RATING EVALUATION CLAIMS

  1. Mental Health %

This is your opportunity to tell the VA how your mental health condition, including PTSD, affects you today.  The VA assigns a rating for mental health conditions based upon how much your symptoms affect you at work (occupational impairment) and interacting with other people (social impairment).

  • Describe your symptoms related to your mental health condition.
  • Do you have trouble sleeping or do you wake up throughout the night? How many hours a night are you able to sleep? Do you have nightmares? How often?
  • Do you have anxiety or depressed symptoms?
  • Do you have panic attacks? How often?
  • Has your short or long-term memory been impaired? Give one or two short examples.
  • Has your motivation or mood changed? Give one or two short examples.
  • How often do you see a mental health specialist? Have you started going to therapy more often recently to help manage your symptoms?
  • What medications do you take for your mental health symptoms? Has your dosage recently been increased? *This is a key indicator that your symptoms have increased in severity.
  • Describe how these symptoms impact you at work or interactions with others and give an example.
  • Do you have difficulty adapting to stressful circumstances? When you feel stressed, do you lash out or become aggressive?
  • Are you irritable or easily agitated when interacting with others? Have others described you as aggressive or impulsive?
  • Do you have trouble making friends or do you avoid situations where you have to interact with others? Have you been divorced or do you have trouble maintaining long-term relationships?
  • Are you suspicious of others or your surroundings? Maybe when you walk into a room you need to sit facing the door, or you immediately look for the exits, etc.
  • Have you had to take time off from work to attend doctor’s appointments or because of your mental health symptoms?
  • Does your employer give you special accommodations for your symptoms? (For example, do you work the overnight shift to avoid being around or having to interact with other people, or can you take extra time off for doctor’s appointments, etc.?)

 

  1. Orthopedic % (Neck, Back, Shoulders, Hips, Knees, Ankles, Feet)

Disabilities of the musculoskeletal system are rated based upon how much the condition affects your ability to perform “normal working movements.” You may be entitled to multiple ratings for the same service-connected condition, depending on whether your symptoms involve separate and distinct functions such as (1) muscle damage, (2) nerve damage, (3) scarring, and/or (4) limitation of motion in one or more joints.

  • State the formal diagnosis or persistent symptoms of your claimed condition (including arthritis). When and where was this condition initially diagnosed? (best estimate)
  • Describe the extent to which you experience pain (a) at rest, (b) with any movement, and (c) with regular or repetitive activity.
  • Do you take any pain medications for this condition? For each medication you have taken, list the name, dosage, and frequency of use.
  • Describe the symptoms associated with this condition and how these symptoms interfere with your day to day life, especially how they have impacted your ability to work.
  • Do you experience radiating pain in your extremities as a result of your orthopedic condition? (Radiculopathies are each assigned a separate rating if they are deemed secondary to your service-connected orthopedic condition.)
  • How do your orthopedic symptoms interfere with your mood? (If you have been diagnosed with a mental health condition such as depression, consider filing a separate mental health claim secondary to your service-connected orthopedic condition.)
  • Describe your symptoms (pain on use, weakness, fatigue, lack of endurance, incoordination) and how these symptoms interfere with your life and your ability to work.

 

  1. Neuropathies & Radiculopathies %

Peripheral nerves are rated based on (a) loss or weakness of muscle (b) loss of sensation (your ability to feel pain, heat, or cold), and (c) loss of reflexes, and how significantly these symptoms interfere with the body part’s overall ability to function.

  • Describe how often you experience symptoms of pins & needles sensation, uncomfortable burning/itching sensation, heightened pain, or the absence of sensations/feeling in each extremity.
  • How would you describe your neuropathy symptoms? (ie. throbbing, shooting, stabbing, burning, cramping, gnawing, aching, numbness)
  • If you experience flare-ups, describe (a) what triggers them, (b) how often they occur, (c) how severe they are, and (d) whether they cause you to experience pain, weakness, fatigue, or functional loss.
  • Describe the extent to which your symptoms interfere with your ability to use that extremity on a regular basis and how these symptoms affect your life and your ability to work.

 

  1. Gastrointestinal % (IBS, Ulcerative Colitis)
  • State the formal diagnosis or persistent symptoms of your claimed condition. When and where was this condition initially diagnosed? (best estimate)
  • Describe the frequency, severity, and duration at which you experience abnormal bowel movements (diarrhea or loose stools) or constipation. If you have reported these symptoms to a physician, you should make a note of this in your statement.
  • Describe the frequency, severity, and duration at which you experience stomach pain. If you have reported these symptoms to a physician, you should make a note of this in your statement.
  • Describe how your gastrointestinal symptoms interfere with your life and your ability to work.

 

  1. Respiratory % (Lungs, Asthma, Asbestosis, Sleep Apnea)

Respiratory conditions are rated based on (a) how often you experience asthma attacks and (b) the type of medication required for your condition (oral or injected medications including steroids such as prednisone or the use of inhalers or bronchodilators).

  • State the formal diagnosis or persistent symptoms of your claimed condition. When and where was this condition initially diagnosed? (best estimate)
  • Describe the (a) frequency, (b) severity, and (c) duration at which you experience asthma attacks or shortness of breath.
  • Do you take any over the counter or prescription medications for this condition? List all active prescriptions related to this condition (including the use of an inhaler), the dosage, and how often you need to use this medication for your symptoms.
  • Have you had a Pulmonary Function Test (PFT) recently? If so, when and where did you have this test done?
  • Describe how your respiratory symptoms interfere with your life and your ability to work.

 

  1. Central Nervous System % (Migraines, Seizures)

In order to receive a compensable rating for your migraines, we need to show (a) how often your migraines occur, and (b) how severe they are, along with (c) how your migraines affect your ability to work and function. In order to receive a compensable rating for your migraines, we need to show the VA that your migraines are “prostrating.”

 “Prostrating” – The term “prostrating” means that you must cease all activity and self-isolate for the remainder of the day or take medication/seek immediate medical attention. You are unable to perform any occupational or daily activities either because of the migraine itself or because of the migraine medication (ie. the medication makes you too drowsy, you cannot operate heavy machinery, etc.).

Frequency Rating
2 or more times per month 50%
Once a month 30%
Once every 2 months 10%
Once every 3 months or less 0%
  • State the formal diagnosis or persistent symptoms of your claimed condition. When and where was this condition initially diagnosed? (best estimate)
  • How often do you experience “prostrating” migraines that require you to cease all activity and self-isolate for the remainder of the day or take medication/seek immediate medical attention?
  • Describe the severity of your symptoms during these prostrating attacks and how these symptoms have affected your life, especially your ability to work.

 

  1. Endocrine % (Diabetes)

In order to receive a compensable rating for diabetes, you must show at least one of the following:

    • Your diabetes is manageable by a restricted diet;
    • Your diabetes requires insulin or an oral hypoglycemic agent;
    • Your diabetes also requires regulation of activities – it is medically necessary to avoid strenuous activities; or
    • You have experienced episodes of ketoacidosis or hypoglycemic reactions (low blood sugar) that have required one or two hospitalizations per year or twice a month visits to a diabetic care provider.
  • State whether you have a formal diagnosis of diabetes mellitus II. When and where was this condition initially diagnosed? (best estimate)
  • Do you require insulin or an oral hypoglycemic agent? When did you start taking insulin/hypoglycemic agent? (best estimate)
  • Explain how your diet has been restricted because of your diabetes.
  • Has your doctor told you to avoid strenuous activity because of your condition? Provide examples of when you had to avoid strenuous activity because of your diabetes condition. (Consider getting a note from your doctor stating that it is medically necessary to avoid strenuous activities because of your condition.)
  • Have you experienced episodes of ketoacidosis or hypoglycemic reactions (low blood sugar) that have required one or two hospitalizations per year or twice a month visits to a diabetic care provider? Explain.
  • Describe how your diabetic symptoms interfere with your life.

 

  1. Urinary % (Bladder, Kidneys, Prostate)

Urinary conditions are rated based upon how frequent or infrequent (voiding) you are able to urinate:

    • requires the use of a catheter or other urinary assistive appliance, or requires the use of absorbency underwear (like pads or depends) that must be changed more than 4 times a day – 60%
    • urinate 5+ times during the night, or if you have to urinate more than every hour during the day – 40%
    • urinate 3 or 4 times during the night, or if you have to urinate every 1 to 2 hours during the day – 20%
    • urinate 2 times during the night, or if you have to urinate every 2 to 3 hours during the day – 10%
  • State the formal diagnosis or persistent symptoms of your claimed condition. When and where was this condition initially diagnosed? (best estimate)
  • Does your urinary condition cause you to urinate more or less frequently? Explain how frequently or infrequently your condition causes you to urinate.
  • Describe how your urinary symptoms interfere with your life, especially your ability to work.

 

  1. Skin % (Eczema, Chloracne, Acne, Scars)
  • State the formal diagnosis or persistent symptoms of your claimed condition. When and where was this condition initially diagnosed? (best estimate)
  • Do you take any topical ointments or medications for this condition? For each medication you have taken, list the name, dosage, and frequency of use. Are you using or have used a corticosteroid or other immunosuppressive drug or topical medication or intensive light therapy?
  • Describe your symptoms related to this condition. If this condition interferes with your ability to work, explain how. Make sure to explicitly state if your condition is painful to the touch.

 

  1. Unemployability
  • How do your service connected conditions affect your ability to perform manual labor (ie. your ability to move around, bend, lift heavy objects, walk up and down stairs, etc.)?
  • How do your service connected conditions affect your ability to perform sedentary work (ie. your ability to concentrate on a certain task, adapt to stressful situations, interact with other people, etc.)?
  • Are you currently enrolled in school?
  • Do you have difficulty concentrating because of your service-connected conditions?
  • Did your school provide you with accommodations because of your service-connected conditions?
  • Did you ever miss class or struggle with attendance because of your service-connected conditions?
  • Are you currently employed full-time?

[IF YES — ask the following]

    • How long have you worked at your current job?
    • Does your employer provide special accommodations for your service-connected conditions?
      • Do you work shorter shifts or night shifts?
      • Is your work station away from people or are you given tasks that don’t involve regular interaction with others?
      • Is your employer very flexible with timeliness or attendance to attend doctor’s appointments?
      • When you are stressed, does your employer give you time to leave work and cool down?
    • Do you have a history of disciplinary actions at work?
    • How much time have you had to take out of work in the past year for doctor’s appointments, disciplinary actions, etc.?

 

[IF NO — ask the following]

    • When is the last time you worked full-time?
    • When you were employed, how much time did you have to take out of work for doctor’s appointments, disciplinary actions, etc.?
    • If you are currently retired, did you have to retire early because of your symptoms?

 

  1. Special Monthly Compensation (erectile dysfunction, loss of use, convalescence, housebound, aid & attendance)

Special Monthly Compensation (SMC) is an additional benefit for conditions that interfere uniquely with your day to day life. There are many different forms of SMC, but the main ones are for (a) loss of use of a creative organ, (b) convalescence (surgery), and (c) aid & attendance/housebound.

  • Loss of Use
    • Do you have a formal diagnosis related to loss of use of a creative organ (ie. erectile dysfunction, bladder removal, etc.)? When and where was this condition initially diagnosed? (best estimate)
  • Convalescence (Surgery)
    • What service-connected condition is requiring you to have surgery?
    • Where is the surgery scheduled to be held? (name of medical facility)
    • When is the surgery scheduled for? (exact date)
  • Aid & Attendance/Housebound
    • Describe your symptoms related to your service-connected conditions and how they affect your ability to perform activities of daily living (getting dressed, cooking, eating, showering, etc.).