Total disability based on individual unemployability (TDIU) is a disability benefit that allows disabled veterans to be compensated at a 100% rate, even if the combined scheduler rating does not equal 100%. TDIU is only awarded in circumstances in which disabled veterans are unable to secure substantially gainful employment because of their service-related disabilities. Medical exams are critical to the determination of whether a veteran qualifies for TDIU, and if your physician gives you an incorrect decision, it can mean the difference of thousands of dollars of compensation per month. If you have received a decision for your TDIU claim that you believe is incorrect, you have options.
The VA has its own set of doctors who perform medical exams for TDIU and other compensation and pension benefit applications. However, exams with these professionals often cause high anxiety for disabled veterans and their results are not always favorable. In addition, exams by the VA for TDIU claims do not have to be completed by a trained physician, further complicating the issue. A doctor, physician’s assistant, nurse practitioner, or medical resident all technically qualify to give the exam at the VA, which can easily lead to an incorrect diagnosis for your case. An independent medical exam can either contradict an incorrect decision by the VA or confirm the diagnosis of disability for your TDIU claims.
VA doctors are inherently biased toward their employer, which is why an independent medical exam helps when applying for TDIU benefits. An independent medical examiner is a physician who has never treated you before and has no ties to the VA. An independent examiner is simply presented the facts in your medical history, service records, lay evidence, and statements, and will then complete an examination and make a diagnosis of disability.
The easiest way to find an independent medical examiner to reevaluate your TDIU claims is through an experienced disability benefits attorney. Attorneys with expertise in this area routinely utilize independent medical examiners for their cases and will be able to quickly set up an appointment for your case. Another option is to search the Independent Medical Examiners Directory or the American Board of Independent Medical Examiners to find one near you. Ho9/wever, if you find an independent medical examiner on your own, you will not have the additional benefits of an attorney advocating for your interests and helping you navigate the system.
The VA processes huge volumes of paperwork on veteran disability claims and because of that, sometimes information gets overlooked and inappropriate denials of benefits made. You can assist the Decision Review Officer determining your TDIU claim for 100% disability, by assembling a solid package of evidence for the VA for both the medical/disability factor, and for the unemployability factor.
If a veteran has been terminated from their former employment for reasons related to service-connected disabilities, the VA MUST consider that in its decision. You can help them do that by providing as much of the following types of evidence as you can –
Veterans Law Group specializes in helping veterans and their families get all of the veteran disability claims benefits to which they are entitled and can assemble the necessary information for appealing a TDIU denial.
Fill out this questionnaire and submit to our office for evaluation. We will review your request for a consultation and contact you as soon as possible. Our consultations are free of charge.
One of the most challenging things for disabled veterans after their discharge from the military is getting accustomed to life with disabilities and another is handling the paper-intensive, bureaucratic process of getting the proper amount of disability benefits. Sometimes mistakes are made in paperwork, or necessary documentation is missing to support certain ratings, and a veteran and his or her family may end up not getting benefits which they are entitled to receive.
When dealing with the disability benefits process with the VA its helpful to treat a denial as an invitation to re-evaluate your application and get some expert assistance in moving past the denial with more information or a changed strategy. One example is a denial for TDIU because the veteran’s disability rating is too low.
As a refresher, TDIU (total disability individual unemployability) is an additional route to getting a 100% disability rating. If you have been denied TDIU, it’s worth re-evaluating several aspects of your claim to see if the denial can be overcome.
A good place to start is the underlying individual disability ratings. Under 38 CFR 4.16(a), one of the criteria for TDIU is the veteran having one service-connected disability with a 60% or more disability rating, or two or more service-connected disabilities with a combined rating of 70% or more. If the VA has concluded you are not eligible for TDIU because your disability ratings do not meet those thresholds, it’s worth re-evaluating those ratings to see if they can or should be increased. If you can get an increase in disability ratings such that they meet the threshold for TDIU, then you may be able to get a changed ruling.
The second criteria for TDIU is medical evidence of unemployability Sometimes medical records clearly reflect aspects of the disability that would reflect unemployability – for example, if the veteran’s doctor notes that because of a service-connected back injury, the veteran cannot stand stationary for more than 10 minutes at a time, or sit stationary for more than 30 minutes at a time with lying down to rest – the medical evidence of unemployability is not hard to decipher. However, sometimes medical records are not so clear in the connection between employment and the particular disabilit(ies) of the veteran. Mental health disabilities are often not documented in a way that makes it immediately apparent that the veteran is unemployable. Additional medical records can be obtained, or a vocational expert retained, to connect the dots between the medical records and the unemployability.
Finally, there is a fallback provision in 38 CFR 4.16(b) that allows for extra-schedular consideration of a TDIU claim, for claims that aren’t as obvious. Though extra-schedular consideration often also requires an appeal to the BVA, they are sometimes approved.
Has your TDIU claim been denied? You might need a second opinion. Veterans Law Group specializes in helping veterans and their families get all of the veteran disability claims benefits to which they are entitled. Fill out this questionnaire and submit to our office for evaluation. We will review your request for a consultation and contact you as soon as possible. Our consultations are free of charge.
We know how hard veterans work to readjust to the civilian work after their tours of duty, applying the same commitment and force of will that kept them going during difficult deployments and challenging assignments. Sometimes, though, struggling past service-connected disabilities to perform a civilian job doesn’t seem to be working. It’s possible that even less than total disability seems to be resulting in employment difficulties. It’s worth finding out whether the veteran is eligible for a 100% disability rating under a theory of Total Disability Individual Unemployability (also known as “TDIU”).
The VA generally refers to a claim as a TDIU claim when two conditions are met: 1) the veteran has one service-connected disability with a 60% or more disability rating, or has two or more service-connected disabilities with a combined rating of 70% or more, and 2) there is medical evidence of unemployability (more about that below). If the veteran satisfies these two conditions, then he will be entitled to be paid at the 100% disability rate, even though he does not satisfy that 100% disability rating under the schedule. See 38 C.F.R. § 4.16(a).
A second method of reaching the same TDIU result is called an extra-schedular rating. An extra-schedular rating applies to veterans who are unemployable due to their service-connected disability(ies), but whose disability(ies) does not meet the percentage requirements under § 4.16(a). See 38 C.F.R. § 4.16(b.)
A veteran can be rated 100% disabled under both a TDIU or extra-schedular theory. See Bowling v. Principi, 15 Vet.App. 1, 5-9 (2001).
Medical evidence of unemployability refers to medical findings of conditions or symptoms that would tend to interfere with the maintenance of regular, full-time employment. Examples could be ongoing panic attacks, social anxiety, frequent emotional outbursts as a result of PTSD, etc.
If you think you might be eligible for TDIU and want to appeal your VA disability decision, Veterans Law Group would love to talk with you. Highly respected in their field, VLG has more than twenty years of experience providing legal help for veterans and their families in their quest for benefits. We can help you obtain additional medical opinion evidence to get you the benefits you deserve.
To get started, simply fill out this questionnaire and submit to our office for evaluation. We will review your request for a consultation and contact you as soon as possible. Our consultations are free of charge and require nothing from you. With so much on the line, why not explore your legal options?