4 Steps to a Winning Lifestyle Impact Claim
Lifestyle impact claims can provide significant benefits to disabled veterans whose service-connected conditions affect their quality of life and mental well-being. Filing a VA lifestyle impact claim has the potential to increase your overall rating by a percentage, especially for veterans who already have one or more rated disabilities but find themselves stuck with a lower overall rating.
Our approach to the lifestyle impact claim has proven highly effective in securing the rightful compensation for veterans. Nonetheless, many veterans find themselves unfamiliar with or confused about this secondary claim type. Questions often arise, such as whether a
VA lifestyle impact claim is the same as a VA disability claim, whether they qualify for such a claim, and how challenging it is to win.
In this comprehensive guide to lifestyle impact claims, we aim to assist you in determining your eligibility for this claim, understanding the lifestyle impact percentages, and providing guidance on building a successful claim.
What exactly is a VA disability lifestyle impact claim?
A lifestyle impact claim represents a valuable secondary disability claim, primarily centered on mental health. It is typically submitted by a veteran whose primary service-connected disabilities significantly and adversely affect their daily life.
For instance, consider a scenario where you have a service-connected physical injury that hinders your ability to work and, as a result, leads to severe depression stemming from your limited mobility. In this case, you may be eligible for a secondary service connection via a lifestyle impact claim, which is essentially a mental health claim. This, in turn, can result in a higher VA disability rating.
To illustrate further, if a knee injury prevents you from engaging in physical activities or obtaining restful sleep, this can have repercussions on your body mass and emotional well-being. Veterans coping with chronic back pain due to a service-connected injury or condition may find it extremely challenging to consistently achieve quality sleep, ultimately resulting in depression and exhaustion, which can adversely affect both work and relationships.
Numerous service-connected conditions have the potential to disrupt your sleep patterns and mental health, making it difficult for you to savor life and maintain regular functionality. This serves as the core rationale behind pursuing this type of claim. You rightly deserve a higher rating to account for this additional impact, and it is attainable!
It’s important to note that if you are already service connected for a mental health disability, you cannot pursue this claim, as the VA will typically assess the veteran based on a single mental health claim (with the rare exception of separate TBI ratings in specific situations).
Does chronic pain syndrome qualify me for a VA lifestyle impact percentage?
Perhaps. Establishing the presence of chronic pain as a standalone condition can be challenging, mainly due to the absence of a dedicated diagnostic code for chronic pain within the VA’s rating system. The VA now assesses chronic pain under the category of somatic symptom disorder.
Nevertheless, it’s worth noting that many veterans grappling with chronic pain also contend with depression. Depression is categorized as a mental health condition, and the concept behind a lifestyle impact claim revolves around the notion that your service-connected disability gives rise to mental health symptoms, thereby qualifying as a mental health disability claim. Additionally, depression can be linked to secondary repercussions, including issues like obesity and insomnia.
Am I eligible for a lifestyle impact claim?
To qualify for a lifestyle impact claim, which involves establishing a mental health condition secondary to a primary disability, certain criteria must be met:
1. You must possess a primary service-connected disability, regardless of whether it is rated at 0%.
2. Your primary disability should lead to the development or exacerbation of a mental health condition stemming from your limited ability to perform your daily tasks.
Lifestyle impact claims, much like all mental health claims, exhibit unique characteristics for each veteran, as they hinge on how the specific injury or disability affects your mental well-being and overall quality of life in a distinct manner. For instance, your tinnitus may lead to insomnia, subsequently triggering depression, or your back injury may result in immobility, which in turn can contribute to obesity and depression.
Nonetheless, despite these individual variations, there are certain common elements that are imperative for all successful lifestyle impact claims, and it is crucial to ensure that your claim satisfies these prerequisites.
How do I file a lifestyle impact claim?
From a technical standpoint, it’s essential to recognize that the lifestyle impact claim essentially falls within the category of mental health claims. Consequently, when initiating a lifestyle impact claim, it’s akin to submitting a secondary claim related to a mental health condition.
There are FOUR KEYS to a successful lifestyle impact claim.
Should you encounter challenges while navigating through these steps, rest assured that we are here to assist. Every day, veterans approach us when they find themselves at a rating standstill, and the lifestyle impact percentage increase serves as the key to breaking free from this predicament and optimizing their compensation.
We often express that the lifestyle impact claim has the remarkable ability to “transform the impossible into reality.” Give due consideration to these four integral aspects of your claim, and do not hesitate to contact us should you require guidance or support!
1. Submit it as a secondary claim.
A common error we observe among veterans is their attempt to establish lifestyle impact as a primary disability and submit it as such. It is crucial to understand that lifestyle impact claims must be predicated on an existing service-connected disability, positioning it as a
secondary condition.
For a secondary service connection to be validated, the following prerequisites must be met:
1 .A medical diagnosis of the present (secondary) disability, which should be in the realm of mental health diagnoses
2 .Substantiating evidence of a service-connected primary disability
3 .The provision of medical nexus evidence establishes a link between the service-connected primary disability and the current secondary disability.
2. Get a medical diagnosis for the mental health condition that is secondary to your primary
disability and that is affecting your lifestyle.
3. Get a nexus letter connecting your mental health or lifestyle impact to the service-
connected disability.
Like other secondary mental health claims, you’ll be required to furnish evidence substantiating the standard elements of the secondary service connection. Of particular significance are the medical diagnosis and the nexus letter, which are pivotal components of the claim.
The significance of documentation cannot be overstated when it comes to a lifestyle impact claim. In our experience, the outcome of most VA disability claims hinges on medical evidence, and lifestyle impact claims are no exception to this rule.
If you have not already obtained a diagnosis for the mental health impact resulting from your primary service-connected disability, it is imperative that you consult a healthcare professional.
We have observed that an independent opinion from a private medical practitioner can significantly influence the medical opinion of a Compensation and Pension (C&P) examiner, as well as the final decision made by the VA rating official.
Furthermore, a well-constructed nexus letter confirming the relationship between your lifestyle impact or mental health claim and the primary service-connected disability is a fundamental factor in securing approval for your lifestyle impact claim. A nexus letter, a substantiated document prepared by a medical expert, serves as a pivotal tool in linking the veteran’s current disability to either their military service (for direct service connection) or another pre-existing rated disability (for secondary service connection). Often, it bridges the information gap in a VA claim and stands as an essential evidentiary component.
If you encounter difficulties in finding a healthcare provider familiar with the VA’s requirements, we can facilitate connections with independent medical practitioners in the VDC Bootcamp’s referral network who possess the requisite expertise to address VA-specific criteria and, consequently, carry significant weight with the VA.
4. Plan for your C&P Exam
Is a Compensation and Pension Exam (C&P) a standard requirement for a lifestyle impact claim? In all likelihood, a lifestyle impact claim will necessitate a C&P examination, and it is of utmost importance that you approach this examination with proficiency. Consequently, it is essential to familiarize yourself with the C&P process as it pertains to this specific type of claim
and to acquire a comprehensive understanding of how to substantiate and advocate for your claim effectively.
5. C&P PRO TIPS:
Ensure familiarity with your medical records, review the Disability Benefits Questionnaire (DBQ) pertaining to mental health conditions, and consult the Electronic Code of Federal Regulations (eCFR), specifically Title 38, Schedule 4, to identify mental health symptoms.
During the evaluation, be prepared to delve into deeply personal aspects of your experience and have a comprehensive grasp of your narrative. This entails a thorough discussion of mental health symptoms linked to your service-connected disability or exacerbated by it. Additionally, possessing all pertinent medical documents, including medical nexus letters from your physician, is imperative.
Another integral facet of every compensation and pension (C&P) examination is unflinching honesty. This principle holds even greater significance in the context of a lifestyle impact claim. It is essential not to minimize your mental health symptoms, including your daily struggles, yet equally crucial not to overstate them. Maintaining this honesty ensures the consistency of your account, which is pivotal for a favorable outcome.
The central focus during your C&P examination for this type of claim should be a comprehensive explanation of how your service-connected disability either directly causes or exacerbates your mental health symptoms.
For additional valuable insights on excelling in your C&P examination, please refer to our video, & Top 10 VA Compensation & Pension (C&P Exam) Tips.” You may also find our recent article, “How Do I Know If My C&P Exam Went Well? Here’s 3 Signs You Had a Favorable C&P Exam,” to be of interest.
What are the lifestyle impact claim percentages? How does the VA rate lifestyle impact
claims?
The rating criteria for lifestyle impacts align with the established criteria for all mental health conditions, with the exception of eating disorders. The following are the VA’s mental health claim percentage rates
100%: Signifying total occupational and social impairment, this rating is reserved for individuals who necessitate constant or near-constant hospitalization and one-on-one supervision. This group always requires psychiatric medication and exhibits symptoms such as delusions or hallucinations, inappropriate behavior, danger to oneself or others, severe memory loss, an inability to understand time or place, an inability to reason or communicate logically, constant anxiety, and an inability to work or engage in social relationships.
70%: Indicating significant occupational and social impairment, this rating applies to individuals who require extensive care, often in a hospital or care facility or through family support. They need one-on- one supervision approximately 50% of the time and may struggle with personal hygiene. Symptoms include the risk of self-harm or harm to others, difficulty in logical communication, frequent psychosis, obsessive-compulsive behaviors, severe anxiety, mood swings, severe depression or panic, impulsive actions, disorientation, and a limited ability to work or form relationships.
50%: Reflecting moderate to significant occupational and social impairment, this rating is assigned to individuals who occasionally require hospitalization but can generally handle basic personal needs. Symptoms may include difficulty expressing emotions, significant anxiety, panic attacks, trouble remembering, logical thinking issues, mood fluctuations, occasional delusions or hallucinations, frequent sleep problems, physical complaints without a physical cause, and suicidal thoughts without a definite plan. These individuals may attempt to work but may find it challenging to maintain a job.
30%: Indicating mild to moderate occupational and social impairment, individuals in this category may experience brief hospitalizations but can largely care for themselves. They may have spikes or drops in mood, anxiety, infrequent panic attacks, mild difficulty sleeping, mild memory loss, and occasional suspicion of others. Generally, they are employable, although there may be sporadic work-related challenges, and they can maintain stable relationships.
10%: Representing mild occupational and social impairment, these individuals are generally self- sufficient and rarely require hospitalization. They may or may not use medication, typically during stressful periods. Symptoms may include mild depression, anxiety, infrequent panic attacks, occasional sleep disturbances, and mild symptoms triggered by stress. They can work without significant issues and maintain functional relationships.
0%: This rating is for mental conditions with a diagnosed but asymptomatic status, meaning there are no symptoms impairing social or occupational functioning or necessitating medication.
Note: If a mental health condition requires 21 days or more of hospitalization, it is rated at 100% while undergoing treatment. The 100% rating remains in effect for the hospitalization duration and an additional six months after discharge for stays of six months or longer. Subsequently, the condition is re-evaluated based on any remaining symptoms.
Learn more about lifestyle impact claims
Explore our most recent video dedicated to lifestyle impact claims!
Lifestyle impact claims can be tricky—we’re here for you!
Lifestyle impact claims offer a vital path to securing the higher rating you rightfully deserve, yet they can be somewhat intricate to navigate. This complexity can stem from the intricacies of the scoring system, the utilization of diagnostic codes, or the challenges involved in substantiating a connection between your primary disability and the resultant mental health condition (lifestyle impact).
If you find yourself in need of assistance with a lifestyle impact claim, rest assured that you don’t have to face these challenges in isolation. Our team of experts at VDC Bootcamp is well-versed in helping veterans achieve success with these claims on a daily basis. During a complimentary VA Claim Discovery Call, you can gain valuable insights into how we can support you in constructing a compelling claim that ensures fair compensation for the entirety of your life.
Get help with your disability claim—and the compensation you deserve.
Irrespective of your eligibility for a lifestyle impact claim, it is of paramount importance to proactively pursue monthly compensation and benefits for disabilities connected to your military service.
The stark reality is that a substantial number of veterans are not receiving the full extent of compensation to which they are justly entitled, primarily due to being underrated for their disabilities.
At VDC Bootcamp, we are steadfast in our commitment to providing you with the guidance and insight necessary to not only comprehend but also take charge of the claims process, empowering you to secure the rating and compensation that is legally and rightfully owed to you.
Our approach has been meticulously crafted to eliminate the ambiguity often associated with the filing of a VA disability claim while simultaneously delivering comprehensive support at every stage of constructing a fully developed claim (FDC). This streamlined procedure is purposefully designed to expedite the enhancement of your rating.
Should you find yourself in a situation where you have already submitted a VA disability claim and encountered denials or received a rating below your expectations, or if you are uncertain about the initiation of this process, we strongly encourage you to reach out to us. Make the most of our FREE VA Claim Discovery Call, where you will gain an in-depth understanding of potential shortcomings in your
approach, empowering you to ultimately secure the disability rating and compensation that you unquestionably deserve.
We take immense pride in our track record of having assisted veterans in achieving successful claims and rating improvements. Now, the opportunity to embark on this transformative journey is yours to seize. Your path begins today.
