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Why the VA Denies TDIU Claims

A determination of total disability due to individual unemployability (TDIU) can make a significant difference in the benefits awarded to a disabled veteran. This special rating allows some veterans with lower disability ratings to receive full VA disability benefits. But, securing a TDIU rating can be challenging. If you believe you may have a TDIU claim, it’s in your best interest to work with an experienced disability benefits advocate who thoroughly understands the criteria and the most effective types of evidence. 

What is TDIU? 

An individual unemployability determination extends 100% veterans disability benefits to veterans who meet the disability ratings listed above and cannot maintain “substantially gainful employment.” The VA describes the ability to engage in substantially gainful employment as being able to maintain steady employment that supports you financially–” marginal employment,” such as odd jobs, doesn’t count.

A veteran who is found to be individually unemployable is eligible for 100% disability payments. In 2023, that means $3,621.95/month versus $1,663.06 for a 70% disability rating and $1,319.65 for a 60% disability rating. The TDIU determination also qualifies the veteran and some dependents for other benefits, such as educational benefits for spouses and children and medical coverage for dependents. 

How to Qualify for TDIU

For any veteran to be found individually unemployable, they must be found to be unable to engage in substantially gainful employment.  38 CFR §4.16(a) says that a veteran’s employment should generally be deemed “marginal” if it is less than or equal to the federal poverty level for one person. In 2023, that’s $14,580/year, or $1,215/month. Note, though, that the determination depends on the veteran being unable to earn at that level due to a service-connected disability. It is not sufficient that the veteran is earning less by choice, due to non-medical limitations, or due to some non-service-connected limitation.

They also must generally be found to be: 

• 60% disabled or more due to a single service-connected condition, or

• 70% disabled or more due to a combination of service-connected conditions, at least one of which carries a 40% rating or greater

There’s no exception to the inability to earn a living requirement, but there is a possibility that a veteran who does not meet either of the disability rating requirements might still be found to be individually unemployable and awarded veterans disability benefits at the 100% level. That’s because the stated intention of the TDIU designation is to ensure that “all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled.”

To ensure that happens, the regulation provides that: 

• Certain types of disabilities may be combined and treated as a single condition so that a 60% disability rating will suffice to find individual unemployability

• Non-service-connected disabilities and previous unemployability shall not be considered if service-connected conditions are sufficient to establish unemployability

It has also been determined that age should be disregarded in this analysis, so a disabled veteran would not be denied a TDIU determination simply because he was old enough he could have retired or might have been expected to retire. 

Common Reasons TDIU Claims are Denied

TDIU claims may be denied for several reasons. Whether and how a disabled veteran can avoid or overcome a denial and receive 100% veterans benefits depends on both the facts and the reason for the denial. For example: 

1. A TDIU claim may be denied because the disabled veteran doesn’t have a high enough disability rating. However, a veteran whose disability rating doesn’t meet the threshold may be able to pursue an adjustment to the rating. And, the rating board is required to refer a claim to the Director of Compensation Service if the veteran is unemployable due to a service-connected disability or combination of service-connected disabilities. 

2. A TDIU claim may be denied because the VA considered marginal work to be evidence that the veteran could engage in substantially gainful activity. As explained above, a veteran need not be entirely unable to work in order to be found individually unemployable. Many veterans who have some income have been found individually unemployable and granted full benefits. 

3. The VA was swayed by the impact of non-service-connected disabilities. If service-connected disabilities render the veteran unable to engage in substantially gainful activity, it doesn’t matter whether they suffer from other conditions that might also prevent them from earning a living. 

4. The VA applies a cookie-cutter approach to the decision. It’s easy to imagine that a person crippled by a serious back injury might still be able to work. For example, a technical writer or financial analyst might well be able to carry on with their career or find other work that they could engage in despite limitations in movement, lifting, and other areas. The same may not be true for a 55-year-old veteran whose entire work history involves working on the line in a manufacturing plant or driving a truck. If the VA doesn’t consider the veteran’s work history and educational background, they may get it wrong. 

Fighting for Your TDIU Determination

The best way to present your TDIU claim and the best way to fight a denial will depend on your disability, your disability rating, and, if you’ve been denied, the reason for the denial. The best way to ensure that your claim has the best chance of success from the start is to work with an experienced veterans disability benefits advocate to put together your initial application and documentation. You can get started right now by calling (855) 855-8992 or contacting us here. 

If you’ve already been denied, Veterans Help Group can help you challenge that denial. Whether that means demonstrating that your ability to work part-time or sporadically does not rise to the level of substantially gainful activity, pushing your file forward for extra-schedular review if the ratings board failed to do so, or requesting an adjustment of your disability rating to help you qualify, we are here for you. We know the process can be confusing and it’s often difficult to know what the VA is looking for. Take advantage of the knowledge we’ve gained through helping thousands of disabled veterans pursue the benefits they deserve.