Total Ratings, Permanent & Total Ratings, and Individual Unemployability (IU)
Total Ratings apply to both VA Disability and DoD Disability, but since the most that can be given for Medical Retirement by the DoD is 75%, they don’t make a significant difference for DoD Disability. Total Ratings only apply to service-connected conditions, and in the case of DoD Disability, to conditions that make the service member Unfit for Duty.
Both Permanent & Total Ratings and Individual Unemployability are concepts that only apply to VA Disability, not DoD Disability. This is because both concepts deal with the veteran’s condition’s long-term effects (the VA deals with the veteran’s condition over time) and not just the veteran’s condition at discharge (the DoD only rates a condition at the time of separation).
Permanent & Total Ratings and Individual Unemployability also only apply to conditions that are service-connected and have been given a VA Disability Rating.
The term “Total Rating” refers to a 100% Military Disability Rating. A 100% rating is given if a veteran’s conditions are so severe that it is impossible for the veteran to work at all. Often, the veteran also has trouble taking care of their own daily needs.
Not all Total Ratings are permanent. Total Ratings can be given on a temporary basis if a condition becomes severe but is expected to improve. Temporary Total Ratings are most commonly seen as Hospitalization Ratings or Convalescent Ratings. The VASRD also includes temporary Total Ratings for many conditions, like pulmonary tuberculosis, that is presumed to make a veteran unable to work while it is active. If the VASRD does not allow for a Total Rating for a condition, then it can only be assigned a Total Rating if it qualifies for hospitalization ratings, convalescent ratings, or Individual Unemployability.
All Total Ratings given by the VA are only given for a particular period. The VA will require a follow-up exam at the end of the designated period in order to re-evaluate and re-rate the condition. They can then either lower the rating if the condition has improved, continue the Total Rating if it hasn’t but is still expected to improve, or assign a Permanent & Total Rating if the condition is no longer expected to improve.
Total Ratings can be given for single conditions (i.e. 100% for active cancer) or as a total combined rating if the veteran has multiple conditions that, when combined using VA Math, result in a 100% rating.
Permanent & Total Ratings
A Total Rating becomes a “Permanent & Total Rating” once it is medically assumed that the condition is unlikely to improve and will remain the same throughout the rest of the veteran’s life. Permanent & Total Ratings are usually only given if the condition is stable (neither getting better or worse), however, if it is clear that the condition has no chance of improvement and will only worsen in the future, as in the case of incurable degenerative diseases like ALS, a permanent status can be assigned to a total rating at the VA’s discretion.
For a Permanent & Total Rating to be given for a single condition, that condition alone must qualify for a 100% rating and be considered permanent. In the case of illness or injury where the original cause passes, but residuals remain, a Permanent & Total Rating can be given if the residuals altogether meet all of the requirements. For example, if an infection causes blindness, then that blindness alone qualifies for a Permanent & Total Rating even though the infection is cured.
If a veteran has multiple conditions, none of which are rated 100%, they can still qualify for Permanent & Total Rating if all of their conditions combined using VA Math equal a 100% rating and none of them are expected to improve at all. For example, if a veteran has their dominant hand amputated (a 70% rating) and their entire left leg amputated (a 90% rating), their total combined rating would be 100%. As amputations are undeniably permanent, their conditions together would qualify them for a Permanent & Total Rating.
Once a 100% rating is given the status of Permanent & Total, it cannot be changed in the future. The VA does not require regular re-examinations of Permanent & Total Ratings, and the veteran can expect to receive full benefits of a Total Rating for the remainder of their life.
Individual Unemployability (“IU”) is basically an exception to the rules of Total Ratings.
Individual Unemployability allows a veteran with a service-connected condition rated less than 100% to be rated at the 100% level because the condition makes the veteran unemployable.
For purposes of Individual Unemployability, a veteran is “unemployable” if they are unable to maintain a regular, steady income. Anything that pays less than half of the usual amount established by the US Department of Commerce does not count as regular, steady income.
To qualify for Individual Unemployability, the veteran must provide full proof of their circumstances and have either
- a single condition rated 60% or higher that makes the veteran entirely unable to work
- a single condition rated 40% or higher with additional conditions that together with the first equal a total combined rating of 70% or more. Each of these conditions must contribute to making the veteran unable to work in order to count towards the 70% rating.
Required proof to support a claim for Individual Unemployability includes
- VA disability records showing evidence of the conditions and ratings to be considered.
- Any medical evidence from the past 12 months that supports the claim that the considered conditions make the veteran unemployable.
- Employment history records that show proof of the inability to get or keep a gainful job. These should be thorough enough for the VA to see that the effort has been made but the veteran is unable to get a job or that the veteran has been unable to keep a job because of their conditions. Details, like the number of hours able to work vs. not able to work because of your disability, etc., are beneficial.
There are rare circumstances where the VA might grant Individual Unemployability for conditions that do not meet these rating requirements, but full and complete proof must be shown that the conditions make the veteran entirely unemployable.
Once a veteran is granted Individual Unemployability, they will be assigned a Total Rating and compensated at the 100% rating level.
To apply for Individual Unemployability, submit VA Form 21-8940. Make sure to include the proof of your conditions and employment history along with the form. After receiving this form, the VA is going to send VA Form 21-4192 to your current and previous employers. However, it is ultimately your responsibility to make sure this form is completed by your employers and returned to the VA, so we’ve included it here as well.