Permanent and Total (PT), AKA 100% P&T, AKA TDIU P&T
Permanent and Total (P&T) is a special status that denotes a Veteran as being paid at the 100% rate (total) as well as their disabilities being considered static (permanent).
When you look at your decision letter itself, it will NOT state you were awarded permanent and total. Your decision letter will instead state that you have been granted entitlement to Dependents Educational Assistance (DEA).
IMPORTANT NOTE:
Permanent IS a misnomer! It does NOT mean that you cannot be reduced! The only time the VA CANNOT reduce an evaluation, is if you have held an evaluation for at least 20 years (barring instances of fraud)!
P&T veterans do NOT have regularly scheduled reexaminations. UNLESS, a non-static condition makes/or could make the veteran entitled to Special Monthly Compensation (SMC). In which case, only the non-static condition is reexamined til such time as it becomes considered considered permanent 'static'.
Statutory P&T
Veterans with the following service connected disabilities are considered P&T automatically:
Loss of the use of both feet;
Loss of both hands;
Loss of both eyes;
Loss of one foot and one hand;
Loss of one foot and one eye;
Loss of one hand and one eye;
Loss of hearing of both ears;
Organic loss of speech; or
Permanently helpless or permanently bedridden.
Veterans with these disabilities are also entitled to SMC.
Active pulmonary tuberculosis will be considered permanently and totally disabling for Non-service-connected pension purposes if 1 of the following circumstances is meet:
Associated with active tuberculosis involving other than the respiratory system;
With severe associated symptoms or with extensive cavity formation; and/or
Reactivated cases, generally;
With advancement of lesions on successive examinations or while under treatment.
Without retrogression of lesions or other evidence of material improvement at the end of 6 months hospitalization or without change of diagnosis from “active” at the end of 12 months hospitalization. Material improvement means lessening or absence of clinical symptoms, and X-ray findings of a stationary or retrogressive lesion.
Becoming P&T (outside of statutory P&T)
As previously mentioned, P&T has two parts:
Total (you are paid at the 100% rate); and
Permanent 'static' (the condition(s) that make up the total are unlikely to improve).
Which means outside of statutory P&T you need:
Permanent 'Static'
VBA's current Policy boils down to:
Raters are to make everything static UNLESS:
The rating schedule states a condition MUST be reevaluated; or
There is some other statutory requirement that a condition be reevaluated.
That said, in VERY RARE circumstances, the rater CAN deviate from this policy if there is VERY strong and convincing evidence that the condition is likely to improve in the future.
However, if the Veteran is at least 55 years old or the condition is rated at the minimum compensational (at least 10%) evaluation - the rater CANNOT make the condition not static, UNLESS there is a statutory or Rating schedule requirement that the condition be reevaluated.
But know in MOST cases, if you are now rated 100% combined that you will be made P&T.
Common Examples of Non-Static Conditions:
These are some examples of conditions that have mandatory reevaluations and generally cannot be made static in an initial grant.
Cancers*
Diabetes insipidus (if rated within 3 months of the initial diagnosis)
Mental health condition due to traumatic stress and is the basis of a Medboard (condition MUST be reevaluated after 6 months of separation)
Stroke (if rated within 6 months of the stroke)
Thyroid conditions (if rated shortly after initial diagnosis)
If your doctor thinks your cancer is *at least as likely as not, unlikely to go into remission before the end or your life and/or cancer treatment is at least as likely as not going to continue for the rest of your life. You may submit their statement to the VA requesting the condition become considered static with a Claim for increase.
Additional Benefits
Veterans who are P&T are entitled to many additional benefits that other 100% Veterans are not. Here are some examples:
For a list of Federal benefits based off combined rating. Click HERE.
Mostly HISTORICAL EXAMPLE
The following example is for the most-part historical since as previously stated, most conditions will now be made static out the gate. However, Veterans who were rated BEFORE October 2021 were more likely to have conditions found to be non-static due to raters getting more freedom to consider conditions non-static.
VA Math Example of Becoming P&T
Having more disabilities that combine over 100% scheduler does NOT necessarily increase the likelihood that the Veteran will become P&T! This is particularly true if those new disabilities/increases are not considered static.
| Jane's Ratings | Static | Combined Ratings Table | Jane's Combined Total Rating (Starts at 0%) |
|---|---|---|---|
| Mental Health = 70% | No | 70% | |
| Bi-Lateral Plantar Fasciitis = 50% | Yes | Row:70%, Col:50% | 85% |
| Back = 40% | Yes | Row:85%, Col:40% | 91% |
| Migraines = 30% | No | Row:91%, Col:30% | 94% |
| IBS = 30% | No | Row:94%, Col:30% | 97% |
| Right Shoulder = 20% | Yes | Row:97%, Col:20% | 99% |
| Tinnitus = 10% | Yes | Row:99%, Col:10% | 99% |
| Neck = 10% | Yes | Row:99%, Col:10% | 99% |
Jane's Combined Rating rounds up to 100%.
P&T?: NO, because their combined static disabilities does not round up to 100%.
Static Math Breakdown
| Jane's Ratings | Static | Combined Ratings Table | Jane's Combined Total Rating (Starts at 0%) |
|---|---|---|---|
| Bi-Lateral Plantar Fasciitis = 50% | Yes | 50% | |
| Back = 40% | Yes | Row:50%, Col:40% | 70% |
| Right Shoulder = 20% | Yes | Row:70%, Col:20% | 76% |
| Tinnitus = 10% | Yes | Row:76%, Col:10% | 78% |
| Neck = 10% | Yes | Row:78%, Col:10% | 80% |
Jane's Static Combined Rating is 80%.
Again, if Jane wanted to become P&T, she would need to have enough static disabilities that combined to 100% scheduler to become P&T.
Frequently Asked Questions
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While uncommon, sometimes raters overlook a grant of P&T. Whenever you are 100% combined and all your conditions are static, but P&T was NOT awarded, the VA will automatically establish an audit (usually within 2 weeks of the rating decision). These audits are conducted by a human who will then give you a grant of P&T, assuming there are no other issues at play.
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Yes, see the TDIU page for more information.
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If the conditions that make up your 100%/TDIU evaluation are all static; The VBA WILL automatically establish (in around 2 weeks) an audit 'review claim' to determine if the rater forgot to make you P&T. So you do not need to do anything.
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Yes.
Veterans can send a request to their VA Regional Office. Your doctor's letter should explain why your condition(s) are not likely to improve. Veterans should include any relevant medical documentation and other evidence that helps prove their service-connected disabilities are not likely to improve.
OR
A Veteran may request an increase on their conditions. After the reevaluation, the Veteran's conditions may become considered static, which would result in the Veteran becoming P&T.
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Veterans may request their C-File which will contain their code sheet. The code sheet will list all the Veteran's conditions and whether the conditions are static or not. Your VSO also may be able to obtain your code sheet for you.
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Click HERE to learn how.
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No, a Veteran's ratings are only truly Protected once they have held that rating for 20 years. After 20 years the only way a rating can be changed is in case of fraud. In this case, the ratings will be removed whenever the fraud is discovered.
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Unless you filed a new claim, you should not have a Reevaluation and this could be an error. However, since the VA does do audits which may identify potential issues with a previous rating decision. It is STRONGLY advised to NOT MISS the C&P exam, as missing the exam may result in you losing your P&T status and your evaluation(s) being Proposed to be reduced/severed!
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No, Veterans who are P&T simply no longer have regularly scheduled reexaminations. The Veteran still is bound by TDIU income limits.
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Organic loss of speech means the loss of the ability to express oneself, both by voice and whisper, through the normal organs of speech if such loss is caused by organic changes in such organs. Where such loss exists, the fact that some speech can be produced through the use of an artificial appliance or other organs of the body will be disregarded.
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Not purely because you had the surgery.
Generally the VA does not care if you have had a surgery. For more information click HERE.
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Yes, the only P&T Veterans who have work restrictions are those who were awarded TDIU.
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On va.gov via the VA Benefit Summary letter. Once logged in, click the green box “Get your VA benefit letters,” then “View letters,” then “VA Letters,” and finally “Benefit Summary and Service Verification Letter.” Scroll down and check the section that says, “You are considered to be totally and permanently disabled due solely to your service-connected disabilities.” If it say are you are, if it say aren't you aren't.
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References
38 CFR § 4.28 Prestabilization rating from date of discharge from service
38 CFR § 6.18 - Other disabilities deemed to be total and permanent
M21-1, Part IV, Subpart ii, Chapter 1, Section A - Determining the Need for Review Examinations
M21-1, Part V, Subpart ii, Chapter 3, Section D - Evaluating Disabilities
M21-1, Part VIII, Subpart iv, Chapter 8, Section A - Prestabilization Ratings Under 38 CFR 4.28