Allowance Rates By Level Of Adjudication
SSA has several levels of adjudication: the initial DDS determination and three levels of appeal. The successive levels for appeals are reconsideration, ALJ hearing, and the Appeals Council.20 After exhausting SSA appeals, cases can be taken to the federal courts. This section examines allowance rates at each level and compares the results with those for disabled-worker DI applicants from the general population in calendar year 2003.
Chart 16 shows that at each of the first three levels of adjudication, as well as overall, veterans with a 100% VA rating had higher allowance rates than did those with an IU rating. Totally disabled veterans overall had higher allowance rates than DI applicants from the general population at the initial level, but they had similar allowance rates at the reconsideration and hearings levels.
Of the 34,766 postaward first DI claims of totally disabled veterans that were ultimately allowed, nearly two-thirds of allowances came at the initial level and over one-quarter came in ALJ hearings. The proportion of allowances coming from appeals is lower for these disabled veterans than for the general disabled-worker applicant population .
Disability And Medical Treatment
Here you will have to provide medical info related to your disabilities. This includes the nature of the disability. And when it was last treated in the past year.
You will provide details on the doctors you have had treatments from. The names of their hospitals and dates of any hospitalization.
The space to fill out this data is limited. If you have more info to give than the space allows, you can still include it. Do this under Item 26-Remarks, which is at the end of Section IV.
Be Patient With The Process
This process can take a while to be completed. Anywhere between a few months to years.
Time is also needed to review and verify supporting documents. You may also be sent a letter from the VA requesting additional information.
Do be patient as your form is processed. If approved, the benefits will be applied retroactively. This means the amount will be backdated to when you initially applied.
If your claim is denied, you have just one year to make an appeal. Thereafter, the decision is made final.
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Can I Invest In Stocks While Receiving Tdiu
Investors income from stock dividends, interest, or capital appreciation is considered passive income. There is no TDIU limit to the income you earn in this way.
The only time income from stocks can get in the way of receiving TDIU is if you cross the line from being considered an investor to being considered a trader. If you are considered a trader, the law classifies you as a business, and the income is then considered earned.
There are several criteria to determine whether a veteran should be considered a trader rather than an investor:
- How long the veteran holds their securities before selling
- How frequently the veteran trades
- How much has been earned from trades
- If the veteran is pursuing this income to support their livelihood
- The amount of time the veteran spends buying and selling securities
Am I Eligible For Backpay Back To The Date I Became Unemployed
Each unemployability claim will take months, and in some cases, years, to be reviewed and processed. The time you spend waiting for approval can amount to significant sums in benefits. The VA is supposed to issue retroactive pay for this time, usually as a one-time lump sum.
In calculating retroactive pay, the most important factor beyond rating is that the VA determines the effective date correctly. The effective date can be considered the time when your unemployability began, not just the date when you filed your application.
It could have taken you years to discover that you might be eligible, gather all the documentation, obtain legal advice, and file the claim. Despite what the VA may say, you may be entitled to receive disability compensation for that time, and a lawyer can help you fight the proper determination.
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How Total Disability Based On Individual Unemployability Works
To be eligible, one must meet certain disability standards. This is as per the VA individual unemployability fact sheet.
If you have one service-related disability, it must be rated at 60% or higher disabling.
If you have many service-related disabilities, one must be rated at least 40% or higher disabling. The combined total disability on IU should add up to at least 70% or higher disabling.
TDIU refers to these disability ratings. And their limits in establishing a need to increase benefits to 100%.
These disabilities should be the reason you cannot hold down a steady job. If in marginal employment , you may still qualify for IU benefits. VA income limits that place you below the federal poverty threshold can grant you IU benefits.
Am I Eligible For Disability Benefits From Va
You may be eligible for disability benefits if you meet both of these requirements.
Both of these must be true:
- You have at least 1 service-connected disability rated at 60% or more disabling, or 2 or more service-connected disabilitieswith at least 1 rated at 40% or more disabling and a combined rating of 70% or moreand
- You cant hold down a steady job that supports you financially because of your service-connected disability. Odd jobs dont count.
Note: In certain casesfor example, if you need to be in the hospital oftenyou may qualify at a lower disability rating.
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What Is Veterans Administration Individual Unemployability And How Do I File For It
If you cant work because of a military service-connected disability, you may qualify for Individual Unemployability . This means you may be able to get disability compensation or benefits at the same level as a Veteran who has a 100% disability rating.
There are two ways to apply for and receive a 100% military service-connected disability rating from the VA.
The VA web site https://www.va.gov/disability/eligibility/special-claims/unemployability/ explains what IU is, what qualifies you for IU, and what forms and evidence you need to submit to file a claim for IU.
You may be eligible for IU if you meet both of the requirements listed below.
EDITORS NOTE
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Do I Have To Have 70 Percent To Be Eligible For Unemployability
No. Frequently veterans that are unable to work due to their service-connected disabilities are told by VA that they are ineligible for unemployability because their service-connected disabilities are rated less than 70 percent. This is incorrect, regardless of what percentage a veteran is assigned, if the service-connected disabilities prevent a veteran from working, they must be paid total disability individual unemployability.
The confusion arises because of VA officers and veterans service officers misinterpreting VAs regulations. VA regulations provide that if a veteran has one-service-connected disability, to be eligible for unemployability,it must be rated at least 60-percent or higher. If the veteran has two or more service-connected disabilities, at least one of those disabilities must be rated at 40-percent or higher, and, after factoring in the ratings for the other disabilities, the veterans combined disability rating must be 70-percent or higher. Thus, veterans are told that if they do not meet these requirements, dont bother applying for unemployability. This is wrong.
That is because VA regulations also provide that It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled.
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Consistency In Individual Unemployabilitydecision Making
The 2005 report of VAs Office of Inspector General focused on the variation in average disability compensation payments from state to state in FY 2004 , but data tables in the reports appendix include the number of IU beneficiaries in each state. An analysis of these data shows that the percentage of veterans receiving compensation in FY 2004 who were rated for IU ranged from a low of 3.3 percent in Maryland to a high of 20.1 percent in New Mexico . In terms of all resident veterans, not
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just veterans with disabilities, IU beneficiaries ranged from 2.5 per thousand veterans in Maryland to 28.2 per thousand in New Mexico .
Vocational Rehabilitation And Employment Service Records
Records from VAs Vocational Rehabilitation and Employment can be favorable evidence in many cases and readily available for veterans seeking individual unemployability benefits to access. Veterans can apply for this program when looking to rejoin the workforce with a service-connected disability. Sometimes this program finds that the veteran is not able to be rehabilitated, which can prove to be favorable evidence in a claim for individual unemployability benefits.
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Origin And History Of Individual Unemployability
Authorization for IU was added to the 1933 Rating Schedule in 1934. Previously, the Rating Schedule said that total disability exists when any impairment makes it impossible for the average person to follow a substantially gainful occupation. The 1934 revision of the regulations authorized total disability ratings without regard to the specific provisions of the rating schedule if a veteran with disabilities is unable to secure or follow a substantially gainful occupation as a result of his disabilities .4
At that time, the ratings were determined by three-member rating boards consisting of a medical specialist, a legal specialist, and an occupational specialist . Currently, the decision is made by a rating veterans service representative , based on medical records, usually including a C& P disability examination by a physician or psychologist, and possibly including a social and industrial evaluation by a VA clinical social worker. The RVSR, although a lay person, has medical and legal training, but not vocational training.
Wrongful Consideration Of Non
In some cases, the VA representative reviewing the application will look at a non-service-related condition and claim that this condition, rather than service-connected disability, is the cause of unemployability. In particular, this could happen when the effects of the service-related and non-service-related conditions overlap.
For example, a Veteran might have a service-connected back or orthopedic condition with a 60% rating that causes a peripheral neuropathy that prevents him or her from working. The applicant could also have a non-service-related condition, such as diabetes, that could lead to the same effect.
In this case, the VA could claim that the inability to work results from the non-service-connected disability and deny the claim. While it might be impossible to prove unequivocally that the unemployment is indeed service-related, that is not how the process should work. If the ailment is at least as likely as not to be service-related, the VA should treat it as such while reviewing the claim.
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Passive Income Vs Earned Income
Passive income does not count towards the TDIU income limit but earned income does. Any passive income is income you receive from an initial investment that you are not actively working for now. Lets look at two common questions related to passive income sources: rental properties and stock dividends.
Wrongful Estimate Of The Veterans Work Situation
Sometimes, the VA will claim that the Veteran is working and thus not entitled to disability compensation. If the Veteran only works part-time or volunteers, and their income is less than the poverty threshold, then that work be considered marginal income. A case like this should be easy to demonstrate in an appeal.
Other times, a Veteran will work and earn an annual income that exceeds the federal poverty level, but the VA may fail to consider that the Veteran is employed in a protected work environment where the employer must make significant accommodations in consideration of the Veterans medical condition.
If this happens while re-applying, it is important to emphasize any special accommodations made for the Veteran to enable them to work.
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How The Va Verifies Your Income
The VA is to verify a veterans income to ensure they meet the criteria to receive TDIU. A department at the VA called the Health Eligibility Center compares the information provided by the veteran on their submitted financial assessment with records from the Social Security Administration and federal tax information from the Internal Revenue Service .
The firm got me to 70%, and I was happy. Individual unemployability was awarded to me and to this day Im so grateful. My future is no longer bleak. These people work very hard for you.
Appeal Tdiu Claim Denials From The Va
Unfortunately, too many veterans are denied their Total Disability Individual Unemployability benefits. Each year, tens of thousands of veterans reach out to our Individual Unemployability benefit denial lawyers because the VA system wrongly denied their claims. First, know this, a large number of veterans win their TDIU benefits appeals with the right evidence and the right lawyer helping them through the complicated VA appeal process.
If you were recently denied TDIU benefits, you may have the option to appeal the Veteran Administrations initial decision. Veterans wishing to obtain TDIU benefits must appeal within one year of the date the decision was made. Veterans that have let their TDIU appeal period collapse do have the option to re-apply for VA benefits. That means that you will have to re-submit your initial application and start the process over from the beginning.
Our VA benefits appeals lawyers have helped thousands of veterans obtain the benefits they deserve. Dont be discouraged by a denial of your Total Disability Individual Unemployability benefits. The VA regularly denies legitimate claims and many of those vets win their appeals.
In this video, veterans disability attorney Sarah Woods discusses the steps we take to appeal bad VA decisions:
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Tdiu Veterans Lawyer: Va Disability Compensation
Your service in the military is a valuable contribution to your country, but unfortunately, it could leave you with injuries and other difficulties that impact your ability to work in civilian life. While there are options to apply for disability benefits through the U.S. Department of Veterans Affairs , a standard claim is not always successful.
Thankfully, an alternative TDIU filing can help you continue to pursue the compensation you deserve. A TDIU veterans lawyer can help you understand your specific options.
Who Qualifies For Tdiu
This program caters to justveterans with service-related disabilities. They must have reached a point where it is impossible to get steady work.
To be eligible, they must meet the threshold of at least 60% or more disabling on single disabilities. Or a combined total rating of 70% disabling or more on multiple disabilities. With at least one disability rating 40% or higher.
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The Role Of Substantially Gainful Unemployment Receiving Tdiu Benefits
To qualify for total disability benefits, a veteran must be unable to maintain substantially gainful employment as a result of their service-connected disabilities. Substantially gainful employment is VAs convoluted term for determining whether the work a veteran can do meets the standards for receiving entitlement to TDIU. This includes not only how much income a person might receive in a year , but also how many hours they might work in a particular week, whether the employer has provided any accommodations, and how long a veteran has held a particular job.
The concept of maintaining employment is important because the ability to receive a job offer, or even to begin working, is different from maintaining that job for a reasonable period. This is why there are a lot of factors that VA looks at in terms of what it means to maintain substantially gainful employment. No matter what, it must only be service-connected disabilities that are considered for TDIU the effect of other disabilities that are not service-connected on maintaining substantially gainful employment is irrelevant.
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Multiple Applications For Di And Final Decision Outcomes
Thus far, we have analyzed veterans’ first applications for DI disabled-worker benefits after receiving the VA rating of 100% or IU. DI applicants who are denied benefits may reapply, generally after exhausting all appeals. To determine the final allowance rate for this population of disabled veterans, we also considered decisions on all subsequent applications.
Chart 18 shows the number of totally disabled veterans who applied for DI by the number of times they applied after receiving the VA award of total disability. We include the 6,559 applicants with technical denials of their first applications because those individuals are eligible to reapply. Nearly 8,500 disabled veterans applied more than once, and individuals applied as many as seven times.
Chart 19 shows the medical decision on the most recent DI application filed by veterans after receiving their 100% or IU rating from the VA that is, it provides the final allowance rate for those veterans as of 2010, the time of data extraction. The final allowance rate for veterans with a 100% rating was 78 percent, compared with 73 percent for those with a medical decision on their first application those rated IU had a final allowance rate of 71 percent, compared with 65 percent for those with a medical decision on their first application.
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