How will my VA Rating affect my Social Security Disability decision?
Short answer: It has NO effect at all.
Your VA rating will not impact your Social Security Disability decision. Why not? Read on.
Changes in SSDI: How does the VA disability rating factor into an SSDI decision?
Many veterans come to us with a VA Rating of 100% Permanent and Total Disability, and expect to easily win an SSA claim for disability.
Unfortunately, the VA’s 100% rating means NOTHING to SSA when deciding a claim. SSA does not even consider the VA’s rating, when deciding whether someone qualifies for Social Security Disability benefits.
In fact, ALJ judges no longer even have to mention the VA rating in their decision letters.
On January 18, 2017, SSA published the “Revisions to Rules Regarding the Evaluation of Medical Evidence.”  The section on “Decisions by other governmental agencies” was revised to make it very clear that determinations by the VA are not binding on Social Security decisions, and ALJ judges no longer have to justify their actions when they disregard a VA rating.
Language of this revised rule:
“Revise § 404.1504 to read as follows:
- 404.1504 Decisions by other governmental agencies and nongovernmental entities.
Other governmental agencies and nongovernmental entities—such as the Department of Veterans Affairs, the Department of Defense, the Department of Labor, the Office of Personnel Management, State agencies, and private insurers— make disability, blindness, employability, Medicaid, workers’ compensation, and other benefits decisions for their own programs using their own rules. Because a decision by any other governmental agency or a nongovernmental entity about whether you are disabled, blind, employable, or entitled to any benefits is based on its rules, it is not binding on us and is not our decision about whether you are disabled or blind under our rules. Therefore, in claims filed (see § 404.614) on or after March 27, 2017, we will not provide any analysis in our determination or decision about a decision made by any other governmental agency or a nongovernmental entity about whether you are disabled, blind, employable, or entitled to any benefits. However, we will consider all of the supporting evidence underlying the other governmental agency or nongovernmental entity’s decision that we receive as evidence in your claim in accordance with § 404.1513(a)(1) through(4). “
Many arguments were made against this revision. For example:
Comments made to SSA:
- Some commenters stated these decisions are important evidence that [SSA] should always discuss because the rules or purposes of other disability programs are similar to [SSA] programs
- Some commenters suggested [SSA] provide additional training to adjudicators about the standards used by other governmental agencies and nongovernmental entities.
- Other commenters asserted that the Department of Veterans Affairs (VA) 100% disability ratings and Individual Unemployability (IU) ratings are highly probative to [SSA] decisionmaking by pointing to [SSA’s] own research showing veterans are substantially more likely to be found disabled than the general population of applicants.
- A few commenters said [SSA] should adopt a VA 100% disability rating or have a rebuttable presumption that someone with a VA disability rating is entitled to disability under the Act.
“While we acknowledge the commenters’ concerns, we are adopting our proposal in these final rules. As we stated in the notice of proposed rulemaking (NPRM), there are four reasons why we are not requiring our adjudicators to explain their consideration of these decisions—
(1) the Act’s purpose and specific eligibility requirements for disability and blindness differ significantly from the purpose and eligibility requirements of other programs;
(2) the other agency or entity’s decision may not be in the record or may not include any explanation of how the decision was made, or what standards applied in making the decision;
(3) our adjudicators generally do not have a detailed understanding of the rules other agencies or entities apply to make their decisions; and
(4) over time Federal courts have interpreted and applied our rules and Social Security Ruling (SSR) 06–03p differently in different jurisdictions.”
What this looks like:
SSA will still look at test results and other medical records, when they evaluate your claim for disability benefits. They just won’t consider your actual VA disability rating. They may even disregard the opinions of VA examiners, altogether.
I agree that SSA should not blindly adopt a VA 100% disability rating, as the VA system and Social Security Disability systems do have very different rules and requirements for benefits. However, I do think the ALJ judge should consider a VA disability rating when deciding a claim.
Disabled veterans undergo extensive examinations, evaluations, and testing during their C&P exams, and often go through this process more than once. All of the exams, test results, and OPINIONS of the VA should be considered by the ALJ judge.
However, this is not how things are done. So, having a 100% disability rating from the VA does not necessarily mean you will receive a favorable decision on your SSDI claim. In fact, the ALJ judge can completely disregard your VA rating with no explanation, whatsoever.
Preparing for your disability claim:
It is VERY IMPORTANT that veterans continue to see their doctors and specialists, and undergo testing, counseling, etc. All of this treatment is medical evidence that will be used when deciding a Social Security disability claim.
 SSA’s Revisions To Rules Regarding The Evaluation Of Medical Evidence. https://www.ssa.gov/disability/professionals/bluebook/revisions-rules.html
 Federal Register, Vol. 82, No 11. Wednesday, January 18, 2017. Rules and Regulations. https://www.ssa.gov/disability/professionals/bluebook/documents/Medical Evidence Final Published.1.18.17.pdf
Originally published here: December 11, 2017
An abridged version of this article was published in the November 2017 edition of the Hardin Disability newsletter.
Last updated: January 31, 2018 at 8:07 am
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