Navigating the VA Maze: A Guide to Achieving 100% Permanent and Total Disability Rating for Veterans

One of the questions that come up often is how to become Permanent and Total for a disability. Permanent and Total means that the VA has determined your disability will in all likelihood not get better, and so they will no longer do 5-year checks on that disability to see if it is improving. Total simply means that you are rated 100%.

To be rated as Permanent and Total (P&T) with the U.S. Department of Veterans Affairs (VA), you need to follow these general steps:

Establish service connection

First, ensure that you have a service-connected disability. This means the disability or condition you are claiming is directly related to your military service. Remember, there are three things that must be present to establish service connection.

a. Current Disability: The veteran must have a current diagnosed disability or condition that is affecting their daily life or overall well-being.

b. In-Service Event, Injury, or Illness: There must be evidence of an event, injury, or illness that occurred during the veteran’s military service. This event could be a specific incident, exposure to hazardous conditions, or the aggravation of a pre-existing condition.

c. Nexus or Linkage: The veteran must establish a medical nexus or link between their current disability and the in-service event, injury, or illness. This requires medical evidence, such as medical records, doctor’s opinions, or expert testimony, demonstrating that the current disability is related to the military service.

Gather medical evidence:

Collect all relevant medical records, including treatment records, diagnostic tests, and opinions from healthcare providers regarding the severity and permanence of your disability. The VA will consider this evidence when evaluating your claim.

Submit a claim for disability benefits

File a claim for disability compensation with the VA. This can be done online through the VA’s eBenefits portal, by mail, or by visiting a regional VA office. Provide detailed information about your disability, its impact on your daily life and ability to work, and any supporting medical evidence.

Attend VA medical examinations

The VA may schedule you for a Compensation & Pension (C&P) examination to assess the severity and impact of your disabilities. Attend these appointments and provide accurate information to the examining physician.

Support your claim with strong evidence

Submit any additional evidence that supports your claim for P&T disability. This can include medical opinions from specialists, statements from family members or friends regarding your limitations, or any other documentation that demonstrates the permanent and total nature of your disabilities. Here are several different sources of evidence you can consider.

1. Medical Documentation: Obtaining comprehensive medical documentation is essential to support your claim. This includes your medical records from military service, post-service medical records, and any relevant private medical records. Gather documentation related to the diagnosis, treatment, and progression of your disability. This can include doctor’s notes, test results, imaging reports, surgical records, and medication history. Make sure your medical records clearly link your disability to your military service or show a significant worsening of a pre-existing condition during service.
2. Nexus or Medical Opinion: Seeking a medical opinion from a qualified healthcare professional is crucial to establish the nexus, or link, between your disability and military service. A medical professional familiar with your condition can provide an expert opinion supporting the connection. This can be done through a VA examiner, private healthcare provider, or specialist. Ensure that the medical professional thoroughly reviews your medical records, examines your condition, and provides a detailed statement explaining how your disability is related to your military service.
3. Buddy Statements: Buddy statements or statements from comrades who served with you can provide valuable supporting evidence. These statements should describe the in-service event, injury, or worsening of a pre-existing condition that led to your disability. They can attest to your symptoms, limitations, or changes in your condition during and after your military service. Gather statements from individuals who have firsthand knowledge of the event or can speak to the impact of your disability on your daily life.
4. Lay Statements: Your own detailed statement describing your disability, its impact on your life, and the connection to your military service is also important. Provide a comprehensive account of your symptoms, limitations, and the challenges you face due to your disability. Be specific about how your disability affects your ability to work, perform daily activities, and maintain relationships. Include any relevant information about the in-service event or worsening of a pre-existing condition. Your personal statement adds a human perspective to your claim and helps the VA understand the true impact of your disability.
5. Expert Opinions: In some cases, obtaining expert opinions from professionals specializing in your specific disability can bolster your claim. These experts can provide a detailed analysis of your condition, its relationship to your military service, and the resulting functional limitations. Expert opinions carry weight and can provide a strong foundation for your claim.
6. Supporting Research and Studies: Compile relevant research, studies, and literature that establish the connection between your disability and military service. This can include medical journals, reports, or official studies that support the association between your condition and military service. Presenting this information demonstrates that your disability is not an isolated case and is recognized in the medical community.
7. Follow-Up Examinations: Be prepared to attend any VA-requested medical examinations or evaluations. These examinations are conducted by VA medical professionals and are used to assess the severity and impact of your disability. Attend these appointments and provide accurate and detailed information about your symptoms, limitations, and medical history. Cooperating with these examinations is crucial to ensure a thorough evaluation of your condition.
8. Organization and Clarity: Present your evidence in a clear, organized, and concise manner. Ensure that all documents are legible and properly labeled. Create a timeline or summary that outlines the progression of your disability, starting from the in-service event or aggravation and continuing to the present day. This helps the VA evaluators understand the continuity of your condition and its impact over time.

Follow up on your claim

Regularly check the status of your claim through the VA’s online portal or by contacting the VA directly. Be prepared to respond to any requests for additional information or clarification promptly.

Appeal if necessary

If your initial claim is denied or you receive a rating that you believe is incorrect, you have the right to appeal the decision. Consult with a veterans service organization or an accredited attorney or representative to understand the appeals process and gather the necessary evidence to support your case.

It’s important to note that the specific requirements and processes may vary based on individual circumstances and the nature of your disabilities. Working with a knowledgeable veterans service officer or a VA-accredited representative can provide valuable assistance throughout the claims process.

Additionally, keep in mind that the determination of P&T status is made by the VA based on the medical evidence and assessment of your disabilities. The VA will consider factors such as the severity, permanence, and impact of your conditions on your ability to work.