How a PTSD Disability Impacts Your VA Compensation Claim

As 13 million people across the country experience Post Traumatic Stress Disorder (PTSD) in some form, there are many highly-functioning people actively managing their disability on a daily basis. Likewise, there are many more who are unaware they may have PTSD or do not know how to go about getting treatment and compensation for it.

If you struggle with the symptoms of PTSD the last thing you want to deal with is extra hurdles for the help you want or need.

Here are some things you should know about PTSD, filing a PTSD VA claim, and how we can help you.

Understanding PTSD

Post-traumatic stress disorder or PTSD is a term that gets thrown around a lot. If two people go through a terrible weekend at a work conference, they might refer to having PTSD in a tongue in cheek way. However, it’s a pretty serious anxiety disorder. That being said, the trauma that leads one person to exhibit chronic symptoms vs the trauma that another person may have experienced to exhibit a whole other set of symptoms (or none at all) is completely subjective. Fact is, no two people are going to react to a traumatic event the same way.

PTSD usually correlates with an intense situation when someone (self or others) has been either exposed to or has incurred a risk of injury or death of someone close to them. Perhaps the biggest paradox surrounding PTSD is that symptoms can occur days, months, or decades after the event took place.

You Need to Make a Claim with the VA

If your anxiety, depression, lack of sleeping, or any other potential symptoms of PTSD are related (even remotely) to your military service your first step needs to be filing with the VA via their special application for people suffering PTSD.

To qualify for VA compensation and related medical benefits, you need to submit your claim to the Compensation and Pension Service.

You can do this online, via the VA’s own site, at www.ebenefits.va.gov.

Even if you’re not computer savvy, this a fairly simple application that will make a huge difference in your life and treatment if and when you’re successful.

Next Steps

You need to get your official PTSD diagnosis to move on in the process. You will have to relate the stress to a specific traumatic event, which will be documented by your psychiatrist in a VA C&P exam. You will then have to show that your PTSD is related to (or made worse by) an experience in your military record.

Assuming you are successful in your claim, you will be given a certain “percentage” of disability, rating just how debilitating your symptoms are. The rating should take into account how often you experience challenges related to your PTSD, what triggers your challenges, and how long they last.

If your ability to work and to function without assistance turns out to be serious enough, you can file for Total Disability Individual Unemployability (TDIU) benefits, an increase in ratings, and of course – Social Security Disability benefits. (Yes, you can claim SSDI & VA disability at the same time!)

A PTSD Disability Should not Stop You from Enjoying Life

Just because you experience PTSD does not mean you should not be able to do everything you want to with the rest of your life.

If your military service is what caused that problem, America is indebted to you and should help you to manage your challenges through fair compensation and adequate treatment.

If you’re wondering how your benefits balance out with your social security, check out our guide for more info.

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Contact us today for assistance in reviewing your current or potential disability claims for Post Traumatic Stress Disorder (PTSD).

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How to Understand VA Schedular Ratings Vs TDIU

How to Understand VA Schedular Ratings Vs TDIU

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

  1. Ulcers
  2. Postgastrectomy syndromes
  3. Weight loss
  4. 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.

  1. Severe, 60%
  2. Moderately severe, 40%
  3. Moderate, 20%
  4. 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.

Contact Us About TDIU Claims!

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