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Tag: Increase VA rating

Increase Your Rating from 70% to 100%

Increase your Rating from 70% to 100%. If you already have a 70% rating, then you may already understand how VA ratings work.  Therefore, you probably know that a 100% rating is the maximum allowed by law.  If so, you are well aware that VA uses a Schedule of Ratings to determine the appropriate percentage.  This article will provide guidance on how to increase your monthly VA payment by approximately $1,688.41.

Single Disability Rated at 70%

If your 70% rating is for a single disability, then your first step is to find the ratings criteria for that disability.   The Schedule of Ratings contains the ratings criteria for all disabilities in various categories.  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, the 9411 code applies to post-traumatic stress disorder (PTSD).  VA rates PTSD –along with many 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%.

Develop Medical Evidence to Increase Your Rating from 70% to 100%

Next, you must develop the evidence to match the criteria for a 100% rating.  VA does not hide the ball here.  The ratings criteria lays out what it takes to get a higher rating.  For example, let’s say you have a 70% rating for PTSD.   According to the Schedule, the only PTSD rating higher than 70% is 100%.  A 100% rating for PTSD is warranted when the veteran is totally impaired both occupationally and socially.

One or more of the following symptoms would yield a 100% rating:

  • 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.

The best evidence to increase your rating from 70% to 100%

To increase your VA disability Rating from 70% to 100% it is important to provide medical records to the VA that shows your symptoms. However, most psychologists and psychiatrists seldom document your symptoms with VA’s criteria in mind.  Fortunately, VA provides rating tools such as Disability Benefits Questionnaires (DBQs) on their website.  These DBQs apply to every kind of disability.  For example, VA provides a DBQ for PTSD that simplifies rating decisions.  The check boxes make it easy for doctors to complete.  If the symptoms noted in a DBQ satisfy the criteria for a higher rating, then VA will likely grant that rating. 

70% Combined Rating with Multiple Disabilities

If you have a 70% overall rating for a combination of conditions, then getting to 100% is much tougher.  This is mostly because of the VA Combined Ratings table.

To get higher ratings for each disability, follow these steps:

  • Read the specific rating criteria,
  • Ask your doctor whether you meet the criteria for higher ratings, and
  • Develop medical evidence to support your request for higher ratings.

Although, it is not as simple as getting an additional 30% rating.  This is because VA does not add your ratings; it combines them.

VA Combined Ratings Table

The VA Combined Ratings table provides that, after individual conditions are separately rated, the disabilities are then all combined using a specific formula. See 38 C.F.R. § 4.25(b).  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 purpose is to prevent an overall rating higher than 100%.

The ratings table is difficult to understand, call us at 1-800-800-3332 to answer your questions or click here to complete a form.

When the combined value ends in a number from 5 through 9, VA rounds up to the next highest multiple of 10.  If the combined value ends in 1 through 4, VA rounds down to the lower multiple of 10. Or, if the combined value ends in 0, then rounding is unnecessary.

Combined Disability Rating to Increase Your Rating from 70% to 100%

For example, a veteran with only PTSD at 50% and asthma at 30% has a combined value of 65%.  A 65% value rounds up to a 70% combined rating.  To get to 100% overall, this veteran must either (1) win a 100% rating for PTSD or asthma, or (2) win at least a 90% rating for an additional disability (or group of disabilities) rated at 90%.

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If you have more questions about how to increase your va disability rating from 70% to 100%, please reach out to us.  We will provide a 100% free VA case review.  We will be happy to answer your questions.

Resources

Our website is also full of helpful information. Firstly, if you would like to review other blogs, click here. Secondly, if you would like to see a list of resources click here. And thirdly, you can click on Testimonials to read the great comments we receive.

To learn what VA Permanent and Total Disability is, click here.

VA Sleep Apnea Eligibility

Service Connection

VA Disability Sleep Apnea Eligibility Criteria. The VA uses sleep apnea eligibility criteria to figure out the correct rating for a veteran’s disability.  That goes for sleep apnea, PTSD, and any other disability.  But before VA will assign a rating, it must first determine whether the disability is related to service.  In other words, VA must first grant service connection before it will assign a rating.

Generally, VA will grant service connection if the veteran can show:

  1. a current diagnosis,
  2. an in-service event, disease or injury, and
  3. a medical connection between 1 and 2.

Schedule of Ratings for VA Sleep Apnea Eligibility

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, and each disability has 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.  Depending on the symptoms, VA will grant either a 0%, 30%, 50% or 100% rating for sleep apnea.

The VA sleep apnea eligibility criteria:

  • 100%: Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or requires tracheostomy;
  • 50%: Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine;
  • 30%: Persistent day-time hypersomnolence; and
  • 0%: Asymptomatic but with documented sleep disorder breathing.

To Prove Sleep Apnea you Need Medical Evidence

Only medical evidence can satisfy the eligibility criteria for these ratings.  It is not enough for the veteran to say “I meet the criteria for a 50% rating.”  Fortunately, VA’s website provides rating tools such as Disability Benefits Questionnaires (DBQs).  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.  If the criteria for a 100% rating for Sleep Apnea is noted on the DBQ, then VA will likely grant that rating.

Most Veterans with VA Connected Sleep Apnea are Eligible for 50% Rating

Most veterans with sleep apnea meet the eligibility criteria for a 50% rating.  The VA Health Care system often prescribes CPAP machines to treat severe cases of sleep apnea.  If you get your sleep apnea treatment at a local VA hospital, then your doctor has probably considered a CPAP machine. 

VA Sleep Apnea Eligibility, 100% Rating

A small percentage of veterans meet the eligibility criteria for a 100% rating.  This is because it reflects the most life-threatening versions of sleep apnea.  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 that goes through the front of your neck into your windpipe.  A breathing tube is placed through the hole and directly into your windpipe to help you breathe.  Naturally, a veteran with these extreme symptoms deserves a 100% VA rating for Sleep Apnea.

Sleep Apnea Pyramiding

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.  This is considered pyramiding, and it is strictly prohibited.  For example, Asthma and Sleep Apnea have nearly identical manifestations.  They both involve impairment of the airways, they share symptoms such as daytime fatigue, and they are under the same category in the Schedule of Ratings.  A veteran who meets the eligibility criteria for both will only receive a rating for one of them.  In that circumstance, VA must assign the higher of the 2 possible ratings.

Sleep Apnea Anti-Pyramiding Rule

The anti-pyramiding rule recently affected a DHG client.  He is a 64 year-old veteran of the Army who filed a claim for asthma and sleep apnea.  VA denied the sleep apnea claim, but granted the asthma claim at 30%.  After a successful appeal, VA granted 60% for his asthma.  In the new decision, VA conceded that his sleep apnea was service-connected and would meet the eligibility criteria for a 50% rating.  However, VA could not grant the additional 50% rating because of the anti-pyramiding rule.  Instead, VA awarded 60% for his “asthma with sleep apnea.”

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Related Articles and Blogs

References

Our website is also full of helpful information. Firstly, if you would like to review other blogs, click here. Secondly, if you would like to see a list of resources click here. And thirdly, you can click on Testimonials to read the great comments we receive.

VA Disability Rating for PTSD

What is Required: VA Disability Rating for PTSD

Before VA will award a disability rating for post-traumatic stress disorder (PTSD), the veteran must first prove service connection.  Thereafter, the VA must determine the correct rating percentage, which will determine how much money VA must pay to the veteran.  Rather than assign percentages at random, VA uses a Schedule of Ratings.

Schedule of Ratings: VA Disability Rating for PTSD

The 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 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%.

The Criteria: VA Disability Rating for PTSD

100% = Total occupational and social impairment

  • 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, such as maintenance of minimal personal hygiene;
  • disorientation to time or place;
  • memory loss for names of close relatives, own occupation, or own name

70% = 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, such as work or a work-like setting;
  • inability to establish and maintain effective relationships.

50% = 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%= Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks

  • depressed mood;
  • anxiety;
  • suspiciousness;
  • panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, 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; or
  • symptoms controlled by continuous medication.

0% = A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.

100% VA Disability Rating for PTSD

A 100% disability rating for PTSD reflects total impairment.  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 Schedule of Ratings.  Especially, if your service-connected disability satisfies the criteria for a higher rating, then VA must grant that rating.

Case Studies: VA Disability Rating for PTSD

To meet the criteria for a specific PTSD rating, the veteran’s symptoms must approximately match the listed criteria.  The following examples show how VA assigns disability ratings for PTSD:

Case Study 2: 50% Rating for PTSD

A 63 year-old veteran with PTSD rated at 10% provided a Disability Benefits Questionnaire (DBQ) from his doctor.  The DBQ noted depressed mood, flattened affect, panic attacks twice a week, impaired judgment and difficulty in establishing effective relationships.  In the end, VA increased his PTSD disability rating to 50%.

Case Study: 10% Rating PTSD

VA rated a 44 year-old veteran at 10% because her PTSD symptoms were well controlled with medication.  She asked VA to increase the rating to 30% because she had 2 panic attacks in the past 12 months.  The panic attacks happened during her commute to her full-time job.  The attacks resolved within minutes, and she did not lose any time from work.  In brief, VA kept her PTSD disability rating at 10%.

Can your VA disability benefits be garnished for child support?

At Disability Help Group we want to keep you informed.  One topic that comes up again and again with our clients is that of alimony and child support.

 

Many disabled veterans want to know if their VA disability compensation can be garnished for child support and alimony.

 

The answer is yes, courts can and do write orders to garnish your disability benefits.  However, the garnishment must meet very strict and specific guidelines.

 

For example, the maximum amount that the Defense Finance & Accounting Service (DFAS) will garnish, outlined in 5 CFR §581.402, is the following:

  • 50% if the service member is providing more than half the support to other dependents not covered by the order.
  • 55% if the service member is providing more than half the support to other dependents not covered by the order, but has a support arrearage.
  • 60% if the service member is not providing more than half the support to other dependents not covered by the order.
  • 65% if the service member is not providing more than half the support to other dependents not covered by the order, but has a support arrearage.

If you need help understanding any portion of your veterans’ disability claim, denial or disability rating please do not hesitate to contact our experienced representatives today.