4. Veteran With a Disability Rated as Total

Section 1902(xx)(9)(A)(ii)(IV) of the Act creates an exclusion for veterans with a total disability rating. The statute references 38 U.S.C. 1155 , which provides VA the authority to create a schedule for rating disabilities. VA assigns disability ratings based on the severity of a veteran's service-connected condition(s), which is stated as a percentage. For purposes of community engagement, a total, or 100 percent, disability rating from VA is necessary to qualify for the exclusion. VA may assign total disability ratings that are permanent or temporary; either would qualify an individual for the exclusion, if rated at 100 percent. New § 435.554(c)(4) adopts this “veteran with a disability rated as total” definition for purposes of the community engagement exclusion at section 1902(xx)(9)(A)(ii)(IV) of the Act.

Some veterans receive total disability based on individual unemployability (TDIU), which allows veterans with service-connected disabilities to receive 100 percent compensation if they cannot secure or maintain “substantial gainful employment,” even if their combined rating is below 100 percent. These veterans, due to receipt of 100 percent compensation, must be treated by States in the same manner as all other veterans who have a combined disability rating of 100 percent, thus meeting the exclusion.

Some veterans will receive a permanent and total (P&T) disability which means that a veteran has a 100 percent (total) disability rating, and their condition is considered static (permanent) with no expectation of improvement. While a veteran only needs a total (100 percent) VA disability rating to meet the exclusion, States are not permitted to reverify a permanent disability determination. Conversely, temporary disabilities assigned by the VA, which are sometimes time-limited or are expected to improve over time, will require reverification at least once every 12 months. For more information about verification requirements and recommended data sources for veterans with total disability ratings, see section II.I.7.d. of this IFC.