What is a rating and how are they

What is a rating and how are they calculated? Presented by Brian Voges

References Used VSO 38 Manual – pages 57 -62 CFR M 21 -1 – Part IV. ii. 2. F. 1. c

Rating Definition: A rating is defined as a formal decision made by the VA based on available medical evidence. In compensation cases, rating activity determines if the disability claim is service related or not.

Basic Rating Facts Congress establishes the payment amount of each rating Ratings increase according to the degree of disability A veteran may be rated from 0% to 100% disabled, depending on the severity of the disability – 38 CFR 4. 104 A veteran can have several individual ratings – However, the veteran will also have one “combined rating” – 38 CFR 4. 25

Special Monthly Compensation (SMC) (38 CFR 3. 350) Special monthly compensation (SMC) is a rating for a special allowance for veterans with certain severe disabilities SMC rating increases the veteran’s rate of compensation payment The SMC designators are: k, l, m, n, o, q, r, and s

Individual Unemployability (38 CFR 4. 16) Individual Unemployability (IU) is a provision where a veteran may receive payment as though he or she was rated at 100% The rating schedule defines total (100%) disability as an impairment of mind or body that is sufficient to make it impossible for the average person to follow a substantially gainful occupation

Individual Unemployability - continued To be considered for IU, the veteran must: Be rated with at least one service connected disability Provide Be evidence of past employment unemployable

Temporary Ratings (38 CFR 4. 28, 4. 29, 4. 30 - Paragraphs 28, 29, and 30) 1. Paragraph 28 (38 CFR 4. 28) or ‘Prestabilization’ Rating 2. Paragraph 29 (38 CFR 4. 29) provides an increased rating for veterans who are hospitalized for more than 21 days for their service connected disability(ies) 3. Paragraph 30 (38 CFR 4. 30) is a temporary 100% rating assigned, usually following surgery, for a service connected disability

Permanently and Totally Disabled (P&T) 38 CFR 4. 15 The rating schedule defines PERMANENT disability as: an impairment that is reasonably certain to continue throughout the life of the disabled person The rating schedule defines TOTAL disability as: an impairment of mind or body that is sufficient to make it impossible for the average person to follow a substantially gainful occupation

Scheduled Reviews/Future Exams (38 CFR 3. 327) Many disabilities, by their nature, are likely to improve with time or treatment. Because of this, VA schedules periodic reevaluations of the disability.

Scheduled Reviews/Future Exams continued Periodic re-examinations are NOT normally scheduled if any of the following circumstances exist: The veteran is over 55 years of age, except in unusual circumstances The disability is established as static (never changing) The disability or disease is permanent in character and is of such nature that there is no likelihood of improvement The combined rating would not change even if a future exam reduces an evaluation for one or more conditions Over a period of five or more years, the findings and symptoms have persisted without material improvement

Confirmed and Continued Ratings (C&C) As the name implies, a confirmed rating is one that confirms and continues the last rating made by the VA

C&C - continued The 10 -year protection rule (38 CFR 3. 957) states that service connection for any disability that has been in force for 10 or more years cannot be severed unless fraud is shown or if the veteran did not have the requisite service or character of discharge. The 20 -year protection rule (38 CFR 3. 951) states that after a veteran has held a rating at or above a specific level continuously for 20 years or more, the percentage assigned to that disability cannot be reduced unless fraud is proven.

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