Once the Department of Veterans Affairs determines that a Veteran does have service connection on a disability that resulted from their military service, the VA considers the severity of that disability and assigns a disability rating. If the Veteran is not satisfied with that disability rating, he or she can appeal the rating by filing an appeal within one year of the rating decision. But what happens if the Veteran decides that the rating is fair and does not appeal and then the disability worsens? Is it ever too late to ask for a higher disability rating?
The answer to that question is “no.” At any time after a disability rating is assigned, a Veteran may file a claim for an increased rating of their VA disability benefits. Filing that claim is easy. All that is required to initiate an increased rating claim is the Veteran’s good-faith belief that his or her disability has worsened.
What Evidence Is Helpful for A VA Rating Increase?
To support a claim for an increased rating, the Veteran needs to submit medical records which demonstrate that the condition is worse. Those records can be private medical records or VA medical records. Even though VA has access to VA electronic medical records, it is important that the Veteran also submits the relevant medical evidence separately. This is the Veteran’s opportunity to make sure that VA is looking at the evidence we want them to see.
It is common for the VA to send the Veteran out for a new compensation and pension (C&P) examination once a claim for increased rating has been filed in order to assess the extent of the Veteran’s disability for VA disability compensation. The Veteran must attend this examination if scheduled so that VA can evaluate for itself whether the Veteran’s medical condition has worsened. The Veteran may also, at this point, get a private medical examination to demonstrate that the disability has worsened.
Is it difficult to increase your VA Benefits Rating?
VA Disability Claims for increased ratings can be tricky. It is important, for instance, to know what the requirements are for a higher rating under the applicable VA diagnostic codes. For example, many orthopedic disabilities, such as disabilities of the spine or knee, are rated on how much the disability limits the Veteran’s range of motion. While pain is one of the symptoms which affects the Veteran’s quality of life the most dramatically, VA does not consider whether the Veteran’s pain is worse when determining whether the Veteran is entitled to a higher disability rating for a spinal disability. Because of that, if a Veteran bases his claim for increased rating solely on the fact that his pain has increased, he will probably not receive a higher rating. It is important, then, to know how to ask for a disability rating increase on your VA claims.
Considering the circumstances, I have described above, where a Veteran’s low back pain or knee pain has worsened dramatically but he is still able to bend just as much as he was before the pain increased, there may still be a way to ask for an increased rating. Under those facts, we might ask for an increased rating based on the fact that the Veteran’s knee is now unstable and causes him to fall so that he is entitled to a separate rating for instability of the knee. Alternatively, we might ask for an increased rating for the Veteran’s low back disability where the pain now causes him to miss so much work that he is now unemployable and entitled to a total rating based on his back disability. Veterans should familiarize themselves with the VA diagnostic codes governing their specific service-connected disabilities so that they know whether they are even entitled to an increased rating as well as how to ask for one. If you need help navigating the diagnostic codes, we can help.
How Can I Get a 100% VA Disability Rating?
Often, simply receiving an increased disability rating isn’t enough. Some Veterans are unable to obtain or hold gainful employment due to their service-connected disability. In this case, the disabled Veteran may be eligible for a 100% VA disability rating.
There are two main ways that a Veteran can obtain this rating: by meeting the criteria for a 100% rating or qualifying for individual unemployability.
Simply meeting the criteria for a 100% disability rating on the VA’s schedule for rating disabilities can be challenging. Veterans will either need to meet the criteria for one disability or obtain a combined rating of 100% for multiple disabilities. However, reaching a combined rating of 100%, even when you’re close, is difficult. You can see how the ratings add up using our disability calculator.
This is why obtaining individual unemployability can be a smart decision for many Veterans.
If a Veteran is unable to secure and hold what the VA calls “substantially gainful employment” due to a service-connected disability (or disabilities), they may be eligible for a total disability rating based on individual unemployability (TDIU or IU). According to the VA, Veterans are eligible for IU if they have:
- at least one service-connected disability rated at 60% or more disabling, or 2 or more service-connected disabilities—with at least 1 rated at 40% or more disabling and a combined rating of 70% or more, AND
- can’t hold down a steady job that supports you financially (known as substantially gainful employment) because of your service-connected disability. Odd jobs (marginal employment) don’t count.
Veterans can apply for IU through VA Form 21-8940.
Veterans can be eligible for a total disability rating regardless of the initial rating that the VA previously assigned them.
Effective Dates & Increased Ratings
One final note regarding claims for increased ratings–the VA regulations only allow VA to assign an effective date for the increase as far back as one year prior to filing the claim. In other words, once the Veteran files the claim for increase, VA can look back at the evidence for the year prior to the claim to determine when the disability worsened and pay the Veteran for that time. Don’t wait to file your claim, as you could be losing valuable benefits to which you are entitled.
Have Questions About Increasing Your Disability Rating?
Pursuing an increased rating for disability compensation benefits can be challenging. If the VA is denying your claim for benefits or IU, the team at Hill & Ponton can help. Our law firm values attorney-client relationships and is committed to helping Veterans obtain the benefits to which they’re entitled.