Non-Clinical Topics   /   TBI

50-Year-Old VA Disability Rating System Just Now Being Fully Revised

USM By U.S. Medicine
March 12, 2012

By Stephen Spotswood

WASHINGTON — For more than 50 years, the VA Schedule for Rating Disabilities (VASRD) has been the mechanism for determining how much disability compensation is provided to veterans. While the system has seen minor adjustments over time, a sweeping revision has never been attempted — until now.

VA is drafting a new VASRD, which, among other things, will put the rating system for mental-health conditions on par with the system for physical disabilities. According to legislators, veterans’ advocates and officials in charge of revising the system, the current schedule results in regular undercompensation of veterans with mental-health conditions, such as PTSD. 

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The VASRD, which is divided into 15 body systems containing more than 700 diagnostic codes, establishes disabilities by assigning percentages in 10% increments on a scale from 0% disabled to 100% disabled. Ratings are based on the average impairments to a veteran’s earning capacity.

In 2004, Congress created the Veterans’ Disability Benefits Commission, which conducted a two-year analysis of the benefits and services available to veterans. The commission concluded that the rating system needed updating and that the rating schedule is outdated.

The commission recommended that the schedule incorporate advances in medical and rehabilitative care, as well as a greater appreciation of certain disabilities, including PTSD.

“We should not be satisfied with a World War II-era system for rating and evaluating veterans’ disabilities,” said Rep. Jon Runyan (R-NJ), chairman of the House VA Subcommittee on Disability Assistance and Memorial Affairs at a recent hearing. “The more-recent updates to diagnostic criteria for newer types of injuries, such as TBI, were a step in the right direction. However, I believe it is our duty to be vigilant in pressing for continued revision reflecting the continued advances and understanding in medical care and treatment.”

Difficulty Holding Jobs

Runyan’s opinion echoes that of veteran service organizations (VSOs). A survey conducted by the Wounded Warrior Project (WWP) found that, of more than 5,800 servicemembers and veterans wounded since 2001, more than 2,300 reported that mental-health issues made it difficult to obtain employment or hold jobs, and two-thirds reported that emotional problems had substantially interfered with their ability to work.

More than 62% were experiencing depression, and only 8% had not experienced mental-health concerns since deployment.

“The biggest challenge we see is to make the rating system for mental-health conditions as fair as possible,” said Frank Logalbo, WWP’s national service director. “Deep flaws in VA’s rating criteria pose real problems for warriors bearing psychic combat wounds.”

 Logalbo’s opinion is backed up by hard research. A panel convened by the Institute of Medicine in 2007 characterized VA’s schedule of ratings for mental disorders as far too general of an instrument to properly assess PTSD disability, and said that VA needs ratings criteria specific to PTSD.

VA has acknowledged that its ratings system, especially the mental health portion of it, needs thorough revision. Beginning in October 2009, VA began a comprehensive revision and update, one body system at a time, of its rating schedule.

Retired Lt. Gen. James Terry Scott, chairman of VA’s Advisory Committee on Disability Compensation, admitted to legislators that veterans with mental-health problems were getting short shrift when it came to their disability ratings.

“Analysis shows that veterans suffering from mental disabilities were undercompensated across the board,” Scott told legislators. “One of the things we’re looking at is how to change the rating schedule to recognize that.”

“What I think we’re going to see is that the degree of disability associated with PTSD is going to be recognized in terms of a higher disability rating [after the schedule’s revision],” Scott said. “You’ll see more people suffering from the more severe PTSD rated at 100%, as opposed to the lower percentage the current criteria seems to place them.”

One of the other areas the revision is targeting is the legalese inherent in the ratings process. According to Tom Murphy, Veterans Benefits Administration’s director of compensation services, VA plans to simplify the process, including the language.

“We realize that our notification process has a lot of legal explanation in there,” Murphy said. “We’re in a pilot phase right now where we’re simplifying that. We’re putting things into plain English, so we can explain it to veterans in such a way that you don’t need a legal degree to interpret.”

Each of the 15 body systems being revised in the VASRD will be published as a draft in the Federal Register and opened for public comment. If the comments are extensive, the draft will be revised and republished.

“A little extra time now will save us significant time [later],” Murphy said.

The full revision is expected to be finished by 2016.

PTSD Compensation and Military Service

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