Some veterans return from their time in uniform with a severe service-connected disability that drastically affects their day-to-day existence as they’re transitioning back into civilian life. Some of those individuals may qualify for what is known as Permanent and Total Disability status from U.S. Department of Veterans Affairs that could dramatically improve their financial well being.
Below, we cover all you need to know about Permanent and Total Disability.
Table of Contents
- 1 Permanent and Total VA Disability
- 2 Permanent and Total Disability for PTSD
- 3 Special Monthly Compensation (SMC) for Service Connected Permanent and Total Disability
Permanent and Total VA Disability
Wounded veterans can apply to have student loans forgiven, but the process of getting their loans discharged can be a lengthy process. In order to have your loans completely forgiven, you’ll have to receive what is known as a Permanent and Total Disability rating by the VA.
Once granted, the Department of Education will grant a Total and Permanent Disability (TPD) discharge, relieving you from having to pay back or complete the following:
- William D. Ford Federal Direct Loan (Direct Loan) Program loan
- Federal Family Education Loan (FFEL) Program loan
- Federal Perkins Loan (Perkins Loan) Program loan
- Teacher Education Assistance for College and Higher Education (TEACH) Grant service obligation
What Does Permanent and Total Disability Mean?
Permanent and total disability, otherwise known as P&T, refers to veterans who have disabilities that are total (rated 100 percent disabling by the VA) and permanent (zero or very little chance of improving). Though the two are often used as a single phrase, veterans might have a total disability that is considered to be temporary, or have a permanent disability that is rated at less than 100 percent.
The benefits you’re available to access depend on the severity of your disability as determined by the VA, based on the evidence you submit as a part of your claim, or based on information from your military records. VA rates disability on a 0 percent to 100 percent scale in 10 percent increments. In other words, disability benefits are rated on a scale based on how your disability affects your ability to work and perform basic skills like driving, bathing, or otherwise taking care of yourself without assistance.
If you have multiple disabilities, as determined by the VA, your disabilities will be arranged by order of severity, beginning with your “greatest disability” and your percentages will be calculated using the VA’s Combined Ratings Table and rounded either up or down to the nearest number that is divisible by 10.
There are a few combinations of disabilities that are automatically deemed to have a 100 percent Permanent and Total, including the loss or use of
- Both hands
- Both feet
- One hand and one foot
- Sight in both eyes, or
- Becoming permanently bedridden
However, the current evaluation system used by the VA is more focused on the residual conditions rather than the severity of the original, in-service injury you experienced.
If you have symptoms that are connected to both a service-connected disability and an out-of service disability and the cause of your symptoms are hard to pinpoint, the VA is required by law required to apply what is known as a “benefit of the doubt” rule. In essence, if the VA can’t determine which disability is causing your symptoms, they are to assume that it is due to the service-connected disability so that you receive VA benefits.
These ratings can also change if your symptoms and injuries better or worsen. If you believe that your disability is unlikely to improve at any point in the future and have the medical evidence to back up your claim, you can write a letter to your VA Regional Office requesting a permanent rating.
How to Get Permanent and Total Disability Status From the VA
If you believe you might be entitled to compensation or student loan forgiveness because of your disability, it’s important that you go through the necessary steps to be evaluated by the VA.
In order to get this process started, the VA office recommends obtaining an eBenefits account and applying online.
In order to do successfully fill out an application, you must have access to the following information:
- Discharge or separation papers (DD213)
- Medical evidence (doctor and hospital reports)
- Dependency records (marriage and children’s birth certificates)
The VA also notes that as an alternative, service members have the option to print and mail-in VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits or call VA at 1-800-827-1000 to have the form mailed to you.
Since the process is often lengthy, you may be able to receive disability compensation benefits in a more timely manner if you apply prior to your discharge from military service through the Benefits Delivery at Discharge (BDD) or Quick Start pre-discharge programs.
Permanent and Total Disability for PTSD
Many soldiers suffer from from Post Traumatic Stress Disorder as a result of lived trauma, a dangerous event, or otherwise harrowing experience.
According to reports by the VA, 11-20 percent of veterans who served in Operations Iraqi Freedom and Enduring Freedom struggle with PTSD symptoms, 12 percent of those who served in Desert Storm struggle with PTSD symptoms, and 15 percent of those who served in the Vietnam War struggle with PTSD symptoms (though it’s worth noting that 30 percent of Vietnam veterans have been diagnosed at some point in their lifetime).
The chances of developing PTSD are much higher if you’ve been in the military. For the general population, 10 percent of women will experience a PTSD diagnosis in their lifetime, and nearly 4 percent of men will receive a similar diagnosis.
How PTSD Can Affect Your Permanent and Total Rating
When you receive a PTSD diagnosis from the VA, you might not receive a Permanent and Total rating, even if you have a 100 percent total rating for your PTSD. This is due, in part, to the difficulty of diagnosing PTSD correctly.
“Diagnosing PTSD can be difficult in the best of circumstances,” Alan Zarembo explained to the LA Times. “Experts have long debated how to define the condition. One person can suffer crippling anxiety from an experience that wouldn’t faze someone else.”
It may also difficult to access a Permanent and Total rating for PTSD with the VA, because many mental health disabilities can improve over time with proper treatment from a psychological professional.
Why the VA Prefers Treatment for PTSD
As previously mentioned, it is the VA’s assessment that service members who have diagnosed with PTSD have symptoms that will improve over time with treatment and psychological help from a licensed expert.
There is truth to this. A recent study published in JAMA Psychiatry looked at 1,888 veterans who had begun prolonged exposure therapy in order to treat their PTSD symptoms. Over 800 of those veterans would go on to fall below the threshold for PTSD on a standard assessment scale. Those traumas not only included from their time in combat, but also included sexual violence as well as painful childhood experiences.
“If a person has a meaningful response [to treatment], they have a meaningful improvement in their quality of life,” Dr. Paula Schnurr, the executive director of the National Center for PTSD under the U.S. Department of Veterans Affairs tells the Times, adding that many treatments for other mental health conditions have similar outcomes. “As scientists we will always try to enhance the effectiveness of these treatments for more people…My takeaway message [from the study] is one of optimism and also encouragement for people to seek treatment.”
Getting Help With PTSD
If you’re a veteran who believes you could benefit from PTSD treatment or help, or a family member of someone who has been recently diagnosed, the VA’s National Center for Posttraumatic Stress Disorder has put together a comprehensive website called About Face that allows you to hear other veteran’s stories and experiences with treatment. This resource also allows you to get advice from VA clinicians who regularly treat veterans with PTSD.
For more information about potential treatment options for PTSD, visit the U.S. Department of Veterans Affairs website, or the American Psychological Association’s recommendations.
If you are a family member of a person who may be living with PTSD, you can find out more about how to best support them through the U.S. Department of Veterans Affairs PTSD resource guide for families.
Special Monthly Compensation (SMC) for Service Connected Permanent and Total Disability
Special Monthly Compensation (SMC) is an additional benefit that veterans may be entitled to. This tax-free benefit can be paid to Veterans, their spouses, surviving spouses, and parents due to special circumstances.
If you, for example, need aid of a nurse, caretaker, or family member for your specific disability, you may qualify for SMC benefits.
These rates you receive typically change annually and can get complicated depending on your individual circumstances as well as your disability rating. For specific information about how to calculate what you might be eligible for based on your specific circumstances, visit the VA’s website here.
Since the VA has a duty to maximize a veteran’s benefits, SMC is not something a veteran has to formally request of the VA. Rather, the VA will consider it when making a decision on the initial claim. If you have not been granted SMC benefits and you believe you were eligible for them, you may be entitled for retroactive benefits or make a claim with the VA indicating there has been an error in their processing of your claim.
Other Benefits You Might Be Eligible For
The VA also has additional housing and insurance benefits to Veterans with disabilities including, Adapted Housing grants, Service-Disable Veterans’ Insurance, and Veterans’ Mortgage Life Insurance. For a full list of benefits you might be entitled to as well as a glossary of terms, visit the Veterans Benefits Administration page on the U.S. Department of Veterans Affairs website.
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