Veterans of the United States Armed Forces who have been found disabled by the U.S. Department of Veterans Affairs (VA) due to a disability connected to active service may also be eligible for Social Security disability benefits. This article will consider whether or not the SSA has to take the VA's determination of an applicant's disability into consideration when determining whether or not the applicant is eligible for Social Security disability benefits.
First let's look at some basic differences between the two programs.
In order to qualify for veterans disability benefits, the veteran must currently have a medically diagnosed disease or disability caused by an incident during active military, naval, or air service. After consideration of the evidence, the VA makes a determination regarding the applicant's degree of disability. The VA assigns the veteran a disability rating, which is measured in 10% increments ranging from 10% disabled to 100% (totally) disabled.
Social Security disability benefits are only available for persons who have worked recently enough (usually five out of the last ten years), and for a long enough period of time (10 years for those 62 and older) in a job paying Social Security taxes. Younger disabled workers may qualify for disability with fewer credits and less recent work.
Additionally, the applicant must be totally disabled; partially disabled or short-term disabled persons do not qualify for benefits. The disability must last for more than one year or be expected to end in death. In order to determine if the applicant is totally disabled, the Social Security Administration (SSA) considers various factors. First, if the applicant has a medical condition that fulfills the requirements of a condition listed on the SSA list of severe impairments, the applicant is automatically considered disabled. Alternatively, if the disability is not on the SSA list, the SSA must determine whether the applicant's medical limitations make it impossible for the applicant to do his prior work or any work in the U.S.
The applicant must provide evidence to the SSA to support his or her claim of disability. The SSA may consider a variety of types of evidence, including objective medical evidence such as laboratory findings and your doctor's notes on your medical history and the treatment you've received. The SSA may also consider a statement from the applicant regarding the applicant's disability, daily activities, and efforts to work and statements from family members of the applicant, as well as statements from public/private welfare agency personnel.
Additionally, Social Security regulations also state that the SSA may consider evidence of rulings made by other nongovernmental or governmental agencies (such as the Department of Veterans Affairs). However, the regulations note that an approval for benefits by another governmental agency does not have to be followed by the Social Security Administration. This is due to the fact that different rules and standards for disability are applied by different agencies and ultimately, the SSA Commissioner must make the determination of disability based on Social Security law.
Note that veterans who've been given 100% permanent and total disability ratings are entitled to expedited processing of their disability applications from the SSA.
Decisions made by other governmental agencies regarding a Social Security applicant's disability should be taken into consideration by the SSA, even though the SSA isn't bound to follow the decision. The SSA must consider and evaluate all evidence in the case record that may have a bearing on its determination of disability, which may include a VA determination of disability. The question, however, is how much weight the SSA must give to another governmental agency's decision.
The issue of how much weight should be accorded to VA decisions has gone before several United States Circuit Courts of Appeals. No circuit court has held that the SSA is permitted to completely disregard an applicant's VA disability rating. Instead, all circuit courts that have addressed this issue have noted that some weight must be given to the VA disability rating, although the courts have differed as to how much weight should be placed on this decision. The U.S Court of Appeals for the Ninth Circuit, for example, held that an administrative law judge (ALJ) must give “great weight” to a VA determination of disability, due to the similarities between the two federal disability programs in both purpose and criteria for rating disability. The Fourth, Fifth, and Eleventh Circuit Courts have also employed this same “great weight” standard.
Other U.S. Circuit Courts, including the U.S. Courts of Appeals for the Second, Third, and Tenth Circuits, have held that the VA determinations must be given “some weight” in the SSA decision, while the U.S. Court of Appeals for the Sixth Circuit has held that “substantial weight” must be given to the VA decision. The U.S. Court of Appeals for the Third Circuit noted that that the evaluation of disability by the VA was “critically relevant and material” in a parallel Social Security disability case.
Therefore, while the specific amount of weight that the Social Security Administration must give to the Department of Veterans Affairs determination of disability for a SSA benefits applicant differs slightly in different Court of Appeals rulings, it is clear that the SSA is obligated to seriously consider the VA's disability rating in the SSA's own determination of disability. Additionally, the SSA should explain in its Notice of Decision and in the case record how much consideration was given to the decisions of other governmental agencies.
If the VA gave you a 100% disability rating, but the SSA denied you Social Security disability benefits, you may want to contact a lawyer. It's likely that the SSA did not give the proper consideration to the VA's finding that you were disabled, and a disability lawyer can help you raise this issue successfully on appeal.