15 February 2022
 February 15, 2022
Category: Major Issues

What if my VA rating percentage does not match the severity I feel on a day-to-day basis?

Legal aid does not typically represent veterans in claims for higher rating percentages because our organization focuses on appeals of denials for service-connection and character of discharge determinations. However, we get a lot of questions about the accuracy of percentage ratings. We hope the information below is helpful.

You are not alone in feeling your schedule rating does not match your day-to-day experience.

This first step to get a higher rating is updating the VA on any changes in your condition. You can do this by giving the VA a form called a “supplemental claim.” After that, you may want to apply for benefits for other conditions that are “secondarily connected” to your current service-connected conditions—meaning other problems caused or made worse by the disabilities you got from service. You shared with us a rating decision showing that you currently get service-connected benefits for patellofemoral pain syndrome and pubic apophysitis. Our advice below is based on these conditions.

What is a schedule rating?

The VA rates all service-connected disability percentages through what is called the schedule ratings. The schedule ratings are created by the VA, not Congress, and are published as rules in the Code of Federal Regulations (CFR). They look like a bunch of tables that list different symptoms next to percentages.

Not all conditions go up to a 100% rating. You may have heard before that tinnitus never goes higher that 10%. Many conditions in the schedule ratings max out at a rating percentage lower than 100%.

Step 1: Submit a supplemental claim

The first step to get a higher rating is to update the VA on changes in your current service-connected conditions. The easiest way to do this is by filing a form called a supplemental claim. More information, including a downloadable claim form, is available here. In this form, you must include ALL your doctors and providers that have been treating your conditions since your last rating decision.

It is important to tell the VA your provider information because it triggers the VA’s duty to help you. When you identify these records, the VA is required to request and review them. This can also trigger the VA’s duty to help you get a new compensation and pension exam.

Step 2: Investigate other conditions caused or made worse by your service-connected conditions

If you are still unhappy with your rating percentage after submitting a supplemental claim, we would advise you to look at any conditions you have now that are caused or made worse by your currently service-connected conditions.

Once you have maxed out your level of rating percentage for your service-connected conditions, you should start thinking about getting other conditions service-connected to raise your rating. We advise this step because you do not have to prove as much as a regular benefits claim. All you need to prove is that you have a diagnosis for the second condition and that this condition is either caused or made worse by your current service-connected condition.

A common secondary condition to explore is any mental health complications of your pain and reduction in functionality. If you think your condition has caused you depression, anxiety, or another mental health condition you should start seeing a counselor right away to explore any mental health complications of your current conditions.

Step 3: Total disability individual unemployability (TDIU)

If your rating percentage gets up to around 60-70%, you could apply for something called total disability individual unemployability (called TDIU). This is the VA’s way of acknowledging that the schedule ratings are not always right. If you get close enough to 100%, but just cannot get all the way there, BUT your service-connected conditions keep you from working, the VA may choose to bump you up to 100% anyways.

You can learn more about TDIU here.

GET HELP: Reach out to your county veterans service commission or a private VA benefits attorney for more help on getting a higher rating percentage. There is a chance that the VA is using the wrong table to rate your condition. The VA also has something called extraschedular ratings when the available schedule ratings really do not do your conditions justice. These are both issues you would want to talk over with an accredited Veterans Service Officer or attorney to find out if this situation applies to you.

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