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August 23, 2019

Total and Permanent Disability VA: The Definitive Guide to Securing 100% P&T Status

Last updated on December 23, 2022

I hope you enjoy reading this blog post.

If you want to learn how to implement these strategies to get the VA benefits you deserve, click here to speak with a VA claim expert for free.

Total and Permanent Disability VA, also known as 100 percent P&T, applies to veterans whose disabilities are Total (any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation) AND Permanent (impairment is reasonably certain to continue throughout the life of the disabled person).

Many veterans mistakenly interchange “Permanent” and “Total,” when, in fact, they have very different meanings.

For example, a veteran can have a Total disability that’s temporary, such as a total knee replacement OR a Permanent disability rated less than 100 percent, such as Sleep Apnea that’s been rated at 50 percent for the past 10 years.

Veterans can also be BOTH Permanent and Total, not just one or the other.

The major benefit of being deemed both “Permanent and Total” or 100 P&T is that veterans are protected from a VA ratings reduction.

This means the VA can NEVER reduce your VA rating!

Furthermore, being rated 100 percent P&T entitles you or your family to a host of additional VA benefits, which are highlighted in this post below.

What is the permanent disability definition?

The VA deems a disability “Permanent” when it is reasonably certain, based upon medical evidence, that the level of impairment will continue for the rest of the veteran’s life. In this instance, the VA can take age into consideration when determining whether a disability is permanent. Thus, it can be more difficult for younger veterans, typically under 55 years old, to be considered permanently disabled.

What is the total disability definition?

Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. Total disability may or may not be permanent. Total ratings will not be assigned, generally, for temporary exacerbations or acute infectious diseases except where specifically prescribed by the schedule.

Total ratings are authorized for any disability or combination of disabilities for which the Schedule for Rating Disabilities prescribes a 100 percent evaluation or, with less disability, where the requirements of paragraph 16, page 5 of the rating schedule are present or where, in pension cases, the requirements of paragraph 17, page 5 of CFR 38 Part 4 are met.

Ratings of total disability based on medical history. In the case of disabilities which have undergone some recent improvement, a rating of total disability may be made, provided:

(1) That the disability must in the past have been of sufficient severity to warrant a total disability rating;

(2) That it must have required extended, continuous, or intermittent hospitalization, or have produced total industrial incapacity for at least 1 year, or be subject to recurring, severe, frequent, or prolonged exacerbations; and

(3) That it must be the opinion of the rating agency that despite the recent improvement of the physical condition, the veteran will be unable to affect an adjustment into a substantially gainful occupation. Due consideration will be given to the frequency and duration of totally incapacitating exacerbations since incurrence of the original disease or injury, and to periods of hospitalization for treatment in determining whether the average person could have reestablished himself or herself in a substantially gainful occupation.

What is the total permanent disability definition?

Permanence of total disability will be taken to exist when such impairment is reasonably certain to continue throughout the life of the disabled person. The permanent loss or loss of use of both hands, or of both feet, or of one hand and one foot, or of the sight of both eyes, or becoming permanently helpless or bedridden constitutes permanent total disability. Diseases and injuries of long standing which are totally incapacitating will be regarded as permanently and totally disabling when the probability of permanent improvement under treatment is remote. Permanent total disability ratings may not be granted as a result of any incapacity from acute infectious disease, accident, or injury, unless there is present one of the recognized combinations or permanent loss of use of extremities or sight, or the person is in the strict sense permanently helpless or bedridden, or when it is reasonably certain that a subsidence of the acute or temporary symptoms will be followed by irreducible totality of disability by way of residuals. The age of the disabled person may be considered in determining permanence.

Total disability ratings for pension based on unemployability and age of the individual

All veterans who are basically eligible and who are unable to secure and follow a substantially gainful occupation by reason of disabilities which are likely to be permanent shall be rated as permanently and totally disabled. For the purpose of pension, the permanence of the percentage requirements of §4.16 is a requisite. When the percentage requirements are met, and the disabilities involved are of a permanent nature, a rating of permanent and total disability will be assigned if the veteran is found to be unable to secure and follow substantially gainful employment by reason of such disability. Prior employment or unemployment status is immaterial if in the judgment of the rating board the veteran’s disabilities render him or her unemployable. In making such determinations, the following guidelines will be used:

(1) Marginal employment, for example, as a self-employed farmer or other person, while employed in his or her own business, or at odd jobs or while employed at less than half the usual remuneration will not be considered incompatible with a determination of unemployability, if the restriction, as to securing or retaining better employment, is due to disability.

(2) Claims of all veterans who fail to meet the percentage standards but who meet the basic entitlement criteria and are unemployable, will be referred by the rating board to the Veterans Service Center Manager or the Pension Management Center Manager under §3.321(b)(2) of this chapter.

Total and Permanent Disability VA How to check P&T status

The only way to know for sure is to review your VA Rating Decision Letter, which is mailed to you in a yellow enveloped via regular US mail. You can also review your VA Benefit Summary letter by logging into your eBenefits account. Once logged in, click “Manage” across the top, then “Documents and Records,” then “VA Letters,” and finally “Benefit Summary – Veteran Benefits.” Scroll down and check the section that says, “You are considered to be totally and permanently disabled due solely to your service-connected disabilities.” It will either say YES or NO in this block. This letter will also show if you are in receipt of Special Monthly Compensation due to the type and severity of your service connected disabilities.

Can I apply for 100 percent P&T?

While you don’t really apply for P&T, there are some steps you can take to secure Permanent and Total Disability status. If you have a 100 percent VA disability rating and believe your level of impairment is reasonably certain to continue throughout your life, you can write a letter to your VA Regional Office requesting a permanent VA rating. With your letter, you should include medical evidence (like treatment records) showing that your medical condition cannot be expected to improve in the future. You may be able to obtain a VA permanent disability letter from your doctor as well, which highlights in their medical opinion, whether your disabilities are likely to improve in the future. You can also open a new claim inside eBenefits or and type the disability of “Request for 100% Permanent and Total VA Disability” and upload medical evidence, buddy letters, and a letter from a doctor.

What are some of the VA 100 percent permanent and total disability benefits?

Here are some of the VA 100 permanent and total disability benefits.

#1. No Cost Healthcare and Prescription Medications and VA Co-Pay Reimbursement

Veterans are charged a copayment for nonservice-connected care provided directly by VA or through a community provider (doctor) outside of VA. The copayment amount is based on the type of health care service you receive and your financial situation. Copayment rates for each service are listed below.

Some Veterans may be exempt from paying copayments and may qualify for free health care and/or prescriptions based on special eligibility factors. You can explore your eligibility for VA health care benefits using the online Health Benefits Explorer tool or by contacting VA at 877-222-VETS (8387).

Click here for a useful explainer link!

#2. Dependents Educational Assistance (DEA)

If your disabilities are determined to be 100 Permanent and Total (P&T), the DEA allows your spouse and children to be eligible for certain educational benefits.

A child is authorized 45 months of accredited schooling. VA presently pays a monthly stipend of around $805.00 for a fulltime student, subject to change. They can receive guidance counseling, tutors, etc. If a child has been in school and then the veteran receives a retroactive benefit that includes the school dates, then the student can file for reimbursement for the months that he/she qualified on the retroactive date.

If the VA deems it appropriate, a student may receive an extension on the initial 45 months. A qualified student is usually 18-26 years of age, but I’ve seen some using the benefit up to 32. Usually the latter is based on a large retroactive benefit granted to the veteran.

A dependent spouse can also qualify for schooling. The dependent student or spouse must handle all the necessary paperwork.

Survivors’ and Dependents’ Education Assistance

#3. CHAMPVA Health Insurance for Spouse and Dependent Children

This is an excellent benefit for the spouse and children of a veteran rated at 100 P&T.

Veterans must receive their care at the VA, but their dependents can receive care at private medical facilities.

CHAMPVA is a fantastic program for veterans rated at 100 permanent and total.

>> 3 Minute Explainer Post: Is CHAMPVA Good or Bad? <<

Veterans rated at the 100 percent permanent and total level must apply for CHAMPVA insurance benefits directly on behalf of their dependents:

VA Health Administration Center CHAMPVA

Phone: (800) 733-8387

Fax: (303) 331-7804

Email: [email protected]

Unfortunately, ChampVA does NOT cover Dental or Optometry expenses.

#4. Dental Coverage

All 100% service-connected veterans are allowed free dental care.

Veterans going through Vocational Rehabilitation are also eligible for dental care.

You can simply call the VA facility closest to you and make a dental appointment.

VA Dental

#5. Uniformed Services Identification Cards

The veteran, spouse and children can apply for this card. They are very similar to our old military I.D. cards. They are issued by the Department of Defense and allow you to access military facilities.

Next Generation Uniformed Services ID Card

If VA did not attach a letter/application, then call your VA Regional Office and ask them to send you a Cover Letter stating simply that you are “100% Total or Permanent and Total”. Be sure they understand that it cannot say anything less than 100%. At the same time ask them for the “Uniformed Services I.D. Card Application”. I would suggest that you do not try filling the application out as it’s one of the most complex one’s I’ve ever seen. Just take it with you when you apply or ask for assistance from a Benefits Representative.

VA Regional Office: 1-800-827-1000

Call the administrative department at your nearest Military Base and ask when they do the I.D. cards. I recommend not filling out the application that is provided. It is very complex. Simply take the application and your DD-214 (You), Marriage License (Spouse) and Birth Certificates (Dependent Children). They will make the I.D. cards.

The veteran’s ID is marked “PERM” and is for life. The spouse/children I.D.’s are marked “TEMP” and must be renewed every 5 years.

These cards will say “MWR” on them. This means “Morale, Welfare and Recreation”. You can use facilities at military bases to include: Exchanges, Commissaries and Recreation facilities. The latter can include Tickets for concerts, boating, weight room, etc. You can even rent items like boats, BBQ’s, lawn mowers, rototillers, etc.

100 percent disabled veterans are authorized to fly “Space A” on USCG transportation!

Disabled Veterans Now Eligible For Space-A Travel

You can stay at “Bachelors Enlisted/Officer Quarters” (BEQ/BOQ) on military bases for $15-30 a night or you can use their “Lodging” which can run $45-75.

#6. Free and discounted Hunting Tags and Fishing Licenses

Check disabled veteran benefits by state here:

Military Benefits Info

#7. Property Tax Breaks for Veterans 100% VA P&T

Most states have property tax breaks for disabled veterans. Typically, a veteran must own the home and you need to use it as your primary residence. You can check disabled veteran benefits by state here:

Military Benefits Info

#8. Golden Access Passport

The name of this passport has been changed, but the benefits are very similar. If you have the old passport then you can use it as the Federal government will not give you a new one.

The new passport is called “America the Beautiful – National Parks and Federal Recreational Lands Pass”.

The pass allows for 50% off Camping/recreation in Federal Parks. Some State and County Parks will honor it.

Be sure to take your Rating Decision letter with you for proof:    

#9. Dependency and Indemnity Compensation (DIC)

The DIC “Clock starts Ticking” once a veteran is rated 100% “Total” or “Permanent and Total”. This allows his spouse and dependent children under 18 years of age to receive a monthly benefit if:

a) The veteran passes of a “service-connected” disability within the first 10 years of being rated 100%.

b) If the veteran lives the full 10 years then he can pass of any disability.

Currently the monthly payment for DIC is approximately $1,400.00, so this gives the spouse about 1/2 of the veteran paycheck when he/she was alive.

#10. Travel Pay Reimbursement of $0.415 cents per mile

All veterans are allowed travel reimbursement for scheduled VA appointments if they are rated 30% service-connected or higher.

VA will also pay travel pay on a “needs basis”. This means if a veteran is under a certain income level then he/she will be paid for scheduled visits.

VA will pay for travel to Compensation and Pension (C&P) exams.

VA Travel Pay Reimbursement

#11. Independent Living Services Program (ILSP)

This is a little-known benefit designed to assist any disabled veteran to live a better quality of life despite their service connected disabilities.

The program shows up briefly on the Vocational Rehabilitation Form 28-1900. I believe that VA has changed the wording on the form to further disguise the program. In fact, they changed the name to “Independent Living Program”. Here is a link to the VA Form 28-1900:


You’ll note on the instructions under “Rehabilitation Services” is states the following:

“If training is appropriate, VA will provide medical and dental care treatment, employment assistance to get and keep a suitable job, and other services you may need. If a vocational goal is not currently feasible for you, VA may provide services and assistance to improve your capacity for living independently.”

Here is a link to the Independent Living Program on the VA website: VR&E Independent Living Track         

The Independent Living program is to make sure that each eligible veteran is able, to the maximum extent possible, to live independently and participate in family and community life increasing their potential to return to work. Services may include the following:

#12. Waiver of VA funding fee for home loan

Generally, all Veterans using the VA Home Loan Guaranty benefit must pay a funding fee. This reduces the loan’s cost to taxpayers considering that a VA loan requires no down payment and has no monthly mortgage insurance. The funding fee is a percentage of the loan amount which varies based on the type of loan and your military category, if you are a first-time or subsequent loan user, and whether you make a down payment. You have the option to finance the VA funding fee or pay it in cash, but the funding fee must be paid at closing time.

You do not have to pay the VA funding fee if you are a:

  1. Veteran receiving VA compensation for a service-connected disability, OR
  2. Veteran who would be entitled to receive compensation for a service-connected disability if you did not receive retirement or active duty pay, OR
  3. Surviving spouse of a Veteran who died in service or from a service-connected disability

VA Home Loans

#13. Vocational Rehabilitation and Employment (VR&E)

You may be eligible to receive Vocational Rehabilitation and Employment (VR&E) services to help with job training, employment accommodations, resume development, and job seeking skills coaching. 

Veteran Readiness and Employment (VR&E)

#14. Concurrent Retirement and Disability Pay (CRDP)

Concurrent Retirement and Disability Pay (CRDP) allows military retirees to receive both military retired pay and Veterans Affairs (VA) compensation. This was prohibited until the CRDP program began on January 1, 2004.

CRDP is a “phase in” of benefits that gradually restores a retiree’s VA disability offset. This means that an eligible retiree’s retired pay will gradually increase each year until the phase in is complete effective January 2014.

You do not need to apply for CRDP. If qualified, you will be enrolled automatically.

CRDP Eligibility

You must be eligible for retired pay to qualify for CRDP. If you were placed on a disability retirement but would be eligible for military retired pay in the absence of the disability, you may be entitled to receive CRDP.

Under these rules, you may be entitled to CRDP if…

  • You are a regular retiree with a VA disability rating of 50 percent or greater.
  • You are a reserve retiree with 20 qualifying years of service, who has a VA disability rating of 50 percent or greater and who has reached retirement age. (In most cases the retirement age for reservists is 60, but certain reserve retirees may be eligible before they turn 60. If you are a member of the Ready Reserve, your retirement age can be reduced below age 60 by three months for each 90 days of active service you have performed during a fiscal year.)
  • You are retired under Temporary Early Retirement Act (TERA) and have a VA disability rating of 50 percent or greater.
  • You are a disability retiree who earned entitlement to retired pay under any provision of law other than solely by disability, and you have a VA disability rating of 50 percent or greater. You might become eligible for CRDP at the time you would have become eligible for retired pay.

If you have any questions regarding your CRDP payment from DFAS, call 800-321-1080.

For questions concerning disability ratings or disability compensation, please contact the VA at 800-827-1000.

#15. [NEW!] VA Student Loan Forgiveness Program

President Trump signed an executive order on August 21, 2019, which relieves and discharges the Federal Student Loan Debt of veterans who are Totally and Permanently Disabled with a 100% P&T VA Rating or 100 percent totally disabled based on an individual unemployability rating.

>> Click HERE to apply now for VA student loan forgiveness if you’re 100 percent permanent and total or 100 percent total based on individual unemployability. <<

The Total and Permanent Disability (TPD) discharge program relieves eligible veterans from having to repay a William D. Ford Federal Direct Loan (Direct Loan) Program loan, Federal Family Education Loan (FFEL) Program loan, and/or Federal Perkins Loan (Perkins Loan) Program loan or complete a TEACH Grant service obligation on the basis of a total and permanent disability rating.

Eligible veterans must complete a TPD discharge application and send it, along with any required documentation of your eligibility for discharge, to Nelnet, the TPD discharge servicer.

The TPD discharge application applies to ALL your federal student loans and TEACH Grant service obligations.

At VA Claims Insider, we’ve seen hundreds of fellow disabled veterans in our VA Claims Insider Elite Membership Program get their student loans forgiven entirely — a truly unbelievable benefit that is potentially worth hundreds of thousands of dollars.

Yes, the VA student loan forgiveness program is 100% legit and an unbelievable benefit for disabled veterans who meet the eligibility criteria outlined on the TPD discharge official site.

To learn more about applying for a TPD discharge and to obtain a TPD discharge application, visit the TPD discharge website and see the “Application Process” located HERE.

Veterans can let Nelnet know that you want to apply and request a TPD discharge application by phone or email.

If you do, any required payments on your federal student loans will stop for 120 days to give you time to submit your application and any required supporting documentation.

You can contact Nelnet by email at [email protected] and by phone at 1-888-303-7818 Monday–Friday from 7 a.m.–2 a.m. Eastern time (ET), and Saturday from 8 a.m.–7 p.m. ET.

For additional ways to contact Nelnet, and to get more information about applying for a TPD discharge, visit the TPD Discharge Official Website HERE.

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About The Author

Brian Reese
Brian Reese

Brian Reese

Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).

Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start. 

As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.

He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).

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