How to Qualify for Disability Benefits for Surgery

VA Disability Ratings for Surgery

How to Qualify for Disability Benefits for Surgery

Veterans may be able to get disability benefits if they have had surgery or received treatment at a VA hospital, approved hospital, or outpatient center for a disability related to their military service. If veterans have had surgery, then both of these must be true to receive benefits:

• The surgery required a recovery time of at least one month or reports show that the surgery or treatment was for a service-connected condition, and
• The surgery resulted in severe issues, such as:
  • Surgical wounds that haven’t totally healed;
  • Stumps of recent amputations;
  • Being unable to move due to being put in splints or casts to help with healing;
  • Being unable to leave their house;
  • Being required to use a wheelchair or crutches

The VA will often assign a temporary total disability rating if the above criteria are met. The VA has three forms of temporary 100 percent disability ratings: prestabilization, hospitalization, and convalescence.

Prestabilization

A prestabilization rating is a temporary, immediate disability rating assigned to a veteran who has been recently discharged from military service with a severely disabling and unstable condition that is expected to continue for an indefinite period of time. These veterans are considered to be “most likely in need and least likely to be self-sufficient.”

Prestabilization ratings are assigned in increments of 50 percent and 100 percent over a period of 12 months following the veterans discharge date. Veterans who receive a 100 percent prestabilization rating typically suffer from an unstable condition incurred in service that will result in severe permanent disability. An 100 percent rating is only assigned if “substantially gainful employment is not feasible or advisable.”

In order for the VA to reduce a veteran’s prestabilization rating a reevaluation must be conducted. These examination are typically scheduled between six and twelve months following separation from service.

Hospitalization

Temporary hospitalization ratings are assigned to veterans who have been hospitalized for over 21 days as a result of a service-connected condition. In order to qualify for a temporary hospitalization rating, the veteran must be receiving treatment at a VA medical center or other VA-approved hospital. The 100 percent rating will continue until the last day or last day of the month which the veteran stopped receiving treatment.

Convalescence

Convalescence is defined as “the stage of recovery following an attack of disease, a surgical operation, or an injury” and recovery as “the act of regaining or returning toward a normal or healthy state.”

Temporary 100 percent convalescence ratings are assigned to veteran who underwent treatment or surgery for a service-connection at a VA-approved facility. In order to qualify for a temporary and total convalescence rating, the veteran must have:

• Undergone treatment or surgery with a convalescence time of at least one month; or
• Experienced severe postoperative residuals that resulted from surgery; or
• Experienced the immobilization of one or more major joints “by a cast without surgery”

A convalescence rating can be corroborated by a work excuse provided by a medical professional if there is a “clear connection between the claimant’s inability to return to previous employment and surgery or cast immobilization,” and that there is no evidence to the contrary.

The effective date of a convalescence rating is that of hospital admission or outpatient treatment, and can continue for one, two, or three months “from the first day of the month following such hospital discharge or outpatient relief”. Extensions of one to three months are possible depending on the progress the veteran has made. Further extensions of one to six more months following the initial six month period may also be granted.

Veterans Help Group have been supporting veterans in getting the benefits they deserve since 1995. We are here to help. Call Veterans Help Group at 855-855-8992 or complete our free veterans benefits case evaluation form.