Understanding the difference between VA schedular ratings and TDIU can be confusing.
In this article, we explain each of them and how you can determine which best fits you.
VA Schedular Ratings Explained
When dealing with VA disability claims there are two distinct ways of viewing ratings or awards. By far the most common system is the schedular system. This is the percentage based rating schedule. The rating schedule is broken up into 10% increments from 0%-100% service connection. Other special ratings, such as TDIU, are based upon the ratings schedule but have criteria that are separate and follow other policy directives.
The VA Ratings Schedule breaks down disabilities into categories based on which part of the body is impacted. Within those categories is a list of diagnoses and each of the diagnoses has a diagnostic code. Each code specifies the symptoms required for different ratings of disabilities. Typically, more severe disabilities receive a higher rating, and then, obviously, less severe disability should receive a lower rating.
An example, Under the Digestive System Category in the Ratings Schedule there are four groups
- Postgastrectomy syndromes
- Weight loss
- Coexisting abdominal conditions
There are three diagnoses under ulcers, one being “ulcer, duodenal.” This diagnosis has a diagnostic code of 7305, and under this code, there are four different ratings.
- Severe, 60%
- Moderately severe, 40%
- Moderate, 20%
- Mild, 10%
Each of these schedular ratings lists symptoms you must have. For a severe rating for an ulcer, you must have periodic vomiting and only partial relief from ulcer therapy.
There are literally thousands of different rating combinations. But each follows this pattern. Category, group, diagnosis, rating. You can get an idea of where you are on the schedule and where you should be. In fact, if you are bookish, you can get a great idea of how to approach your initial claim or appeal, based on doctors records and your current conditions as they relate to the ratings laid out for your disability.
How Does the VA Assign my Rating
The VA looks at what body system category is affected. They will then locate your diagnosis and find the diagnostic code that correlates with your symptoms. They will carefully look at your medical information to make sure the evidence matches the rating they are assigning.
To find out how much the VA currently pays for each rating you can see current VA compensations rate tables.
Total Disability based on Individual Unemployment (TDIU)
If you can not do a substantial amount of work and can prove that you are unable to do a substantially gainful occupation, you may be eligible for Total Disability for Individual Unemployment (TDIU) even if you are not rated at 100% disabled under the schedular ratings (above). Being able to do a substantially gainful occupation means being able to have an occupation that has an annual income above the poverty rate. The benefit of pursuing TDIU is that you could be compensated at 100% even though by the schedule you are not at 100%.
This seems counter-intuitive at first, however, the purpose of a 100% rating is to reflect total unemployability (or total disability which is assumed to be unemployable) due to an injury. The problem is that by schedule, and through the multiple disabilities calculator linked above, it is quite difficult to come up with a combination of ratings that are individually less than 100% and have them come together to form a collective 100%. Without going too deep into the math. Assuming you have 50% for PTSD, 50% for Bi-Lateral Hearing Loss, & 50% for Back Injuries – your overall rating would be, 90% (not 150%). So, even though you got a lot of challenges, even with (3) serious ratings decisions, you still are not rated at 100%! VA Math… But, that’s the gap that TDIU fills.
The basic criteria for TDIU: An inability to work needs to be linked to a service-connected disability rated at 60% or higher. If you have more than one disability, then at least one of the disabilities needs to be rated at 40%, and the combined rating needs to be 70% or more.
How to Tell Which Fits You Best
If you have a service-connected disability, you want to apply for VA disability benefits as soon as possible. Once you receive your rating, if you believe you are eligible for TDIU, then you need to apply for TDIU. To apply you use the VA Application for Increased Compensation Based on Unemployment.
Both the schedular ratings and TDIU will get you the same end result; being paid for your disability. They use a different process to decide a rating but can give you an income where you may not have one otherwise.
Often clients will reach out to us seeking Social Security while receiving VA Disability. In that conversation, it is discovered that they should have, or already have, qualified for TDIU and it either was not pursued, was turned down, or was never considered by the VA. This is wrong and we can help.