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Unemployability or TDIU:

Understanding Total Disability Based on Individual Unemployability

Introduction: In certain cases, veterans with less than a 100% scheduler rating may be unable to work due to their service-connected conditions. To address this, the law provides an avenue for veterans to claim benefits at the 100% level even without a full scheduler rating. This benefit is known as "total disability based on individual unemployability" (TDIU), or simply "individual unemployability" (IU). In this blog, we will delve into the significance of TDIU and explain the requirements and considerations involved in making this claim.

Understanding the Percentage Requirements for TDIU Eligibility

1. Single Disability Rated at 60% or More:

  • To qualify for TDIU with a single disability, that disability must be rated at 60% or more by the VA. This means that the impact of this single service-connected condition on your ability to work and perform daily activities is significant enough to warrant a 60% disability rating.

2. Multiple Disabilities with a Combined Rating of 70% or More:

  • If you have multiple service-connected disabilities, you can qualify for TDIU if the combined rating of these disabilities is at least 70%.

  • Additionally, at least one of these disabilities must be rated at 40% or more.

Understanding TDIU:

TDIU benefits veterans who cannot engage in "substantially gainful employment" due to their service-connected conditions. Substantially gainful employment refers to holding a job that pays at least the annual poverty level set by the federal government. To qualify for TDIU benefits, the following requirements must be met:

  • Single Condition Rating: If the veteran has only one service-connected condition, that condition must be scheduler-rated at 60% or more.

  • Multiple Condition Rating: If the veteran has two or more service-connected conditions, at least one of those conditions must be rated at 40% or more, and the combined VA disability rating must be 70% or more.

  • Unemployability: Regardless of the number of conditions, the veteran must demonstrate that they are unemployable due to their service-connected conditions.

Establishing Unemployability:

To establish "unemployability" or the "inability to substantially maintain gainful employment," veterans must provide evidence of unemployment resulting from their service-connected conditions. This includes employment history records, such as hours worked, gross annual income, and dates of employment. Additionally, medical evidence, such as a doctor's opinion letter, is crucial in demonstrating that the service-connected condition renders the veteran totally disabled and unemployable.

Exceptions to TDIU Qualification:

Having a paying job does not automatically disqualify a claimant from receiving a TDIU award. There are exceptions that may allow employment while still qualifying for TDIU, including:

  • Marginal Employment: Working a job that pays substantially less than the prevailing poverty level. For example, a part-time job or low-paying job that does not provide a sustainable income.

  • Sheltered Employment: Holding a job that is protected from certain conditions or requirements that others in the same position would typically be expected to fulfill. This could include accommodations made by the employer specifically for the veteran's disability.

  • Employment with Friends or Relatives: Working for a friend or relative in a manner that would not be considered "substantially gainful employment." This typically involves working in a family business where the job is tailored to accommodate the veteran's limitations.

Evidence Needed to Qulify:

Includes medical documentation and employment history showing how disabilities affect work capability. TDIU provides compensation at the 100% disability rate, even if the veteran's disabilities are not rated at this level, recognizing the significant impact on employment. (Current Clients Click to File)

VA Form 21-8940: TDIU Application

Click to File This form is crucial for veterans seeking TDIU, designed for those whose service-connected disabilities prevent them from securing sustainable employment. Eligibility: Typically requires one disability rated at least 60% or a combined rating of 70% with one disability rated 40%.

 

VA Form 21-4140: Employment Questionnaire

Click to File An annual form for verifying the employment status of veterans receiving TDIU benefits, ensuring continued eligibility.

 

VA Form 21-4192: Request for Employment Information

Click to File Used by employers to provide a veteran's employment history, crucial for TDIU claims processing.

 

VA Form 21-2680: Examination for Housebound Status or Permanent Need for Regular Aid and Attendance

Click to File Assesses eligibility for A&A or Housebound benefits for veterans requiring daily personal assistance or substantially confined to their home. Eligibility: Veterans who require the aid of another person for personal functions daily, are bedridden, or are housebound.

 

VA Form 21-4142: Authorization to Release Information to the VA

Click to File Allows the VA to obtain medical records from non-VA providers, supporting the claim process.

 

VA Form 20-10207: Request for Priority Processing

Click to File For veterans facing severe financial hardship or terminal illness, expediting the claim review process.

 

VA Form 21-10210: Lay/Witness Statement

Click to File Enables provision of personal statements or witness accounts, supporting evidence for claims.

 

VA Form 21-4138: Statement in Support of Claim

Click to File Allows veterans to provide additional evidence or explanation supporting their claims. Importance: This form is critical for documenting specific circumstances or conditions related to service-connected disabilities, providing a platform for veterans to detail their experiences and the impact of their disabilities on their daily lives.

VA's Duty to Review TDIU Claims:

While it is ideal to submit a specific claim for TDIU, the VA has a duty to identify potential TDIU claims based on the evidence in the veteran's VA claims file, also known as a "C-file." Even if a veteran does not explicitly request TDIU, the VA is obligated to review the claims for TDIU as it is part of every claim for VA disability compensation. If the initial decision denies TDIU, the veteran can submit evidence of unemployability while a claim for scheduler benefits is still being processed.

Ongoing Monitoring and Obligations:

TDIU is not a permanent benefit, and the VA may require claimants to undergo periodic medical examinations to confirm their continued inability to work due to a service-connected condition. It is essential for veterans to attend these examinations and cooperate fully with the VA's requests. Claimants must also be cautious.

 

The Advocate Advice:

To enhance your chances of having a Total Disability Based on Individual Unemployability (TDIU) claim approved, it is crucial to meticulously gather and present all relevant medical evidence and employment history. This evidence should clearly illustrate how your service-connected disabilities hinder your capacity for gainful employment. A robust statement from your physician, detailing the extent of your disabilities and their impact on your work abilities, can significantly bolster your claim.

 

Additionally, personal statements that articulate the daily challenges posed by your disabilities can provide invaluable insights into your situation. Seeking guidance from a Veterans Service Organization (VSO) can also be instrumental in navigating the complexities of the application process, ensuring your claim is thorough and accurately reflects your circumstances. Remember, the goal is to convincingly demonstrate that your service-connected conditions directly contribute to your unemployability, thereby justifying your eligibility for TDIU benefits.

The VA Disability Advocates Main Office is Located in Las Vegas, NV. We Represent Veterans throughout the United States. 702-209-5722 

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