4 Steps To A Winning Lifestyle Impact Claim:  The #1 Way to Increase Your Rating Fast

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4 Steps to a Winning Lifestyle Impact Claim

Lifestyle impact claims can be of huge value to disabled veterans whose quality of life and mental well-being are impacted by their service-connected conditions. A VA lifestyle impact claim can boost your overall rating with a percentage increase. This kind of claim is an opportunity for veterans who already have one or more rated disabilities yet are stuck at a lower overall rating.

The lifestyle impact claim is one of our most successful methods for helping veterans get the full compensation they deserve. However, many veterans are unfamiliar with or confused by this type of secondary claim. Many veterans wonder if a VA lifestyle impact claim is the same as a VA disability claim, whether they would qualify for such a claim, and if it’s difficult to win.

In this Insider’s Guide to Lifestyle Impact Claims, we’ll help you explore if you’re a candidate for this type of claim, what the lifestyle impact percentages are, and how to build a claim successfully.

What exactly is a VA disability lifestyle impact claim?

A lifestyle impact claim is a high-value secondary disability claim that is a mental health claim—filed by a veteran whose primary service-connected disabilities significantly impact their life in a negative way.

For example, suppose you’re service-connected for a physical injury that prevents you from working and produces severe depression due to your lack of mobility. In that case, you may be entitled to a secondary service connection with a lifestyle impact claim (which is a mental health claim)—and with it  higher VA disability rating.

If your knee injury, for example, prevents you from working out or sleeping well, this can impact your body mass and mood. A veteran who suffers from chronic back pain (due to a service-connected injury or condition) may find it nearly impossible to log quality sleep consistently. Over time, this can lead to depression and burnout, negatively affecting work and relationships.

Many ratable conditions can impact your sleep and mental health, making it hard for you to enjoy life or function normally. This is the foundation of this type of claim. You deserve a higher rating for this additional impact, and you can get it!

Note: If you’re already service-connected for a mental health disability, this is not a claim you can pursue, as the VA will only rate the veteran for a Single Mental Health Claim (in rare situations they could be rated for TBI separately).

Does chronic pain syndrome qualify me for a VA lifestyle impact percentage?

Possibly. Chronic pain by itself is difficult to prove, partly because VA has no specific diagnostic code for chronic pain. Chronic pain is now rated by the VA as Somatic Symptom Disorder.

However, many veterans who experience chronic pain also experience depression. Depression is a mental health claim, and the idea of a lifestyle impact claim is that your service-connected disability causes mental health symptoms and therefore a mental health disability. Plus, depression can be linked to further impacts, including obesity and insomnia.

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Am I eligible for a lifestyle impact claim?

To be eligible for a lifestyle impact claim (mental health secondary to a primary disability), you need to have an existing primary service-connected disability (even if it’s rated at 0%).

Your primary disability must also result in some kind of mental health disability—either causing or aggravating your mental health diagnosis due to your inability to perform your daily activities.

Lifestyle impact claims, like all mental health claims, will look different for every veteran because it’s all about how the particular injury or disability affects your mental health and quality of life in a particular way. Perhaps your tinnitus causes insomnia which causes depression, or your back injury causes immobility which causes obesity and depression.

In spite of individuality, however, there are certain elements all successful lifestyle impact claims will fulfill. You’ll want to make sure your claim hits all of them.

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How do I file a lifestyle impact claim?

The lifestyle impact claim is, technically speaking, a mental health claim. Thus, filing a lifestyle impact claim should be thought of as filing a secondary claim for a mental health condition.

There are FOUR KEYS to a successful lifestyle impact claim. 

If you’re struggling with completing any of these steps, we can help. Veterans come to us daily who are stuck at a certain rating, and the lifestyle impact percentage increase is the ticket to getting unstuck and maximizing compensation.

We like to say the lifestyle impact claim “makes the impossible possible.”

Pay attention to these four components of your claim, and reach out if you feel like you need support! 

1. Submit it as a secondary claim.

One mistake we see veterans make is trying to establish lifestyle impact as a primary disability and filing it that way. Lifestyle impact claims must be secondary to an existing service-connected disability.

A secondary service connection always requires:

• A medical diagnosis of the current (secondary) disability, which must be a mental health diagnosis
• Evidence of a service-connected primary disability , AND
• Medical nexus evidence establishing a connection between the service-connected disability and the current 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.

As with other secondary mental health claims, you’ll need to provide proof of the typical elements of secondary service connection. The medical diagnosis and nexus letter are important elements of the claim.

Documentation is critical to a lifestyle impact claim. In our experience, most VA disability claims are won or lost based on medical evidence, and lifestyle impact claims are no exception.

If you don’t already have a diagnosis for the disabling mental health impact of your primary service-connected disability, get yourself to a doctor.

We find that the independent opinion of a private medical professional can greatly influence a C&P examiner’s medical opinion, as well as the VA rating official’s final decision.

Additionally, a solid nexus letter confirming the connection between your lifestyle impact/mental health claim and the primary SC disability is crucial for winning your lifestyle impact claim.

A nexus letter is an evidence-based document prepared by a medical professional that helps to establish a connection between the veteran’s current disability and either military service (for direct service connection) or another rated disability (for secondary service connection). It’s often the missing link in a VA claim and an essential piece of evidence.

If you’re having trouble finding a practitioner that speaks the VA’s language, we can connect you with independent medical providers in Va Claims Insider’s referral network that will hold weight with the VA because they know how to address VA requirements.

4. Plan for your C&P Exam

Is there always a Compensation and Pension Exam (C&P) for a lifestyle impact claim? A lifestyle impact claim will almost certainly require you to undergo a C&P exam, and it will be important that you handle it skillfully. Therefore, it’s vital to learn how the C&P process works for this type of claim, and to understand how to support your claim.

5 C&P PRO TIPS:

• Know what’s in your medical records
• Review the DBQ for mental health conditions
• Review the eCFR, Title 38, Schedule 4 for mental health symptoms
• Be uncomfortably vulnerable
• Know your story cold, and be ready to discuss the mental health symptoms that stem from or are aggravated by your service-connected disability.

It’s also essential to have your medical documents, including medical nexus letters from your doctor.

Another fundamental component of every C&P exam is honesty. This is especially true when it comes to a lifestyle impact claim. It’s imperative not to downplay your mental health symptoms (including your day-to-day pain). It’s equally important not to exaggerate your symptoms, however. Maintaining honesty keeps your narrative consistent, which is critical to a positive outcome.

The most important aspect of your C&P exam for this clam type will be to adequately explain how your service-connected disability causes or aggravates your mental health symptoms.

For more great tips on acing your C&P exam, see our video Top 10 VA Compensation & Pension (C&P Exam) Tips.

You might also like our new post How Do I Know If My C&P Exam Went Well? Here’s 3 Signs You Had a Favorable C&P Exam.

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What are the lifestyle impact claim percentages? How does the VA rate lifestyle impact claims?

The ratings criteria for lifestyle impacts are the same as those used for all mental health conditions (excluding eating disorders).

Below are the VA’s mental health claim percentage rates:

100% = Total occupational and social impairment.  

This individual requires constant or near-constant hospitalization and one-on-one supervision.

Medications:

This individual requires psychiatric medication at all times.

Symptoms: 

Some or all of the following symptoms will be present.

• Regular or constant delusions or hallucinations and the inability to tell fact from fiction
• Inappropriate behavior (such as drooling, mumbling, shouting, etc.)
• Constant danger of hurting self or others (including suicidal tendencies)
• Significant memory loss, including not being able to remember names of close friends, family, or self, and other important information
• Inability to understand the idea of time or place
• Inability to reason, think or communicate logically
• Constant anxiety, fear, suspicion

Ability to Work: This individual cannot work at all.

Social Relationships: This individual cannot seek, invite, encourage or build any relationships—he or she cannot interact with another person. Family members may care for the individual, but this is a one-way relationship.

70% = Significant occupational and social impairment.

This rating will have the majority of the following circumstances and symptoms:

Individuals at this rating cannot take care of themselves most of the time. They may be in the hospital or a care facility or are being taken care of by family members, and require one-on-one supervision 50% of the time. They are unable to take care of their own personal hygiene.

Medications: 

This individual requires psychiatric medication at all times.

Symptoms: 

Some or all of the following symptoms will be present.

• The regular possibility of hurting self or others (including suicidal tendencies)
• Often cannot communicate logically
• Actively psychotic, but may have intermittent contact with reality
• Obsessive-compulsive behavior that causes repetitive physical actions that interfere completely with daily necessary activities
• Severe, constant anxiety
• Mood often changes radically without warning.
• Almost constant severe depression or panic, with the inability to function at all in stressful situations
• Cannot control impulsive actions like anger, violence, etc.
• Often disoriented regarding time and place

Ability to Work: 

This individual may not be able to work at all or may be severely under-employed (such as a former intelligence analyst now working part time as a custodian).

Social Relationships: 

This individual cannot participate in any relationships most of the time. Family members may care for them, but it is normally only a one-way relationship. They cannot seek, invite, build or encourage relationships the majority of the time.

50% = Moderate to significant occupational and social impairment.

Those given this rating will have the majority of the following circumstances and symptoms.

This individual is occasionally hospitalized, but can mostly take care of basic personal needs like bathing or going to the bathroom (although personal hygiene may not be kept up regularly). Such individuals may also be able to function with tasks such as shopping, driving, cleaning, etc.

Medications: 

This individual requires psychiatric medication at all times.

Symptoms: 

Some or all of the following symptoms will be present.

• Trouble expressing or showing emotions (not simply reserved, but rather completely blank the majority of the time), or shows the wrong or inappropriate emotion for the situation
• Constant significant signs of anxiety
• Regularly gives unnecessary or unrelated details when communicating
• Two or more panic attacks a week
• Trouble understanding complex directions
• Trouble remembering things (forgetting to complete tasks, etc.)
• Trouble thinking logically; often has poor judgment
• A serious lack of—and/or excessively elevated—mood or motivation
• Occasional delusions or hallucinations
• Frequent to constant trouble sleeping (nightmares, insomnia, anxiety, etc.)
• Complaints of physical symptoms, such as pain, that do not have a physical cause
• Suicidal thoughts, but no definite plan for self-harm

Ability to Work: 

This individual may try to work, but usually will not be able to hold a job for more than 3 or 4 months because of the inability to remember or follow directions, or other similar reasons based on the symptoms or circumstances described under this rating. This individual would typically be hired for jobs such as cleaning, picking up trash, or other simple tasks.

30% = Mild to moderate occupational and social impairment.

Individuals at this rating may have occasional, short hospitalizations, but can entirely take care of themselves most of the time.

Medications: 

This individual usually requires medication to function normally.

Symptoms: 

Some or all of the following symptoms will be present.

• Spikes or drops in mood, or depression
• Often anxious or becomes easily stressed
• Panic attacks no more than once a week
• Some difficulty sleeping (nightmares, insomnia, anxiety, etc.)
• Mild memory loss (could include regularly forgetting names or directions)
• Often suspicious of other people, especially strangers

Ability to Work:

This individual will be usually able to work and function normally. There may be occasional times where such individuals are unable to properly fulfill all job requirements. This might result in job loss in some cases.

Social Relationships:

As with the ability to work, this individual can usually maintain fairly stable relationships. These relationships may be strained by the symptoms of the individual’s condition.

10% = Mild occupational and social impairment.

Individuals at this rating will always be able to take care of themselves and will very rarely, if ever, be hospitalized.

Medications: 

This individual may or may not be taking medication. Meds may be taken all the time, or only during stressful times. Continuous medication satisfactorily keeps all symptoms under control.

Symptoms: 

Some or all of the following symptoms will be present, but only during times of significant stress. The majority of the time there are no symptoms.

• Mild depression or other mood changes
• Mild to moderate anxiety
• Mild panic attacks may occur, but very rarely
• Occasional difficulty sleeping (nightmares, insomnia, anxiety, etc.)
• A range of other very mild symptoms, which could include suspiciousness of strangers and hyperarousal

Ability to Work: 

This individual will be fully employable and will very rarely have any problems at work that are caused by the mental health condition.

Social Relationships: 

This individual will have full, functional relationships with only occasional, mild stresses that are caused by the condition.

0% = If a mental condition has been diagnosed but there are no symptoms that impair social or occupational functioning or require medication, it’s rated 0%.

NOTE: If a mental health condition requires 21 days or more of hospitalization, the condition is rated 100% while being treated. The 100% rating will continue for the duration of hospitalization, and then return to the previous rating after the service member is discharged from the hospital. If the condition requires hospitalization for six months or more, the 100% hospitalization rating will continue for an additional six months after the service member is discharged. After this six-month period, the condition will be re-evaluated and rated based on any remaining symptoms.

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Learn more about lifestyle impact claims

Check out our latest video specifically on lifestyle impact claims!

Lifestyle impact claims can be tricky—we’re here for you!

Lifestyle impact claims are an incredibly important avenue to the higher rating you deserve—but they can be a bit puzzling. This can be due to the scoring system, diagnostic codes used, or difficulty in proving a link between your primary disability and the mental health disability (lifestyle impact).

If you need support with a Lifestyle Impact Claim, you don’t have to struggle alone. VA Claims Insider’s experts can help—we see veterans win these kinds of claims every day!  On a FREE VA Claim Discovery Call, you can learn more about how we can help you build a successful claim that compensates you for the rest of your life.

Get help with your disability claim—and the compensation you deserve.

Regardless of whether you qualify for a lifestyle impact claim, it’s important to pursue monthly compensation and benefits for any disabilities connected to your military service.  

Most veterans are underrated for their disabilities and therefore not getting the compensation they’re due. At VA Claims Insider, we help you understand and take control of the claims process, so you can get the rating and compensation you’re owed by law.

Our process takes the guesswork out of filing a VA disability claim and supports you every step of the way in building a fully-developed claim (FDC)—so you can increase your rating FAST!

If you’ve filed your VA disability claim and have been denied or have received a low rating—or you’re unsure how to get started—reach out to us! Take advantage of a FREE VA Claim Discovery Call. Learn what you’ve been missing—so you can FINALLY get the disability rating and compensation you deserve!

We’ve supported more than 15,000 veterans to win their claims and increase their ratings. NOW IT’S YOUR TURN.

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