Vets’ disability benefits for tinnitus, mental health issues may change

Proposed changes to the Department of Veterans Affairs disability ratings system will mean lower payouts for veterans with sleep apnea and tinnitus in the future but higher payouts for veterans facing mental health challenges like post-traumatic stress disorder and depression.

The changes are part of a months-long review of the department’s Schedule for Rating Disabilities, which governs how VA staffers evaluate and compensate veterans with service-connected injuries.

In a statement, Thomas Murphy, acting VA undersecretary for benefits, said the goal of the work was not to reduce or increase the number of veterans receiving disability benefits but instead to ensure that “veterans receive decisions based on the most current medical knowledge relating to their condition.”

For veterans currently receiving those payouts, the changes will not take away any existing benefits or lower their disability rating. They could see their ratings increased based on the changes, if the new rules end up more advantageous to their health situation.

But veterans who apply for benefits in the future will see a different set of standards applied to their cases than their older peers, and that could have significant financial ramifications for those individuals.

Under VA rules, a disability rating of at least 10 percent can mean monthly payouts of more than $140 for a veteran. One who receives a disability rating of 100 percent — either from a single service-related condition or a combination of injuries and illnesses — can get about $3,100 a month in disability compensation.

VA did not provide any information on how the changes will affect its budget.

Outside critics have lamented that the current ratings system too frequently compensates veterans for conditions that are treatable and do not prevent them from maintaining a full-time job.

But veterans advocates have said the system is still cumbersome and difficult to navigate, often forcing veterans to wait for months or years to get compensation for disabling conditions that are obvious to even those without a medical degree.

The number of veterans receiving compensation for sleep apnea — interrupted breathing during sleep — has risen sharply in recent years, from less than 1 million individuals in fiscal 2015 to more than 1.3 million in fiscal 2019, according to the department’s inspector general.

Under proposed changes outlined in the Federal Register on Tuesday, VA officials for the first time could offer a “0 percent evaluation” for asymptomatic sleep apnea, allowing the department to formally acknowledge a veteran’s condition without requiring any compensation if the condition is easily controlled with treatment.

Veterans would receive ratings of 10 percent or more for sleep apnea “only when treatment is either ineffective or the veteran is unable to use the prescribed treatment due to comorbid conditions.” Currently, veterans can receive a rating of 10 percent or more for the condition even if treatments are effective at dealing with the condition.

Similarly, veterans diagnosed with tinnitus — a high-pitched ringing caused by damage to the ears — would face a higher bar for higher levels of disability compensation. More than 1.5 million veterans are currently receiving disability benefits for the condition.

Instead of evaluating veterans just on the frequencies they can discern in hearing tests, evaluators in the new plan would review whether veterans can understand specific words or if the condition is “a symptom of an underlying disease, rather than a stand-alone disability.”

Officials said those changes would likely reduce the number of veterans qualifying for disability ratings of 10 percent or more, although they noted the number of veterans who have the condition entered into their case files for future reference would not change.

In contrast, veterans dealing with mental health issues would see a lower bar for getting increased disability ratings under the changes.

Conditions like anxiety, depression or post-traumatic stress disorder would be evaluated on how they affect veteran’s ability to perform everyday functions, with even mild impairment available for compensation.

The proposed rules state the changes better recognize the impact of mental health on individuals’ well-being “by placing greater emphasis on a disabled veteran’s ability to function in the work setting, rather than focusing on symptoms alone.”

Past VA studies have estimated as many as one in every eight veterans may suffer from post-traumatic stress or related mental health issues, but outside experts have said the requirements for proving impairment under the current disability ratings system remains difficult.

VA officials do not have a planned implementation date for the ratings changes. The public has 60 days to provide feedback on the proposals before any final deadlines can be set.

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