Category: Veterans Disability Law
VA Extra-Schedular Rating vs. VA Schedular Rating: Interpreting the VA Schedule of Ratings
VA Schedule of Ratings
If you have a disability or injury as a result of your military service, you may be eligible for financial compensation from the United States Department of Veterans’ Affairs (VA). VA decides how much money you get by comparing the symptoms you experience to a set of symptoms associated with your condition. When the symptoms match, you will receive a schedular rating. If you experience symptoms that are not included on VA’s list, you may need to apply for an extra-schedular rating to receive the proper compensation.
What Is a Schedular Rating?
A schedular rating is one that falls inside the regular bounds of the VA rating criteria. VA has something called the VA CFR 38, Schedule of Ratings, which provides specific requirements for veteran disability ratings. Once these requirements are met, a veteran will be rewarded a specific disability rating based on the exact symptoms of their condition(s).
The rating will fall between 10 and 100 on any increment of 10%. The more severe your condition, the higher your disability rating will be. Your disability rating directly correlates with the financial compensation you will receive from the VA each month.
VA CFR 38 is a diagnostic code that helps to streamline this process by quantifying the severity of a veteran’s disability. As long as conditions fall within this set criteria, things are pretty self-explanatory and can usually be assessed by a medical professional. Sometimes, however, the condition may have unusual circumstances that cause it to fall outside of the VA Schedule of Ratings, and that’s where extra-schedular ratings come into play.
What Is an Extra-Schedular Rating?
Extra-schedular ratings are assigned when a veteran’s medical evaluation does not fit any of the diagnostic codes in the normal schedule. This is usually a result of the condition manifesting in such a way that the affected individual cannot perform their regular duties or ends up in the hospital more frequently than expected. There is additional compensation included with extra-schedular ratings, which is intended to make up for wages lost because of a veteran’s inability to work.
For example, while a service-connected knee injury might not cause extreme pain, it may make you unable to stand for periods longer than 30 minutes. If this inability to stand lasts a long time, it could prevent you from working as much as you normally would, thus decreasing your income. You could apply for an extra-schedular rating for this disability on the basis that you can’t work with said condition.
How to Qualify for Extra-Schedular VA Ratings
Qualifying for an extra-schedular rating doesn’t just mean having an extra-schedular disability, you also must prove it. This doesn’t just mean proving that you have a service-connected injury, it also means you have to prove that a schedular rating will not provide sufficient compensation.
You must convince VA that the schedular rating does not account for any interference with employment or additional hospital visits, thereby proving that you have more extreme symptoms and require additional compensation for your service-connected condition.
When attempting to qualify for an extra-schedular VA rating, it’s important to get copies of all information and documentation you submitted with your original claim file. If you forget to include something, it will be regarded as an absence of evidence, which could stop you from receiving an extra-schedular rating.
Below is a list of the kinds of evidence that can have a significant impact on your application for extra-schedular compensation.
- Service records: Depending on the event that caused your service-connected injury, service records could be extremely useful to your case. If the military holds any record of your behavioral changes after an event, or even a record of them sending you home because you were no longer able to perform the same duties, you can use that to indicate a change in your physical/mental capacity.
- Medical records: If provided correctly, medical evidence is one of the most powerful forms of evidence. These records typically include a statement from your medical provider noting that they have looked at your entire case and believe the regular rating schedule would be insufficient to try and rate your condition. On top of this opinion, these records should include a detailed explanation of all the extreme symptoms of your condition which warrant additional compensation.
- VA buddy letters: Also called lay statements or lay evidence, these letters include testimony from individuals who have witnessed the effects of your condition on your life. This can come from other veterans, friends, or family members who experienced firsthand how the disability may have changed your functionality. Doctors cannot always see changes in mood, motivation, or how difficult simple tasks such as getting out of bed can be.
The final decision on whether or not your condition warrants extra-schedular compensation is made by either the Director of Compensation Service or the VA Undersecretary for Benefits. One of these officials will review the criteria under which your disability was rated against the symptoms you are experiencing to decide if you deserve more benefits. If your claim is denied, you will still be able to appeal to the Board of Veterans Appeals for another chance at the compensation you deserve.
Extra-Schedular TDIU Ratings
So far, we have been discussing extra-schedular consideration on regular VA disability ratings, but extra-schedular benefits can also be awarded for those applying for Total Disability Rating based on Individual Unemployability (TDIU).
TDIU is a designation that will provide benefits to an individual equal to a 100% disability rating if they are unable to maintain what is called “substantially gainful employment.” Substantially gainful employment indicates work that results in an income above the poverty line. This rating can be reached even if the veteran doesn’t necessarily have conditions which add up to a combined total of 100%. A veteran can qualify for TDIU with at least one disability rated 60% or higher or a combined rating of at least 70% if one of the disabilities is at least 40%.
Extra-schedular TDIU could be available even to those veterans who don’t meet schedular criteria as long as their symptoms are more severe than those outlined by the schedule.
VA Extra-Schedular Ratings vs. VA Schedular Ratings
The difference between schedular and extra-schedular ratings deals mainly with a veteran’s unquantifiable symptoms. While the Schedule of Ratings does its best to cover the effects of as many disabilities as possible, there is always going to be a level of severity or potential symptom that is not addressed. This is where extra-schedular ratings can provide additional compensation and ensure the veteran receives the money they deserve.
Contact Tuley Law Office for Assistance With Your Extra-Schedular Rating
Whether you are trying to determine if you are eligible for extra-schedular benefits or you are filing an appeal to the BVA for your denied extra-schedular claim, the VA disability lawyers at Tuley Law Office are here to answer questions you may have about the process. Our attorneys have been helping veterans receive the compensation they deserve for years, and you could be next.
Fill out our online contact form to reach one of our lawyers and get started on your case today.
Have questions about your case?Contact us