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What is a Permanent & Total rating?
In the language of your VA, the word permanent does not mean that your benefit is
permanent! To have a 100% P & T rating only implies that your dependents are
eligible for benefits like DEA & CHAMPVA.
Your rating is NOT protected! There is but one way to achieve a "protected" rating...
you must hold it uninterrupted for 20 years. Until you've held the rating for 20 years VA
may contact you at any time to evaluate (and lower) your rating.
How do you know if your rating is temporary or permanent? You go to your original award
letter and look for the secret codes VA likes to use to confuse you. If your award letter says
"No future exams are scheduled..." that means that your rating is permanent. If you see
"Eligibility to dependents Chapter 35 DEA / CHAMPVA are established",
your rating is permanent.
Those phrases may differ from one VA Regional Office (VARO) to the next but there
should be something similar on your award letter.
If you see "Future exams are scheduled" or similar, or no reference at all to future exams or
other dependents benefits, your award is probably temporary.
VA establishes the rating as permanent when there is little chance that the condition will improve.
VA makes a lot of mistakes when establishing the permanence of a rating. It's up to you to
know what to do...nobody will do this for you.
As a rule, most mental health conditions and cancers will be temporary ratings.
A veteran must hold a 100% permanent rating for 10 years, uninterrupted, for his/her
family to be eligible to apply for DIC benefits should the veteran
die of anything other than a service connected condition.
Permanent or Temporary?
The veteran is finally rated 100%. She sees on the award letter “future exams are scheduled”. She learns that this means her spouse isn't eligible for CHAMPVA and her kids won't see the C-35 DEA benefits she hoped would help pay for their college. The state she is in has generous benefits for permanently disabled vets but the “future exams are scheduled” keeps her out of those benefits. Her disability is one that does not seem to be likely to improve and she believes that she should be P & T and
qualified to apply for CHAMPVA and DEA.
Should she ask VA for P & T? Is there a legal or regulatory basis to do so?
There are many variables that every veteran must consider when contemplating whether or not to seek the assignment of permanence. Each vet must carefully review his or her own circumstances. As a general rule, the permanent rating will provide significantly better benefits for dependents than a temporary rating. However, if the veteran isn't well prepared when asking that the rating be modified from temporary to permanent, there is some risk. Seeking to change the status of your award from temporary to P & T is the same as asking for an increase to an existing rating.
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Are you totally disabled? Is your rating Permanent?
In other words, are you P & T? If not, what do you want to do about it? What can you do?
The difference between P & T and temporary may mean tens of thousands of
dollars in benefits to you and your family. Take a minute now and find your original award letter.
You're going to need it to determine your status.
TDIU awards may be permanent or they may be temporary.
When VA writes to say "No future exams are scheduled" they do not mean "We will never
subject you to an exam in the future". All this means is that there is no examination
scheduled. VA can schedule an exam at any time and for any reason.
If you are rated at 100% and you decide to file for another disabling condition, you may be
scheduled for a C& P exam to review the current rating. If the C & P exam shows improvement,
you'll probably be advised of a proposal to reduce your "permanent" 100% rating.
If you are TDIU and you miss completing the VA Form 21-4140 that is required each year,
you will probably be advised of a proposal to reduce your rating.
Most states require that you be permanently and totally disabled before you may pick
up any state benefits for disabled veterans. Most states don't understand what "no future
exams" means. You may write to your VARO and request a letter that spells
out your disability status.
Do you NEED a permanent rating assignment?
Are your kids heading to college and your spouse isn't covered by insurance?
Don't tell VA about it! If your rating is temporary and you want it to be permanent so
that you have those benefits, you may write to your VARO and ask for a permanent
rating designation. However, the assignment will not be made based on your need.
You must tell VA that there is no reasonable chance that your condition will improve.
That's the only factor that will be considered.
Do your homework. Know whether or not your rating is permanent or temporary!
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38 USC 1156 - Temporary disability ratings
Assignment of Temporary Ratings.
(1) For the purpose of providing disability compensation under this chapter to veterans,
the Secretary shall assign a temporary disability rating to a veteran as follows:
(A) To a veteran who —
(i) was discharged or released from active duty not more than 365 days before the date
such veteran submits a claim for disability compensation under this chapter;
(ii) has one or more disabilities for which a rating of total is not immediately assignable —
(I) under the regular provisions of the schedule of ratings; or
(II) on the basis of individual unemployability; and
(iii) has one or more —
(I) severe disabilities that result in substantially gainful employment not being feasible or
(II) healed, unhealed, or incompletely healed wounds or injuries that make material
impairment of employability likely.
(B) To a veteran who, as a result of a highly stressful in-service event, has a mental disorder
that is severe enough to bring about the veteran’s discharge or release from active duty.
(C) To a veteran who has a service-connected disability that requires hospital treatment or
observation in a Department of Veterans Affairs or approved hospital for a period in excess of 21 days.
(D) To a veteran who has a service-connected disability that has required convalescent
care or treatment at hospital discharge (regular discharge or release to non-bed care)
or outpatient release that meets the requirements of regulations prescribed by the Secretary.
(2) With respect to a veteran described in paragraph (1)(A), the Secretary may
assign a temporary disability rating to such veteran regardless of whether such veteran
has obtained a medical examination or a medical opinion concerning such veteran’s disability.
(3) With respect to a veteran described in paragraph (1)(B), the Secretary shall
schedule a medical examination for such veteran not later than six months after the
separation or discharge of such veteran from active duty.
Termination of Temporary Disability Ratings. —
(1) Except as provided in paragraph (2), a temporary disability rating assigned to a veteran
under this section shall remain in effect as follows:
(A) For a veteran who is assigned a temporary disability rating under subsection
(a)(1)(A), until the later of the date that is —
(i) 12 months after the date of discharge or release from active duty; or
(ii) provided in regulations prescribed by the Secretary.
(B) For a veteran who is assigned a temporary disability rating under subsection (a)(1)(B),
until the date on which a rating decision is issued to such veteran following the medical examination scheduled under subsection (a)(3).
(C) For a veteran who is assigned a temporary disability rating under subsection
(a)(1)(C), until the later of the date that is —
(i) the last day of the month in which the veteran is discharged from the hospital as
described in such subsection (a)(1)(C); or
(ii) provided in regulations prescribed by the Secretary.
(D) For a veteran who is assigned a temporary disability rating under subsection (a)(1)(D),
until the date that is provided in regulations prescribed by the Secretary.
(2) The Secretary may extend a temporary disability rating assigned to a veteran under
subsection (a) beyond the applicable termination date under paragraph (1) if the
Secretary determines that such an extension is appropriate.
The Secretary shall prescribe regulations to carry out the provisions of this section.
Nothing in this section shall be construed to preclude the Secretary from providing
a temporary disability rating under an authority other than this section.