Your VA disability rating determines the amount of compensation you’ll receive. A 100% rating signifies total disability and eligibility for the maximum benefits available from the VA. However, most veterans suffer from multiple disabilities and have a combined rating for their claims. How does the VA determine this rating?
Loss of Function
VA disability ratings are based on how much a condition reduces your ability to function in the workforce. The higher the rating, the more you’re entitled to receive in benefits. The first step in this process is for the VA to assign a diagnostic code to your condition. These codes are in the Schedule of Rating Disabilities and range from 0% to 100% in 10% increments. For presumptively service-connected conditions, the VA must also determine how much your military service has aggravated the situation. For example, if you had sleep apnea before entering the military and it was 20% disabling but your assistance made it 50% disabling, you would receive a special rating of 50%.
This rating is then combined with any schedulable 100 percent (P&T) ratings you have to reach your final combined rating. However, you can’t add your ratings to get 120%—a specific formula determines the final combined rating.
A person’s total disability rating determines how much the VA will pay. This rating is determined by how severely a service-connected disability or disease impairs their ability to work. The rating also includes any secondary conditions resulting from the original condition. For example, tinnitus can result in debilitating side effects like depression or sleep problems. These are called secondary conditions and can result in a higher total disability rating.
Many veterans have multiple conditions rated in order of severity. A veteran’s combined disability rating is determined by a mathematical formula that considers each disability rate. The ratings are then added together using a table. For example, a veteran with a TBI and a back injury rated at 50% each would receive a rating of 75%. A 100% rating of disability means a veteran is considered unemployable and cannot sustain substantially gainful employment. This entitles the veteran to the maximum compensation for disability rates available. This is adjusted yearly to account for inflation and rising costs of living.
A disability rating can consider the number of incapacitating episodes a person has per year. This is important because the more episodes a person has, the higher his or her rating will be. Incapacitating episodes are important for many conditions, especially those affecting the spine or skin disorders. The VA will examine the number of flare-ups and how long they last. This is also important in cases where multiple conditions travel together, such as depression and a knee or back condition. A combination of disabilities may warrant a 100 percent total disability based on an individual unemployability (TDIU) rating. The percentage of veterans applying for DI after receiving a 100 percent or IU rating peaked in the fiscal year 2004 and has since fallen. This is likely due to the shorter period that such ratings will remain in effect before a veteran can apply for DI again.
Having service-connected disabilities that affect both your arms, legs or paired skeletal muscles (like the biceps and triceps that work together to bend and straighten an arm) means you’ll get a higher disability rating than if just one of your conditions is impactful. This is because it is much harder for an opposing limb to compensate for the limitations of a condition that impacts both sides of your body. This is also why you’ll receive a higher disability rating if your injury affects your dominant hand than the non-dominant hand for a shoulder or arm injury. However, VA math can be confusing, and the bilateral factor can complicate matters. The good news is that new rules for calculating disability ratings make it easier for veterans to understand how this is calculated. In particular, the new law allows VA adjudicators to exclude a disability from the calculation of the bilateral factor if doing so will result in a higher combined evaluation when combining the veteran’s other disabilities.