Gettting VA Benefits & Social Security Disability Benefits

Veteran's Administration (VA) Disability Criteria

As many readers aldready know, the VA pays benefits on the basis of individual impairments on a percentage basis. Then the VA calculates each individual impairment rating into an overall disability percentage rating. Benefit amounts are paid on the basis of this overall rating. I have heard it said that the calculation of the individual ratings into the overall rating is "VA math."

Social Security Disability Criteria

Social Security benefits are paid to you as an adult if you cannot perform full-time work. "Full-time work" is a bit complicated under Social Security law, and a longer discussion is discussed here - Overview - SSI/SSDI Disability Benefits. It is an all-or-nothing full-time work determination; there are no percentages of any medical impairment.

Getting Both VA and Social Security Disability Benefits

Social Security Disabilty Insurance (SSDI) Benefits

SSDI benefits are paid to you if you have Social Security work credits awarded to you by the Social Security Administration by virtue of your work history, and you are disabled. You can receive both SSDI and VA benefits at the same time. That's correct, you get both. Neither benefit offsets/reduces the other.

Example. You have a VA disability rating, and you are receiving $1,500 in monthly VA disability benefits. You apply for and are awarded Social Security disability benefits. You begin receiving $1,600 in monthly Social Security benefits, and you receive $30,000 in backpay. You will continue to receive your monthly VA benefits of $1,500. You will also receive the monthly Social Security disability benefits of $1,600. Hence, you will receive $3,100 in combined VA and SSDI disability monthly benefits. You will keep your all of your $30,000 in Social Security disability backpay.

Supplemental Security Income (SSI) Disability Benefits

To receive SSI disability benefits, you must be disabled, and your income and resources must be below certain financial limits. If you receive VA disability benefits and SSI disability benefits, your SSI disability benefits will be reduced.

Social Security condsiders your monthly VA disability benefits unearned income. But for $20, Social Security will reduce your monthly SSI benefits dollar-for-dollar against your VA benefits.

Example 1. You receive $1,500 in monthly VA disability benefits. You are awarded monthly SSI disability benefits in the amount of $970. Social Security will take $1,500 and minus $20 equalling $1,480. Because $1,480 is more than $970, you will receive no SSI disability benefits as there is a total offset.

Example 2. You receive $800 in monthly VA disability benefits. You are awarded monthly SSI benefits in the amount of $970. Social Security will take $800 and minus $20 equalling $780. Social Security will then take $970 and minus $780 dollar-for-dollar equalling $190. You will continue to receive your monthly VA benefits, and you will receive $190 in monthly SSI disability benefits.

How Social Security Evaluates Your VA Award

Social Security, officially, is not required to consider a VA rating decision, and Social Security does not give any weight to a VA rating decision. Even if you have received a 100% disability rating, or a lesser rating and deemed unemployable, Social Security will not officially consider the VA rating in determining whether you are disabled under Social Security's rules. This may seem strange since both administrations are federal and both are evaluating disability, but the Social Security takes the position that the disability criteria for VA benefits is different than the disability criteria for Social Security benefits.

It is my opinion that unoffcially, certain Social Security adjudicators and administrative law judges (ALJ) do consider your 100% rating important. Obviously, your medical condition is severe, and after all, you were found totally disabled by another federal administration. That said, I have experienced Social Security disability clients with 100% VA disability ratings lose their Social Secuirty case.

Social Security is required to consider the Compensation and Pension (C&P) exams as these constiute medical evidence written by a medical professional. These exams are only sometimes a part of your medical records or your MyHealtheVet account. Hence, one needs to specially request the C&P evalutions when ordering medical records from the VA.

If you want to read more about the Social Security's position on this issue, you can read the following: CFR 404.1504.

Expedited SSA Claim Processing

For a veteran with a 100% disability rating, Social Security will expedite (speed up) the processing of your Social Security disability claim. Generally, an initial level decision takes about eight months, a reconsideration level decision takes about eight months, and a hearing level decision takes about 12 months. My estimation is that the Social Security will process these timelines for a veteran with a 100% disability rating about 25% to 33% faster than a non-100% veteran.

Medicare/Medicaid and VA Medical Benefits/TRICARE

Social Security disability recipients are entitled to Medicare (SSDI) or Medicaid (SSI). For nearly all SSDI disability recipients, Medicare is mandatory. Medicare requires a monthly premium and co-pays the recipient must pay; it is expensive. However, if you are entitled to VA medical benefits, you are allowed to decline Medicare. If you are entitled to VA medical benefits, and you accept Medicare, you will pay for Medicare premiums and co-pays, and you will have two forms of medical insurance. Medicare will allow you to obtain medical care outside of the VA. If you are entitled to VA medical benefits and TRICARE, and you accept Medicare, and you obtain medical care outside the VA, Medicare will be the first payer, and TRICARE the second. Generally, a combination of both Medicare and TRICARE will result in you paying for Medicare premiums but not co-pays.