.  It helps to have knowledgeable experts on your side. 

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.

How to Qualify for VA Compensation While Receiving SSI

Can a Veteran Receive Both VA and Social Security Benefits?

Can a Veteran Receive Both VA and Social Security Benefits? Veterans can qualify for both VA and Social Security benefits.  Frequently, veterans apply for both VA and Social Security benefits.  However, VA and Social Security benefits have different requirements. 

VA benefits for veterans

VA benefits or service-connected disability, have specific requirements.  You must show that your disabling condition was “incurred or aggravated by your military service.”  You will not qualify for VA benefits if you have a dishonorable discharge.  You can receive partial disability benefits from the VA.  VA disability compensation rates range from 10-100%, in 10% increments. 

Social Security benefits

Social Security has two types of benefits, disability insurance benefits (SSDI) and supplemental security income benefits (SSI).  Under SSDI, you must have worked and earned at least 20 work credits.  Generally, this means you must have worked at least 5 out of the last 10 years.  Under SSI, you do not need any work credits.  However, you must meet certain financial requirements.  You must show that your medical conditions keep you from working for at least 12 months.  Unlike VA benefits, Social Security doesn’t offer partial disability. 

Applying for both VA and Social Security benefits

If you get approved for one benefit, it doesn’t increase your chances for getting approved for the other.  Social Security and the VA follow different rules.  However, Social Security considers medical evidence from the VA.  Similarly, the VA considers your Social Security records. 

Expedited processing for veterans

Fortunately, Social Security can fast-track certain cases for veterans.  Social Security expedites processing for veterans with a 100% VA rating.  You should identify as a “Veteran rated 100% P&T” when filing your application.  You should also include your VA rating notification letter.  Additionally, Social Security fast-tracks case for Wounded Warriors.  You should tell Social Security that your injuries happened while on active duty.  

Application process for VA benefits

Both the VA and Social Security reviews medical records.  The VA uses military doctors and other health personnel to evaluate your disability claim.  The VA may ask you to attend a claim exam, known as a C&P exam.  This exam helps the VA rate your disability.  Additionally, the VA assigns a disabling rate to each of your conditions.  These rates determine your Total Combined VA disability rating.  The VA uses this rating to figure out the amount of your benefits.

Application process for Social Security benefits

Unlike the VA, Social Security doesn’t rate your conditions separately.  Social Security looks at how the combination of your conditions impacts your functioning.  First, they consider if any of your conditions meet certain conditions under their listing of impairments, known as the “Blue Book”.  Most conditions will not meet these strict requirements.  Next, Social Security considers your residual functional capacity or RFC.  Your RFC includes both physical and mental limitations.  If Social Security determines that your conditions keep you from working, they will approve your disability claim.  Like the VA, Social Security may ask you to attend a medical exam to help evaluate your claim. 

Disabled veterans and your age

Social Security has special disability rules the older you are.  They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.”  The grid rules make it easier for older people to win their case.  Social Security considers your age, education and work background.  The older you are, the easier it can be to win your case. 

How much can I get from VA and Social Security benefits?

As discussed, the VA calculates your payments based on your Total Combined VA disability rating.  Social Security uses a complicated formula based on the amount of earnings you paid taxes on.  Therefore, everyone’s amount is different.  VA benefits will not affect your SSDI payments.  In other words, you can receive both payments in full.  Unfortunately, any VA benefits will reduce your SSI payments. 

VA and Social Security medical benefits

Veterans receiving VA disability automatically receive TRICARE benefits, which cover health costs found “medically necessary” for your condition.  SSDI recipients qualify for Medicare benefits which start two years after Social Security finds you disabled.  Medicare covers a variety of medical costs, usually regardless of a specific condition.  SSI recipients receive Medicaid benefits.  If you receive both TRICARE and Medicare, Medicare becomes your primary insurance.  However, if you receive both TRICARE and Medicaid, TRICARE becomes your primary insurance. 

Can a veteran work and receive both VA and Social Security benefits?

If you are working, you may not qualify for Social Security disability.  Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA and if you earn over the SGA limit, you will not qualify for Social Security disability.  For 2021, SGA is earnings $1,310 per month or more (before taxes).  You can still qualify for Social Security disability benefits if you earn less than SGA.  However, any work may make it harder for Social Security to approve your claim.  Unlike Social Security, veterans can work while receiving VA disability benefits unless you receive Total Disability Based on Individual Unemployability (TDIU.)   

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.