Elaine M. Tripi, Post Traumatic Stress Disorder, PTSD, veterans, veteran advocate, women veterans, assaulted veterans, raped women veterans, Veterans Administration, veterans benefits, unemployability, employability, individual unemployability, Eye Movement Desensitization and Reprocessing, EMDR, vocational testimony, Adjustment to Disability, Depression, Disability, disabled veterans, expert vocational testimony, psychologist, rehabilitation, rehabilitation consultant, social security disability. Dealing with an impairment, whether physical or emotional, is a loss and can create serious difficulty in one’s life.

As a rehabilitation professional for the past twenty-five years, I have come to work with many individuals who require counseling / therapy to assist with understanding and coping with their disability. Assisting clients through the five stages of loss proported by Kuvler - Ross (1981), I explore denial, anger, bargaining, depression, and acceptance. Many are able to gain needed insight and reframe the situation. I educate clients on coping skills, relaxation techniques and communication. A veteran may be considered as unemployable upon termination of employment which was lost as a result of a service connected disability.

Individual Unemployability Related to Veterans Administration. Total disability ratings for compensation may be awarded where the scheduler rating is less than total, and the veteran is unable to secure or follow a substantially gainful occupation.

Marginal employment shall not be considered substantially gainful employment – that is, when a veteran’s earned annual income does not exceed the amount established for the U.S. Department of Commerce as the poverty threshold for one person or by per case basis. (Currently at $7,547.60 Fed. Reg. 65,090).

It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disability shall be rated totally disabled. (4.16). Total Disability shall be considered to exist when there is present an impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation provided that the disability is reasonably certain to continue throughout the life of the disabled person. Under the law, a veteran who has one or more service connected disabilities, which cause him/her to be unemployable is entitled to receive a 100% rating, not withstanding the underlying rating assigned to their condition or conditions. There will be a clarification of what substantially gainful employment means as well as what specific activities are generally required for such activity.

Social Security - If you have worked long enough under Social Security and become severely disabled before attaining your normal retirement age, you may be entitled to monthly disability benefits.

Disability under Social Security means that you are so severely impaired, physically or mentally(or a combination), that you can not perform substantial gainful work based on your age, education, past work history, and medically determined limitations. The impairment must be expected to last at least 12 months or result in death.

Depression refers to a sustained emotion that colors the way a person views life. It is more than unhappiness. Approximately 20% of adult women and 10% of adult men may be experiencing depressive symptoms. The prevalence of depression appears to be increasing in both sexes. It can occur in any race or social class. Single individuals who have no

significant other in their lives or who have minimal social supports tend to be more

susceptible. Common symptoms include: Depressed mood. Interests or pleasure is markedly

decreased in nearly all activities. Eating and weight – marked gain or loss of weight

(unintentional). Excessive sleep or cannot sleep. Observable psychomotor activity –

either speeded up or very slow. Fatigue, tiredness, loss of energy. Feelings of

worthlessness or guilt. Difficulty concentrating or having problems with making decisions.

Suicidal thoughts or attempts. These symptoms cause clinically significant distress or

impair social, personal or vocational functioning.

100% Service Connected Unemployable Rating - The attitudes of all contacts except the most intimate are so adversely affected as to result in virtual isolation in the community. Totally incapacitating psychoneurotic symptoms bordering on gross repudiation of reality with disturbed thought or behavioral processes associated with almost all daily activities such as fantasy, confusion, panic and explosions of aggressive energy resulting in profound retreat from mature behavior. Demonstrably unable to obtain or retain employment.

70% Service Connected Rating - Ability to establish and maintain effective or favorable relationships with people is severely impaired. The psychoneurotic symptoms are of such severity and persistence that there is severe impairment in the ability to obtain or retain employment.

50% Service Connected Rating - Ability to establish or maintain effective or favorable relationships with people is considerably impaired. By reason of psychoneurotic symptoms the reliability, flexibility and efficiency levels are so reduced as to result in considerable industrial impairment.

30% Service Connected Rating - Definite impairment in the ability to establish or maintain effective and wholesome relationships with people. The psychoneurotic symptoms result in such reduction in initiative, flexibility, efficiency and reliability levels as to produce definite industrial impairment.

10% Service Connected Rating - Less than criteria for the 30 percent, with emotional tension or other evidence of anxiety productive of mild social and industrial impairment.

Note (1). Social impairment per se will not be used as the sole basis for any specific percentage evaluation, but is of value only in substantiating the degree of disability based on all of the findings.

Note (2). The requirements for a compensable rating are not met when the psychiatric findings are not more characteristic than minor alterations of mood beyond normal limits; fatigue or anxiety incident to actual situations; minor compulsive acts or phobias; occasional stuttering or stammering; minor habit spasms or tics; minor subjective sensory disturbances such as anosmia, deafness, loss of sense of taste, anesthesia, parestlesia, etc. When such findings actually interfere with employability to a mild degree, a 10 percent rating under the general rating formula may be assigned.

Note (3). It is to he emphasized that vague complaints are not to be erected into a concept of conversion disorder. A diagnosis of conversion disorder must be established on the basis of specific distinctive findings characteristic of such disturbance and not merely by exclusion of organic disease. If a diagnosis of conversion disorder is found by the rating board to be inadequately supported by findings, the report of examination will he returned through channels to the examiner for reconsideration.

Note (4). When two diagnoses, one organic and the other psychological or psychoneurotic, are presented covering the organic and psychiatric aspects of a single disability entity, only one percentage evaluation will be assigned under the appropriate diagnostic code determined by the rating board to represent the major degree of disability. When the diagnosis of the same basic disability is changed from an organic one to one in the psycho logical or psychoneurotic categories, the condition will be rated under the new diagnosis.