The Blog at Military Disability Made Easy

The Blog at Military Disability Made Easy: January 2014

Sunday, January 19, 2014

How does Congress decide how to rate the different conditions?

The VASRD (Veterans Affairs Schedule for Rating Disabilities) is a law (actually, a regulation, but it's as powerful as a law, so we call it that to keep things simple) passed by Congress that regulates how various conditions of different severities are assigned Military Disability Ratings. It is massive and quite confusing. Since both lawyers and doctors helped put the VASRD together, it has some definite flaws, and doesn’t always live up to its goal. Plus, lawyers and doctors speak two totally different languages, and combining them makes it seem almost impossible to translate—believe me, we spent a long time translating for this site, and thinking about it makes me feel like this guy.

The first key to understanding how the VASRD was made is to understand its purpose. The goal of the VASRD is to give a fair rating for every condition that reflects the seriousness of the disability. Not having a foot is a much worse disability than just having limited motion in the ankle. Thus, the rating for the limited motion will be much less than for the loss of the foot. The worse your condition, the higher your rating should be.

The main question the lawyers and doctors focused on, and that the Rating Authorities are supposed to focus on when applying the laws of the VASRD, is “How does the condition affect the overall functioning of the veteran?” Does the condition make it so the veteran cannot work at all? That would be a serious disability and deserves a fairly high rating. Does the condition make the veteran unable to perform even the smallest every day tasks like dressing and eating? That would be an even worse disability and deserves an even higher rating. If the veteran is basically able to care for himself and be employed, then the rating should be much lower since the disability isn’t as severe.

So, when these lawyers and doctors got together to make the VASRD, they had a seriously big job. They had to create laws that would cover every severity of every type of disability. There are thousands of ways the human body can misfunction, so while we like to complain about the problems with the VASRD, due credit must be given. Overall, it does a pretty darn good job. It’s impossible to rate every single condition, so in addition to the specific ratings, the VASRD has a bunch of VASRD Principles that are designed to help adjust the VASRD for special circumstances.

As for the ratings themselves, they are meant to reflect the seriousness of the condition. Here are all the possible ratings: 0%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100%. Each rating entitles the veteran to different Military Disability Benefits for both VA Disability and DoD Disability.  0% means that the veteran isn’t really disabled by the condition at all, and thus will receive the fewest benefits. 100% means that the veteran is completely disabled and unable to hold a job or function productively, and thus deserves the most benefits.

That being said, there are a couple of areas in the VASRD where these guidelines aren’t optimally followed. The most obvious example of this, and the one that makes me most question what the heck they were thinking, are the rating requirements for hearing loss and vision loss. In the VASRD, vision loss is rated on CORRECTED vision, so how well you see WITH glasses or contacts. Hearing loss, however, is not rated on corrected hearing. It is rated on how well you hear WITHOUT a hearing aid. How can this possibly be fair? Either both should be rated on corrected, or both on uncorrected. Either the vision loss people are getting screwed or the hearing loss people are being spoiled. 

You might notice as you find your conditions on this site that there are many times where every rating is not available for a certain condition. For example, the majority of mental disorders can be rated 0%, 10%, 30%, 50%, etc. They do not have 20%, 40%, 60%, etc. ratings. This happens because there have to be very clearly separated requirements for each rating, and some conditions don’t have enough different levels to make using each rating logical. They simply looked at all the different severities and decided which rating most closely reflected the disability.

Overall, the VASRD does a good job. It does have its faults, but the majority of conditions are given pretty fair ratings. Before finding your conditions, make sure you read the VASRD Principles page so that you know how to apply the ratings to your particular case.

Thursday, January 9, 2014

Rating Cosmetic Procedures for Military Disability

We’ve had numerous questions about whether or not various cosmetic procedures can be given a Military Disability Rating for military disability.

The short answer: No. Why should the military pay for a procedure that had nothing to do with service and that you chose to have because you wanted to, not because you had to?

But there are some exceptions. Sort of. Let’s discuss a couple of scenarios.
  • The Breasts. There are no cosmetic procedures for the breasts that are ratable by themselves since none can be caused by military service. If, however, a breast reduction is necessary to relieve back pain, then the need for the procedure comes from a condition that can be rated: back pain. The cosmetic procedure cannot be rated, but the back pain can. The removal of the breast because of cancer or other medical problems can also be rated since that is clearly a medical procedure and not just a cosmetic procedure. 

  • Reconstructive Surgery. The only type of cosmetic surgery that can always definitely be rated is reconstructive surgery. Again, though, it is not the procedure itself but the scarring and/or disfigurement that's rated.

  • Conditions/Side Effects caused by Cosmetic Procedures. There is a principle in the VASRD that states that a condition is not ratable if it was treated outside the military medical system unless it was referred outside by the military system. If you underwent a cosmetic procedure outside the military system, then it and any and all complications from it are NOT ratable. The military medical system does do some cosmetic procedures, however. These are not ratable unless they cause serious side effects. The side effects CAN be rated since the military system caused those side effects. This is the only time the DoD and VA will rate conditions caused by a cosmetic procedure. 

Overall, cosmetic procedures are not ratable, but there are some circumstances where a rating can be given. It’s ultimately up to the decision of the Rating Authorities as to what qualifies for a rating and what doesn’t.

If you're cosmetic procedure qualifies for disability but was denied, you can file an appeal. Remember, the best way to have a successful appeal is documentation, documentation, documentation.