Breaking Down TDIU Eligibility Requirements
All disability determinations involve a combination of medical and economic factors, this is also true for TDIU eligibility. The doctor never sits you down and tells you “You are 30% disabled.” That’s because it’s not just about your diagnosis. It’s about how your condition affects you and what it stops you from doing. This is especially true in Total Disability due to Individual Unemployability claims. In fact, TDIU determinations are so subjective that many people might not know if they’re eligible.
The way the TDIU rules are written, a VA disability lawyer might be able to get you maximum benefits even if you haven’t been declared officially disabled by a doctor or government agency. Maximum benefits usually include about $3,000 per month, depending on the nature of the disability, household size, and some other factors. These benefits also include free VA medical care. In many cases, the medical care benefit might be more valuable than the financial payments benefit.
There are two ways to be eligible for TDIU. Schedular TDIU counts up the ratings for your disabilities, and if they are high enough you can get a total rating. This follows the 60/40/70 rule. Veterans must have a single disability with a 60% rating, or a combination of two or more conditions with a combined 70% rating. At least one of those conditions must have a 40% disability rating. If either of those applies, and if you are not substantially employed you can get TDIU.
Claims Examiners look exclusively to the disability ratings charts to determine the extent of disability. The chart sets its ratings based on how serious the symptoms are. The VA usually asks a C&P (Compensation and Pension) examiner and follows what they say, but other evidence like your reports of symptoms can help.
C&P measurements are often unreliable. For example, the C&P doctor might not specialize in the Veteran’s area of injury. Ear, Nose, and Throat doctors can accurately diagnose breathing problems, at least in most cases. But they often lack these basic skills if the Veteran has a brain injury. Furthermore, self-reported symptoms are not always accurate. Many Veterans downplay their symptoms, even to themselves. This is where an experienced attorney can help you argue for a higher rating.
A brief note about VA math. In this world, two plus two does not always equal four. If a Veteran has a 40% disability because of a knee condition and a 40% back disability, according to the VA, this Veteran is 60% disabled, not 80%.
This is because if the Veteran is 40% disabled by their knee condition, you can think of it as “60% healthy.” 40% of that 60% brings them down to 36% healthy and 64% disabled. This rounds off to a 60% rating. It can get even more complicated, such as if there are disabilities affecting both the left and right knees, but it is always at least this complex.
This VA math matters because this is the number that needs to reach 70%. If you have a 30% disability and a 40% disability, that is not enough. 40% and 50% would be.
The other type of TDIU does not have as much math. This is “extraschedular” because it is outside the disability rating schedule. You can get TDIU if you have service-connected disability that prevents you from working. This does not depend on what your VA disability rating is, but the higher it is the easier it will be to convince VA that you are disabled enough to be unemployable. Extraschedular TDIU is more subjective, which means a lot depends on how well the evidence is presented. This is another area where an experienced veterans’ benefits attorney can help you receive the highest rating you are entitled to.
To qualify for TDIU benefits, Veterans must be unable to obtain and hold substantial, gainful employment in an unsheltered environment. The inability has to be because of their service-connected disabilities, not for other reasons.
Generally, SGA means a job which lifts the Veteran, and any dependents, above the poverty line. Because of their disabilities, some Veterans can only work limited hours or can only work light-duty jobs, like parking lot attendant or crossing guard, which do not pay very much.
Claims examiners often focus on theoretical employment prospects. If the Veteran could possibly find an SGA job, the Claims Examiner might deny the petition. Attorneys often partner with vocational experts in these situations. The VA reviews all the facts and determines whether a Veteran can keep and hold an SGA job in the real world.
If a Veteran is working in a sheltered environment, it might not bar TDIU. The most common sheltered environments are Veteran-owned businesses and family-owned businesses. Veterans who work in such environments often receive accommodations unavailable elsewhere, such as time off for medical appointments.
Reach Out to Dedicated Attorneys
Full disability benefits are often available to partially-disabled Veterans. For a free consultation with an experienced Veterans disability lawyer, contact the Cameron Firm, P.C. at 800-861-7262 or fill out the contact box to your right. We are here to represent Veterans nationwide.
This article is for educational and marketing purposes only. It does not create an attorney-client relationship.