When you apply for veterans disability benefits, your claim is evaluated to determine whether you meet the eligibility requirements. The individuals who perform these evaluations are called rating specialists. If your claim has been denied, you may wonder why. Understanding how rating specialists interpret examination records can help you know how to proceed with your appeal.
At The Law Offices of Michael Hartup, we know that applying for VA disability can be a complicated and frustrating process. Our team has helped many Tennessee residents successfully apply for VA disability benefits or go through the appeals process. If you aren’t sure of the next step to take when pursuing disability benefits, contact us online or call our Jackson, Tennessee, office at (731) 513-5282.
What Is a Disability Rating?
If the government agrees that you are eligible for VA disability benefits, you will be assigned a disability rating. This rating is a percentage; a completely disabled person would have a disability rating of 100 percent.
Your disability rating percentage determines the amount of your disability payments. A higher disability rating (e.g., 80 percent) would qualify for more disability benefit money than a lower disability rating (e.g., 10 percent).
If you have more than one injury or illness, each one receives its own rating. The VA then combines these ratings to come up with an “overall” disability rating that determines your benefits. However, the process of calculating that final rating isn’t just a matter of adding the individual ratings for each injury or illness together. The VA uses a complicated “whole person theory” to combine your ratings and come up with an overall disability rating.
How Are Ratings Determined?
The VA has a Schedule for Rating Disabilities: 38 CFR Book C. Rating specialists use this resource to determine the disability rating of your injury or illness. According to Book C, there are several different categories of disabilities that are eligible for VA benefits, such as musculoskeletal, mental disorders, digestive issues, and immune disorders. There are 15 categories in all.
Factors that affect your rating
According to Veterans Affairs, there are several factors that go into determining your rating:
- Medical evidence (e.g., medical test reports, doctor’s reports, treatment history)
- Relevant information from other sources (e.g., military service records showing that your injury occurred during combat)
- A VA claim exam
You may not need to get an exam from the VA if you have enough medical evidence from your own healthcare providers. However, if the Rating Veterans Service Representative (RVSR) doesn’t feel that your medical evidence offers enough proof of your condition, they may order you to undergo a VA medical examination.
RSVRs aren’t medical professionals
It’s essential to understand that most VA disability rating decisions are made by individuals who are not medical professionals. Doctors and nurses aren’t prohibited from serving as RSVRs, but there is no requirement for a rating specialist to have a medical background.
That means that the quality of your medical evidence is vital to the success of your claim. You must have medical documentation that is enough to convince someone who is not a medical professional of your disability.
If your claim is denied, or you end up with a rating that is less than you expected, it may be that your rating specialist didn’t feel that your doctor’s records, treatment history, or examination notes were thorough enough.
Get Expert Help With Your VA Disability Claim
As you can see, the process of determining eligibility for VA disability is complicated. Even if the VA determines that you are eligible for benefits, it may not give you an overall disability rating that seems fair or accurate. Understanding how your exam records are interpreted by rating specialists can help you figure out whether to go through the appeals process.
At The Law Offices of Michael Hartup, we are here to help you navigate the complicated world of VA disability benefits. Our disability attorneys understand how disability ratings work and can help you put together the best application or appeals packet.