Fallacy Series: 100% Mental Health

There are some Veterans who have been assigned a rating of 100% for PTSD or other mental health category and because they are not TDIU (assigned less than 100%, but paid at 100%), believe they can work full time and earn as much as they want, without consequences.

They are wrong. They cannot.

There are three different ways to get paid at the 100% rate:

  • Be assigned multiple ratings that add up to 100%; and
  • Be awarded TDIU.
  • Be assigned a single rating that is 100%; or

In the first case, you can work and earn as much as you want.

In the second case you can work and earn, provided that you don’t earn more than the current poverty rate.

In the last case it depends on the single condition that the 100% rating was assigned.

Let’s compare two disparate conditions at the 100% level using 38 CFR Part 4 subpart B:

  • Endocarditis: "For three months following cessation of therapy for active infection with cardiac involvement"
  • Mental Health: "Total occupational and social impairment…"
Medical Opinion

In the first case, the criteria does not include occupational impairment. Therefore if you are assigned the rating, you are not restricted from having gainful employment.

In the case of mental health, you are not restricted in earning capacity because you are assigned the 100% rating, but the criteria of the rating itself requires "total occupational and social impairmentt," not "partial."

Therefore, by definition, if you work and have gainful employment, you cannot be assigned the 100% assignment of this rating. If you can work, at most you can be rated at the 70% level. You simply do not qualify for 100% by definition.

It is solely because the definition of the assignment of that severity rating, as it pertains to the mental health category of conditions, requires "total occupational and social impairment."

In some cases VA assigns this rating while the person is still working. That could be due to error or because the Veteran exaggerated their symptoms. Maybe VA didn’t realize the Veteran was capable of working, and assigned an improper rating.

If VA finds out, VA will reduce your percentage if you maintain gainful employment - and they should. The assignment of that rating is not conducive to a Veteran having the ability to work.

VA can reassess the initial claim and determine fraud occurred. If that happens, all money paid can be reclaimed, all service connections can be terminated, and criminal charges can be filed.

We firmly support all Veterans and want everyone to attempt to maintain gainful employment. Some may need therapy or medications to get there, but once they do and they can hold down a job, they should. It’s the American way to support yourself if you can. However, it also means that you won’t be able to maintain the 100% mental health rating.

The VA will reassess and determine that your mental health condition has improved, which is fantastic! So don’t get trapped in thinking you have to stay completely incapacitated. Work to get better and be grateful when you can hold down a job and your disability rating goes down. It’s a sign you are getting better. The reduction should be celebrated not feared. Work toward a better you. Work toward getting better.

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