How Do Disability Ratings Work for Veterans Benefits?
The Department of Veterans Affairs uses a disability rating system to determine the amount of compensation provided to disabled Armed Forces veterans.
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Veterans of the United States Armed Forces with disabilities connected to, or aggravated by, active service may be eligible for veterans disability benefits. After the veteran has applied for benefits, the Department of Veterans Affairs (VA) evaluates the medical evidence and determines whether or not the veteran qualifies for benefits. The VA then assigns the disability a rating level, which dictates the amount of monetary compensation the veteran will receive due to his disability or disease.
In order to qualify for veterans disability benefits, certain criteria must be met. (See our article on filing for veterans disability benefits.) If the VA determines that a the veteran qualifies for disability benefits, it assigns the disability a rating to signify the extent of the disability or disease. The disability rating represents the "average detriment to earning capacity" resulting from the disability or disease.
The ratings are assigned in 10% increments, ranging from 10% to 100% disabled. A higher disability rating indicates the veteran has a more severe disability, and therefore receives a higher monthly compensation payment. For example, under the current wartime rates for veterans without dependents, a 10% disabled veteran is entitled to receive $123 per month, a 50% disabled veteran is entitled to receive $770 per month, and a 100% (or totally) disabled veteran is entitled to receive $2,673 per month. Generally, the compensation rates are subject to an annual cost of living increase.
The law also provides for special compensation rates for many enumerated, more serious disabilities or injuries. Injuries such as loss of a single hand or foot, blindness or severe injury to one eye, loss of ability to speak, and deafness, to name a few examples, are entitled to an increase of $96 per month per injury (maximum $4,667 per month) above the base compensation rate. Loss of both hands, both feet, blindness in both eyes, or a permanent bedridden state entitles the veteran to $3,327 compensation per month. The law also lists several other disabilities that may merit higher, specific payments. Additionally, the statute allows for the Secretary of the VA to approve higher payments for more severe disabilities if necessary, with a maximum of $4,667 per month.
Rating for Multiple Disabilities
When a veteran has more than one disease or disability, the disability ratings are not simply added together (for example, a 40% disability rating plus a 20% disability rating does not equal a total 60% disability rating.) Instead, a formula is used to determine the total disability rating level for multiple disabilities. First, the disabilities are ranked from most to least severe. Then, it is determined what percentage of efficiency the veteran retains after the first, most severe disability. For example, if the veteran's most severe disability is rated at 40%, he is still 60% efficient.
After that, the second most severe disability is considered. That second disability rating is applied to the vet's remaining efficiency. For example, if the veteran after the first disability has a remaining 60% efficiency, and his second most severe disability has a 20% disability rating, then 20% of the 60% efficiency is calculated – in this case, 12%, and that number is added to the original disability rating (40% plus 12% equals 52% disabled).
The new disability rating is rounded up or down to the closer 10% increment. In the example above, the 52% rating would be rounded down to a 50% disability rating, and that veteran would be considered 50% disabled.
Reexamination and Changes to Disability Ratings
Once a disability rating is assigned, it may be subject to change in certain circumstances. For example, the VA may require medical re-examination of the veteran six months after leaving service, and then again between two and five years later. The VA does this to verify either the continued existence of or the current severity of a disability, particularly in cases where it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability, or that the current rating may be incorrect. In such cases it is possible that the rating and benefits may be reduced or discontinued.
Re-examination would not likely occur in cases where the disability was determined at the outset to be permanent, in cases where the disability has not sustainably improved in five years, or in cases where the veteran is older than 55 years of age and his rating would not be changed by reexamination.
A veteran receiving benefits may file VA Form 21-4138 to request a new evaluation if he develops a new disability or disease connected to his service, or if he finds his condition worsening. The VA may then increase the veteran's disability rating and therefore increase the monthly compensation.
When Benefits Cannot Be Reduced
The VA cannot reduce a disability rating for a veteran with a 100% disabled rating unless there is a medical examination or evidence of ability to maintain employment for 12 consecutive months that shows “material improvement” in his physical or mental condition.
If a veteran has been deemed to have permanent and total disability and has been receiving disability benefits for twenty years or more, his benefits cannot be reduced. If the veteran's disability is less than permanent and total, and the veteran has been receiving disability benefits for twenty years or more, and upon re-examination by the VA the veteran's disability rating is lowered, the amount of compensation will not drop below the original level. For example, if the veteran has been deemed to be 40% disabled for a period of twenty continuous years or more and is then re-evaluated to be only 30% disabled, the amount of his benefits will not drop below the 40% compensation rate.
For information on applying for benefits, and how veterans disability benefits relate to Social Security disability benefits, see our section on veterans benefits. If you disagree with your disability rating and wish to challenge it, arrange a consultation with a disability lawyer certified with the VA.