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How the Rating System Affects Your Veteran Disability Benefits

July 4, 2017

Veteran disability benefits are available to anyone who has served in the military, was discharged for reasons other than dishonorable ones, and who has a disability that is either connected to or exacerbated by active military service.  If you qualify for veteran disability benefits, then you could potentially receive anything from $133 to more than $3,400 a month, tax-free, depending on the disability and dependents.  The amount a disabled veteran receives in monetary benefits is directly related to the rating level prescribed to the veteran after the Department of Veterans Affairs (VA) has evaluated the medical evidence and subsequently assigns a rating level.  The rating system, therefore, has a direct impact on the veteran’s benefits.

What are Disability Ratings?

A disability rating is a rating system that places a value on “average detriment” a disability has on a veteran’s “earning capacity.”  In other words, disabilities are assigned a number that indicates the extent of t  It is a simple yet complex system designed to be easily understood and flexible enough to consider all the disabilities an individual veteran may have and then to be compensated accordingly.  Disabilities, obviously, are not created equally.

The rating system assigns a percentage of one’s disability from 10% to 100%, in 10% increments.  Therefore, there are ten disability rating levels.  The higher the rating, the more severe the disability attached to the veteran. The higher the rating, the more the monthly monetary benefits.  The lower the rating, the less the monthly monetary benefits.

The disability rating is the base, but the actual monthly payment will take into consideration the following factors:

  • The veteran’s dependents (including spouse, children, and/or parents); and/or
  • State of the veteran’s spouse, i.e. spouse is also disabled.

The following are some examples:

  1. A 10% disabled veteran with no dependents: $133 per month.
  2. A 30% disabled veteran with a spouse and one child under 18 years: $492 per month.
  3. A 60% disabled veteran with a spouse and two children, one under & one over 18 years and in school: $1,386.*
  4. A 70% disabled veteran with a spouse, parent and a child: $1,625.

*For dependent children, there is a rate for under 18 and over 18 and in school full-time.  For each additional child, the monthly rate increases by the same rate for dependent children.

Generally, disability ratings are subject to an annual cost of living increase.  To see the entire schedule for base disability ratings, go to the VA’s benefits page.

What are the Exceptions to the Standard Rating System?

Not all disabled veterans fall nicely under the standard disability rating system.  To make the benefits fairer, two primary exceptions can be applied to ensure that individual disabled veterans receive the compensation specific to their disability.  Some disabled veterans have what are called “special compensation rates” applied to their disability, while other veterans have multiple disabilities that carry with them a separate disability rating.

Special Compensation Rates

In addition to the standard disability rating system, there are also rates for special compensation, and these include the more severe disabilities or injuries, such as:

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  • Amputated hand or foot;
  • Blindness or severe eye injury;
  • Loss of ability to speak;
  • Loss of hearing;
  • Permanent bedridden state;
  • Among many other severe disabilities or disease.

If a disabled veteran is deemed to have a special compensation rate, he or she may be entitled to an additional $103 per month per injury above the base compensation rate (maximum monthly compensation totaling $4,977).  The law also allows the Secretary of the VA the discretion to approve higher payments if the Secretary confirms it is necessary.

Multiple Disabilities Rate Calculations

Sometimes a veteran will have more than one qualifying disability.  To make compensation fair, the VA takes into consideration the multiple disabilities.  The ratings, however, are not simply added together.  For example, if a veteran is deemed to have a 40% disability

On the contrary, a formula is applied to determine the total disability rating level for veterans with more than one disability.  The formula is limned as follows:

In other words, the calculation is: X + (YZ) = A, with the factors being:

X=most severe disability percentage

Y=efficiency percentage of most severe disability percentage

Z=second most severe disability percentage

A=new percentage rounded up or down to nearest 10th percentage increment.

For example, using the above scenario of a veteran with a 40% hearing disability and a 10% chronic pain disability, the calculation would be as follows:

  • X = 40% disability
  • Y = 60% efficiency (the most severe disability is considered, and from that disability rating percentage the efficiency percentage is determined by the percentage of functionality that remains (thus, 40% disability means the veteran has a functioning capacity of 60%)
  • Z = 10% disability (the second most severe disability, which in this case is the 10% disability rating for chronic pain).
  • 60% divided by 10% equals 6%.
  • 40% plus 6% equals 46%, which rounded to the nearest 10th is 50%.
  • The multiple disability rating for this veteran would then be 50% disability.

For additional disability ratings, the process would begin again using the new rating of the first two combined ratings with the third most severe disability rating, and so on.

Can benefits be reduced or withdraw?

Most often disability ratings are not re-assigned, but there are times when a re-examination will result in a different disability rating, particularly in cases where there was always a possibility that the condition could improve.  If such cases, the first re-examination may be within six months of the initial examination, and then another re-examination could be years (2-5 years) later, depending on the nature and prognosis of the disability.

Re-examination could also occur if it were believed (1) there was a material change in disability, or (2) the initial rating was incorrect.  In such cases, it is possible that benefits could change, either by increasing (usually not the case) or decreasing (almost always the case).

Re-examination usually does not occur in such cases where:

  • The veteran has a 100% disability rating;
  • The disability was deemed permanent from the outset;
  • The disability has not improved at all after five years; and/or
  • The veteran is older than 55 years of age.

A re-examination of a veteran who has been receiving benefits for more than 20 years will not see his benefits reduced even if the re-examination attributes a lower disability rating to his or her disability.

In addition, a veteran whose disability has worsened or who has either (1) developed a new disability; or (2) acquired a new disease that relates to his or her service, can file a new VA Form 21-4138 to request a re-examination or new evaluation.  In such cases, the VA will increase the disability rating and the monthly compensation as appropriate.

The rating system for veteran disability benefits may, on the outside, appear complex, but when you dig in, the veil of complexity dissolves into a system designed to address disability benefits in a fair and just manner.  Overall, don’t be intimidated by the formulas and tables. But if you are a veteran with a disability, and you find yourself intimidated, contact a veteran disability attorney to discuss the process and learn about the possible monthly benefits owed to you.

 

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