Have you ever wondered, “How does the VA calculate my disability rating?” I know I did! When it was time for me to do my retirement physical, I had to gather my medical records to provide the doctors so they could review them. I had no idea what to expect! If you a disabled Veteran, or so will be and are like I was, you’ve come to the right place!
In this post, I am going to explain how the VA calculates your disability rating. The calculations are based on whether you have one disability or multiple disabilities. Full disclosure, I am not a doctor or a lawyer. There is a ton of information and regulations that govern this topic, and these laws and regulations change periodically. This information is subjective, but to the best of my knowledge, true and accurate as of the date it was written.
How severe is my disability?
Many disabilities come from all types of injuries and diseases encountered while performing military service. To determine how severe that disability is, you must have accurate, thorough, fully descriptive medical examinations. When possible, exams should include a psychiatric and neurological examination and any other special exams indicated by the condition.
They must also emphasize the limitations of the disabling condition. Evaluators use these exams to determine how this disability will affect your earning capacity in civil occupations. The more severe the disability, the higher the rating percentage.
For example, a service member with a mental disability could have a severity rating between 0 and 100%. A rating of 0% could be for a formally diagnosed disability that is not symptomatic. Or if the symptoms do not interfere with your ability to function socially and occupationally. If it does not require continuous medication, your severity could earn a 0% rating.
On the opposite side of that spectrum, disabilities that cause total social and occupational impairment could earn a 100% rating. Examples include persistent delusions, persistent self-injurious behavior, or inability to conduct activities of daily living, your disability severity.
It is quite common for a veteran’s disability rating to change over time. Veterans may need to undergo additional examinations to reassess the current rating for increased or decreased severity. The Veteran or the VA may request exams per medical advancement changes, medical knowledge, and existing laws.
Severity of Mental Disorders
As I previously mentioned, the severity of a mental disorder could range from 0% to 100%. You’re probably asking yourself, “If the rating can range from 0%-100%, how does the VA calculate MY disability rating?” So let’s dig into this a little more precisely.
The disorder’s naming is based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). This manual lists over 20 different categories of mental disorders. The general rating formula for mental disorders is as follows: (These formulas are not all-inclusive but include examples of things that could warrant the indicated severity rating).
- If your disorder includes symptoms like a complete or significant loss of communication or thought processes; consistent hallucinations; grossly inappropriate behavior; delusions; not being oriented to time or place; memory loss for your name, your occupation, or names of close relatives, the disability could warrant a rating of 100%
- Suppose the disability creates occupational and social impairment, with deficiencies in most areas, like judgment, mood, school, work, and relationships. You have symptoms like irritability with periods of violence (without being provoked) or thoughts of suicide. Or if your speech does not make sense or is not relevant. If you almost always have feelings of depression or anxiety that limit your ability to function independently, appropriately, and effectively. Or you have difficulty adjusting to stressful circumstances; the disability could warrant a rating of 70%.
- If you experience a reduction in reliability and productivity because of symptoms like panic attacks more than once per week. Or, you have flattened affect or struggle to understand compound commands. Do you experience loss of short and long-term memory (like forgetting to finish tasks or only remembering things that you were very knowledgeable on before). You lack motivation, have frequent mood swings, or difficulty in establishing and maintaining effective work and social relationships; your disability could warrant a rating of 50%
- If your disability creates an occasional decrease in work efficiency or sporadic periods of inability to complete work-related tasks. If symptoms include depression, anxiety; chronic sleep problems, or mild memory loss; your disability could warrant a rating of 30%.
- Disabilities that cause mild or transient reductions in work efficiency during times of high stress, or if the symptoms can be controlled by continuous medication, your disability could warrant a rating of 10%.
- Formally diagnosed disabilities that do not result in any symptoms severe enough to interfere with work or social functions could warrant a 0% rating.
NOTE: This article does not cover eating disorders as they follow their own separate rating formula. If you have questions regarding these ratings, please feel free to contact me.
Severity of Physical (Musculoskeletal System) Disorders
The VA divides the skeletal muscles of the body into 23 muscle groups to determine ratings and severity. These groups are further divided into five anatomical regions. First, there are six muscle groups for the shoulder girdle and arm. And there are three muscle groups for the hand and forearm, three for the foot and leg. Then six groups for the pelvic girdle and thigh, and finally, five muscle groups for the torso and neck.
Disability of this system is based mainly on its inability to perform normal working movements. That is to say, with normal excursion, coordination, strength, speed, and endurance because of damage or infection in the system. Due to the complexity of these rating systems, I will not go into detail here, but you can find the most current and up-to-date schedule for rating disabilities here.
Multiple Disabilities and Combined Ratings – Ready for your head to spin?
It is extremely common to have multiple disabilities. If this is your case, the VA does not just add your disability ratings up to reach a total. For example, if you had a disability rating of 40% for your right shoulder and a disability rating of 30% for your right knee, they would NOT add these numbers together to give you a combined total rating of 70%.
In fact, your combined rating for these two disabilities would be 58%. They would round to the nearest 10 (60%) for compensation purposes. Combined values ending in five are rounded up, but nothing is rounded until ALL disabilities are combined. Here is why. When the VA calculates your total disability rating for multiple disabilities, they base the calculations on your efficiency as affected by each disability.
So, in the example above, if you are 40% disabled due to your right shoulder, that means you are 60% efficient after consideration of the first disability. The next 30% disability is then based on you being 60% efficient. So 30% of the 60% efficiency you still have is 18%. This 18% is then added to your initial rating of 40% for a total of 58%. Clear as mud, right? Good! 🙂
Let’s do another example with a few more disabilities added in…
Let’s say I have five rated disabilities. How does the VA calculate my disability rating? First, they list the five ratings in order from most severe to least severe. So, if my severity ratings are: 50%; 40%; 30%; 20%; and 10%, respectively, what total combined rating would I have? (Hint, it’s not 150%!). Here is how the VA calculates my disability rating:
- Most severe rating = 50% (which means I am still 50% efficient).
- The next rating = 40%. After consideration of my most severe rating, 40% of 50% = 20%. Add this amount to my original rating of 50% for a total combined rating of 70%. This means I am still 30% efficient.
- Then, the next rating = 30%. After consideration of my combined rating of 70% from my first two disabilities, 30% of 30% = 9%. Add this percentage to my current rating of 70% for a total combined rating of 79%. So, I am still 21% efficient.
- My next rating = 20%. After consideration of my combined rating of 79% from my first three disabilities, 20% of 21% = 4%. Yes, I know it is actually 4.2, but it rounds down. This amount is then added to my current rating of 79% for a total combined rating of 83%. Therefore, I am still 17% efficient.
- The next rating = 10%. After consideration of my combined rating of 83% from my first four disabilities, 10% of 17% = 2%. The 1.7% rounds up to 2%. This amount is then added to my current rating of 83% for a total combined rating of 85%.
- Because this is the last disability rated in my example, we round the final combined rating to the nearest 10%. So in this example, I would have a rating of 90% disabled by the VA. Clear as mud right?
This process continues for as many disabilities as you have. Once your total combined rating exceeds 95%, you would be considered 100% disabled according to the VA guidelines and regulations.
So, throughout this article, I described, in some detail, how the VA calculates your disability rating. The severity of your rating is based on a myriad of factors. Some factors I covered here and others can be found in the source I provided above. I also detailed how to calculate your own disability rating based on having multiple disabilities. Do you have questions or concerns regarding how the VA calculates your disability rating? If so, please feel free to leave your questions below, and I will do my best to answer them! Want to know more about your benefits? Check out this article!