How Does The VA Evaluate TDIU Claims?
It’s critical to know how the VA will evaluate TDIU claims before you file for benefits. Total Disability due to Individual Unemployability (TDIU) claims are much different from other Veterans Administration disability claims. TDIU matters are not quite original determinations and not quite pure reconsiderations. In 2009, the landmark case of Rice v. Shineski clarified the legal status of TDIU claims.
Even if the disability rating is less than 100% the VA would award the veteran full disability benefits. In this context, “unemployable” means the Veteran is unable to maintain substantial, gainful employment outside of a sheltered environment.
Our VA disability team routinely handles TDIU claims. We understand that establishing a medical disability is only part of the process. We also work hard to prove that the Veteran is unemployable because of the symptoms of that disability, and not just because of the disability itself.
In 2001, a Regional Office declared the veteran 30% disabled because of service-related Post Traumatic Stress Disorder. The VA backdated the rating to 1998. In response, the Veteran simultaneously filed a request for TDIU benefits and a Notice of Disagreement (NOD) with the rating.
A quick aside here. Claims Examiners almost always initially deny claims, at least in part. This Veteran was probably very frustrated that the RO assigned such a low disability rating. It is important not to give up, because the case is just beginning at that point.
In 2002, the VA adjusted the disability rating to 70 percent and determined that the Veteran was unemployable as of 2000.
Another brief aside. As mentioned above, “unemployable” is not just a medical term. We frequently partner with vocational professionals who evaluate the Veteran’s condition and opine if the Veteran is capable of substantial, gainful employment.
The Veteran disagreed with the backdating procedure. He argued that the TDIU claim and NOD were essentially one and the same, so they should both be retroactive to 1998.
The Court agreed and ruled that a TDIU claim is not a standalone matter but a request for reconsideration. Therefore, both the enhanced disability rating and the TDIU finding in this case should be retroactive to 1998.
Essentially, NOD claims remain open for a year. During that time, the Veteran may submit new evidence to bolster the claim. In this case, that new evidence was proof of individual unemployability due to a service-related disability.
Why are the dates of a VA disability claim such a big deal? Total disability benefits average about $3,000 per month, depending on the family’s size and some other factors. If the VA had entitled the Veteran to an extra 24 months of benefits, an earlier retroactive date could mean tens of thousands of dollars.
Cash benefits are only part of the puzzle. Disabled Veterans are also entitled to free medical care. So, if the Veteran accrued medical bills, in this case between 1998 and 2000, the VA may have forgiven those bills. In many cases, medical care benefits might be more valuable than the cash benefits awarded.
Count on Effective Attorneys
Often the key to a successful result is a veterans’ understanding of the nature of a TDIU claim. For a free consultation with an experienced Veterans disability lawyer, contact 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.