VA disability ratings are governed by VA rules in a variety of ways. For example, you may have multiple medical issues which are individually rated by the percentage of disability-0% meaning no VA disability rating whatsoever all the way up to 100% (in increments of 10, more on that below) for total disability.
But no matter what the individual percentages add up to, no veteran can draw more than 100% disability.
Such rules (and others like them) exist throughout the VA rating system; what do VA rules say about how VA disability ratings are calculated and applied?
VA Disability Ratings Are Based On Your Service-Connected Medical Conditions
The Department of Veterans Affairs assigns disability ratings, “based on the severity” of the individual condition. The percentage your disability is assigned affects not only how much compensation you may be entitled to receive, but also determines your eligibility for other VA benefits.
Some service-connected injuries or medical conditions don’t rate high enough to qualify for certain services or programs that may be provided to those with higher VA disability ratings. For veterans with multiple conditions, the final rating involves a VA-proscribed formula for calculating the percentages as a whole.
You don’t need a pencil and paper to do the math yourself; the VA official site has a Combined Ratings Calculator on the Disability Benefits page. It’s simple to use, veterans must enter each individual rating into the calculator, click “calculate” and the math is done automatically.
How The VA Determines Your Percentages
VA ratings are based on a combination of your military medical records, any supporting evidence or documentation provided, the results of a VA claim examination (if the VA decides you need one), and other information that may be available from government agencies on your behalf.
Rounding The Numbers
The final determination for any VA disability rating may not result in a round number in increments of ten, but VA policy is to round the number to the nearest ten percent. The procedure involves looking at the number, rounding down for 1, 2, 3, and 4 to the nearest ten percent, and rounding up for numbers 5, 6, 7, 8, and 9.
So if your VA rating for an individual condition came in at 15%, it would be rounded up to 20%. If it came to 14%, it would be rounded down to 10%.
Service-Connected Medical Issues Versus Pre-Existing Conditions
VA compensation may be available for those who entered military service with a pre-existing condition, but the VA must calculate the “level of aggravation” of the condition due to service. That level is what determines the VA percentage.
If you were rated at 10% for a condition that existed before you started your career in uniform, and the VA rates that condition at 20%, the ten percent increase (the aggravation) is the amount you would be compensated for by the VA, NOT the 20% rating itself. That is because in the eyes of the VA, the 10% you had prior to military service was aggravated by 10%.
The VA 20-Year Rule
Veterans who have been rated with a service-connected disability for two decades or more may be protected from having their VA rating reduced below that level even if it is later determined that the condition has improved.
This is known as a protected rating. Conditions apply and your individual circumstances will determine whether or not this rule applies to you. There are other protections in this vein. The VA can’t reduce your disability if it has been paid for five years unless the condition has improved and is shown to remain so.
A similar rule, the “10-Year Rule” says a condition cannot be reduced after being compensated for a full decade unless there is medical evidence of improvement of the condition. Yet another rule prohibits reducing a veteran’s rating if they are older than 55.
Those rated with 100% disabilities are similarly protected unless there is medical evidence of an improvement.
Cost Of Living Adjustments For VA Compensation
The amount of VA disability you draw is subject to revision and increase due to Cost of Living Allowance adjustments. Also known as COLA, these adjustments are tied directly to adjustments made for Social Security Payments.
Some veterans may have misdiagnosed conditions–for example, the VA may have mistakenly rated more than one medical issue as a single problem.
Depending on circumstances, this may warrant a review and re-rating IF the combined rating of each disability is equal to or is greater than the original rating assigned AND the effective date for the separate disabilities is the same as for the prior single disability.
Medical conditions don’t always stay the same; some may improve, some may get worse. Still others manifest new or different symptoms that may replace or add to others. In such cases the VA may require a different rating using other criteria than the original rating. This may involve using different VA diagnostic codes.
What veterans need to know about this is that the old rating may have been protected under one of the rules discussed above (the five-year rule, 10-year rule, etc.) but in the event that a new diagnosis or rating is needed, that rating is considered brand new and NOT subject to the rules above until the appropriate amount of time has passed for the new diagnosis.
The clock is reset to zero and begins counting toward five, ten, 20, 55, etc. when the new rating or diagnosis is established. Any symptoms present prior to the new rating are protected under their original “timeline.” New symptoms identified as part of the condition are not until they age according to the guidelines mentioned above.
Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News
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