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June 19, 2023

How Do I Get a 100% VA Permanent and Total Disability Rating (P&T)?

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The crème de la crème of VA disability ratings is undoubtedly the 100 percent VA Permanent and Total Disability Rating (P&T).


First, if you have a 100 Permanent and Total (P&T) VA rating, it’s highly unlikely you’ll be re-evaluated or ever have your rating reduced.

Second, there are a ton of amazing benefits if you have a 100% permanent and total disability rating.

Alright, let’s explore permanent and total disability ratings in more detail.

What is a 100 Percent VA Permanent and Total Disability Rating?

What is a 100 Percent VA Permanent and Total Disability Rating
  • Permanent Disability means the impairment is reasonably certain to continue throughout the life of the disabled veteran.
  • Total Disability is any impairment of mind or body which is sufficient to render it impossible for the average veteran to follow a substantially gainful occupation.

Now, combine the two definitions into one.

A 100% Permanent and Total Disability is a Total disability that’s Permanent in nature.

By definition, a veteran can have a temporary Total disability, such as a total knee replacement or a Permanent disability rated less than 100%, such as PTSD that’s been rated at 70% for the past 10 years.

Veterans can also be both Permanent and Total.

According to 38 CFR § 3.340 Total and Permanent VA Ratings a 100% Permanent and Total disability exists when:

  • Such impairment is reasonably certain to continue throughout the life of the disabled person. This means your disability is unlikely to improve. This is the most common reason why the VA grants Permanent and Total (P&T) disability status.
  • 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 permanent and total when the probability of permanent improvement under treatment is remote.
  • The age of the disabled veteran may be considered in determining permanence.

How Does the VA Determine Total and Permanent Disability Status?

The VA Rater follows M21-1 when determining whether you meet the criteria for a 100 percent total and permanent disability.

The key concepts are a total disability that’s also permanent (unlikely to improve).

Total disability means:

  • Schedular or extra-schedular evaluations of 100 percent under, or by analogy to, any DC in 38 CFR Part 4 
  • Veteran has a combined evaluation of 100 percent, or
  • Veteran has a total evaluation based on Individual Unemployability.

Permanent disability means:

  • Veteran has disabling manifestations reasonably certain to continue throughout the lifetime of the individual. Translation: This means your disability is unlikely to improve over time.

Pro Tip: Permanence of a total disability evaluation (100% P&T) may be established when the evidence of record clearly establishes that a disability is expected to continue at its current level of severity (and not show material improvement over time). Clear and specific evidence is not required to establish permanence. 

When the evidence of record does not clearly or specifically show that the total disability will continue but also does not show that a re-examination to ascertain improvement is warranted pursuant to 38 CFR 3.327(b)(2), concede permanence of the evaluation based on a reasonable certainty that improvement is not likely.

How Do I Get a 100% Permanent and Total VA Disability Rating?

Generally, if you qualify for a 100 percent permanent and total disability rating, the VA Rater will automatically assign “P&T” status in his/her VA rating decision letter.

If you have a 100% scheduler rating and are trying to get a 100% P&T rating, and the VA Rater didn’t assign it already, you can apply for “P&T Status” on

Can I Apply for a 100 Percent P&T VA Rating?

Yes, you can apply for a 100 percent P&T VA rating!

If P&T status isn’t automatically granted, here’s how to get permanent and total disability from the VA in 4 simple steps:

  • Step #1. Open a new claim online at, and add a new disability called “Request for Permanent and Total Disability Status.”
  • Step #2. Upload medical evidence showing that your disabilities meet the definitions of permanent and total (e.g., your PTSD has been rated at 70% for 5 years or more and isn’t going to get better – along with a host of other disabilities that are permanent and total in nature and your combined rating is 100%).
  • Step #3. It’s helpful to have your treating physician or other private medical professional write a letter on your behalf explaining how your disabilities are Total, Permanent, and unlikely to improve. This is called a “P&T Request Letter” from a doctor.
  • Step #4. You should write a personal Statement in Support of a Claim documenting how your disability condition(s) are “static” and not subject to a Routine Future Examination (RFE).

Can the VA Reduce a 100 Permanent and Total Disability Rating?

Yes, the VA can reduce a 100 permanent and total disability rating.

Generally, there are 4 ways the VA can take away a 100% permanent and total disability rating:

  • The initial 100% P&T rating was found to be based on fraud.
  • If you have a 100% P&T rating but open a new claim for compensation to include Special Monthly Compensation (SMC), the VA Rater can potentially see that one or more conditions has gotten better, have it re-evaluated, and subsequently reduced. This can happen if your disability conditions are not static.
  • If you have a 100% P&T rating but open a new claim for a Specially Adapted Housing (SAH) or Special Housing Adaptation (SHA) grant, it will automatically trigger a C&P exam for the increase. Your disability conditions could be subject to a re-evaluation, especially if they aren’t static.

Am I Allowed to Work With a 100% P&T VA Rating?

Yes, you can work full-time with a 100% VA permanent and total disability rating.

Contrary to what you might have heard, there are no income restrictions on disabled veterans working with a 100 percent P&T rating!

The only time income is a factor is if you’re in receipt of Individual Unemployability because of your service connected disabilities.

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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