What is a rating and

how are they

calculated?

Presented by Brian Voges

References Used

 VSO Manual – pages 57-62

 38 CFR

 M21-1 – Part IV.ii.2.F.1.c

Rating Definition:

A rating is defined as a formal decision

made by the VA based on available medical
evidence.
 In compensation cases, rating activity
determines if the disability claim is service
related or not.
Basic Rating Facts

 Congress establishes the payment amount of each

rating
 Ratings increase according to the degree of disability
A veteran may be rated from 0% to 100% disabled,
depending on the severity of the disability – 38 CFR
4.104
A veteran can have several individual ratings –
However, the veteran will also have one “combined
rating” – 38 CFR 4.25
Special Monthly Compensation (SMC)
(38 CFR 3.350)
 Specialmonthly compensation (SMC) is a
rating for a special allowance for veterans
with certain severe disabilities

 SMC
rating increases the veteran’s rate of
compensation payment

 TheSMC designators are: k, l, m, n, o, q, r,

and s
Individual Unemployability (38 CFR 4.16)

 IndividualUnemployability (IU) is a provision

where a veteran may receive payment as
though he or she was rated at 100%

 The rating schedule defines total (100%)

disability as an impairment of mind or body
that is sufficient to make it impossible for the
average person to follow a substantially
gainful occupation
Individual Unemployability - continued

 To be considered for IU, the veteran must:

Be rated with at least one service

connected disability

Provide evidence of past employment

Be unemployable
Temporary Ratings (38 CFR 4.28, 4.29,
4.30 - Paragraphs 28, 29, and 30)
 1. Paragraph 28 (38 CFR 4.28) or ‘Prestabilization’ Rating

 2. Paragraph 29 (38 CFR 4.29) provides an increased rating

for veterans who are hospitalized for more than 21 days
for their service connected disability(ies)

 3. Paragraph 30 (38 CFR 4.30) is a temporary 100% rating

assigned, usually following surgery, for a service
connected disability
Permanently and Totally Disabled (P&T)
38 CFR 4.15
 The rating schedule defines PERMANENT disability as: an
impairment that is reasonably certain to continue
throughout the life of the disabled person

 The rating schedule defines TOTAL disability as: an

impairment of mind or body that is sufficient to make it
impossible for the average person to follow a substantially
gainful occupation
Scheduled Reviews/Future Exams (38
CFR 3.327)
 Manydisabilities, by their nature, are likely
to improve with time or treatment.
Because of this, VA schedules periodic
reevaluations of the disability.
Scheduled Reviews/Future Exams -
continued
 Periodic re-examinations are NOT normally scheduled if
any of the following circumstances exist:
 The veteran is over 55 years of age, except in unusual
circumstances
 The disability is established as static (never changing)
 The disability or disease is permanent in character and is of
such nature that there is no likelihood of improvement
 The combined rating would not change even if a future
exam reduces an evaluation for one or more conditions
 Over a period of five or more years, the findings and
symptoms have persisted without material improvement
Confirmed and Continued Ratings (C&C)

 Asthe name implies, a confirmed rating is

one that confirms and continues the last
rating made by the VA
C&C - continued

 The 10-year protection rule (38 CFR 3.957) states that

service connection for any disability that has been in force
for 10 or more years cannot be severed unless fraud is
shown or if the veteran did not have the requisite service
or character of discharge.
 The 20-year protection rule (38 CFR 3.951) states that
after a veteran has held a rating at or above a specific
level continuously for 20 years or more, the percentage
assigned to that disability cannot be reduced unless fraud
is proven.
 Any Questions??

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