As you are likely aware, when you are awarded service connection by the VA, your service connected condition is also assigned a rating. However, for some veterans, the objective criteria in the disability rating schedule may not accurately reflect their true level of disability. In such cases, the VA is able to consider certain additional factors in order to determine if a veteran’s specific disability warrants an increase in evaluation, or in other words, an extraschedular rating.
There are two things a veteran must be prepared to show in order to be awarded an extraschedular rating. First, the veteran must show that the evaluation under the disability rating schedule does not take into consideration the veteran’s level of disability and symptomatology and is therefore inadequate to rate the veteran’s disability. Second, the veteran must be able to show that his or her disability has other related factors such as marked interference with employment or frequent periods of hospitalization.
The first step in determining whether an extraschedular rating is appropriate is to find the diagnostic code used to rate your disability and look up the code in the VA’s disability rating schedule that is linked above. This will show you what symptoms the VA is looking for when it rates disabilities. After finding the appropriate diagnostic code for your condition, you should determine all of the additional symptoms that you have that are not covered under the VA’s disability rating schedule. When presenting your case to the VA, you will want to argue that these symptoms are not taken into consideration under the rating schedule and therefore, the rating schedule is inadequate to rate your disability. It is important to present medical evidence that shows your symptoms, as well as statements from family and friends who can describe your symptoms and the effects on your activities of daily living, including work.
It is important to detail the effects of your symptoms on work because of the second step in proving an extraschedular rating is appropriate: marked inference with employment or frequent periods of hospitalization. It may not surprise you that the VA has not defined what “marked interference with employment” means. Therefore, it is important to present as much evidence as you are able to in order to show how your disability affects your work. Again, this should include medical evidence as well as statements from friends and family members. In addition, it would be helpful to gather statements from coworkers that show excessive absenteeism, an inability to complete tasks on time, how often others at work need to complete your projects for you, or any other work-related problem due to your disability. In regards to “frequent periods of hospitalization,” this has not been defined by the VA either. It is likely that anything less than one hospitalization per year for several years in a row would be considered “frequent,” so it is important to document each hospitalization related to your disability.
Note that the “related factors” in the second prong is the subject of some debate. Case law from the Court of Appeals of Veterans Claims is unclear as to whether “marked interference with employment” and “frequent periods of hospitalization” are the only related factors that can be considered for an extraschedular rating. Because of this, a veteran who has not experienced marked interference with employment or frequent periods of hospitalization may still want to pursue an extraschedular rating if he or she is able to produce evidence of other related factors that make his or her case exceptional. In such case, it would likely be useful to obtain an independent medical opinion or vocational evidence in order to prove that the veteran’s particular disability warrants a departure from the rating schedule.
It is important to remember that because extraschedular ratings are so highly individualized, it will take much longer in order for a veteran to receive a decision if he or she decides to pursue an extraschedular rating. But for those veterans whose disabilities are truly not accurately reflected in the disability rating schedule, it may be worth the extra time and effort to attempt to get an extraschedular rating.