Many veterans returning from military duty have suffered service-connected injuries, disorders, or health conditions that severely impact their quality of life. These veterans are eligible to apply for disability benefits through the U.S. Department of Veteran Affairs (VA), and this agency uses an extensive ratings schedule to designate ratings for a long list of disabilities.
The ratings schedule assigns a numeric diagnostic code to these conditions and groups them by areas of the body. This schedule cites the types of symptoms a disability must present to qualify for that rating. These ratings vary from 0 percent-100 percent, and typically are assigned in increments of 10. If a veteran is assigned a 0 percent rating, his disability has received a non-compensable rating and will receive no benefit. A disability that receives a 100 percent rating means the veteran is totally disabled.
When a veteran applies for VA benefits, his application is also considered for Total Disability based on Individual Unemployability (TDIU). A TDIU payment is the equivalent of a 100 percent disability benefit payment and is intended to help veterans who are unable to sustain gainful employment due to their disabilities.
To qualify for TDIU, you must meet one of two criteria:
- Schedular. This criterion requires a veteran have one impairment that’s been given a rating of 60 percent, or multiple impairments that have a 70 percent combined rating, with at least one impairment with a rating of 40 percent.
- Extra-Schedular. If a veteran’s impairment doesn't meet the scheduler criteria, he may still be considered under the extra-schedular rating if he has an unusual or unique disability.
Veterans who believe they meet the criteria for the extra-schedular consideration should seek the help of a VA disability lawyer to assist them through the appeal process for this type of VA benefit.
What Are the Extra-Schedular Criteria?
Sometimes, a veteran has a condition, disorder, or an injury that doesn’t fit the listed definitions and presents in ways that don't match the criteria. The symptoms of these illnesses may be “above and beyond” the rating code for that disability, have life-altering consequences, and make it impossible for a veteran to work. In these instances, the VA considers the claim for the extra-schedular rating, which gives the veteran an additional percentage for that disability.
To qualify for the extra-schedular consideration, a veteran must demonstrate that his symptoms are rare, unusual, and exceed what's expected for that rating code. For example, a veteran with an ankle injury might receive a 20 percent rating because the ankle’s range of motion is limited. However, the veteran might be considered for the extra-schedular if the ankle causes extensive pain and inflammation when he stands for more than 30 minutes.
How the VA Determines Eligibility for Extra-Schedular Consideration
If the VA determines that your symptoms exist outside the rating code criteria, the agency then decides if the disability or condition interferes with your ability to hold a job or requires hospitalization on a consistent basis.
For example, if you sustained a neck injury, it might not limit your range of motion, but you may suffer from severe headaches or neck pain after sitting at a desk for more than an hour, and this could demonstrate a significant interference with your employment. Or, you may suffer from inflammatory bowel disease, and your symptoms may require frequent hospitalization.
If your condition meets the criteria, the VA refers your case to the Director of the VA Compensation and Pension Service, which determines if your disability will be given the extra-schedular rating. However, it’s important to remember that any service-connection compensation can be re-evaluated by the VA at any time. Unless you’ve received “total and permanent disability” for more than 20 years, the VA can re-assess your situation and change your compensation.
How We Can Help
If you have a service-connected injury you believe qualifies for TDIU, and you want to determine if you meet the extra-schedular criteria, contact the VA disability attorneys at Cuddigan Law. We can help answer your questions. Contact us at (402) 933-5405 or start a chat