Use of Department of Veterans' Affairs Disability Decisions by the Social Security Administration

April 11, 2011

904093_army.jpgWhen deciding a claim for Social Security Disability Benefits (SSDI) or Supplemental Security Income (SSI) the Social Security Administration is required to take into account a disability decision made by the Department of Veterans' Affairs (VA). Similarly, the VA is required to take into evidence a favorable decision with regard to Social Security benefits. The VA's regulations, however, are not as claimant friendly as the Social Security Administration's.

According to the Social Security Administration's own rules and regulations, a decision by any governmental agency about whether an individual is disabled or blind must be considered evidence. See 20 C.F.R. §404.1512(b)(5); see also Social Security Ruling 06-03p. While such evidence is not binding on the Social Security Administration, various Circuit Courts have helped determine the weight that should be given to favorable/unfavorable disability decisions. See 20 C.F.R. §404.1504. With regard to a veteran's disability rating from the VA, the Circuit Courts that have jurisdiction over 20 states and over Guam and Northern Mariana Islands have said that the Social Security Administration must give them evidentiary weight.

For veterans living in Georgia, Alabama, or Florida, the 11th Circuit Court held that a VA decision rating a veteran's disability is entitled to "great weight". See Brady v. Heckler, 724 F.2d 914, 921 (11th Cir. 1984).

The same decision was reached in the 4th Circuit, which has jurisdiction over North Carolina, South Carolina, Virginia, West Virginia and Maryland. See De Loatche v. Heckler, 715 F. 2d 148, 150 n.1 (4th Cir. 1983). Also the 5th Circuit, covering Mississippi, Louisiana and Texas, said such a decision is entitled to "great weight". See Chambliss v. Massanari, 269 F.3d 520, 522 (5th Cir. 2001). And finally the 9th Circuit, covering California, Nevada, Arizona, Oregon, Idaho, Montana, Washington, Alaska, Hawaii, Guam and Northern Mariana Islands, held a VA disability rating shall be given "great weight". See McCartey v. Massanari, 298 F.3d 1072 (9th Cir. 2002).

For veterans living in Pennsylvania, New Jersey, and Delaware, the 3rd Circuit held that a VA decision is entitled to "substantial weight". See Kane v. Heckler, 776 F.2d 1130, 1135 (3d Cir. 1985).

Similar to the regulations forcing the Social Security Administration to accept a VA disability rating decision as evidence, the VA has the duty to obtain a copy of the Social Security Administration's file in order to assist in the development of a veteran's claim for service connected or nonservice connected disability benefits. See 38 C.F.R. §3.159(c).

This requirement of the VA to obtain the Social Security file is based in the VA's "Duty to Assist". The Court of Appeals for Veterans Claims stated that for a "thorough and complete review" the VA was obligated to get the Social Security file. See Hayes v. Brown, 9 Vet. App. 67, 73-74 (1996); see also Murincsak v. Derwinski, 2 Vet. App. 363, 372 (1992).

The VA does not, however, have to necessarily give weight to a favorable Social Security decision. This is because the VA may find that where a veteran who has filed for an increase in his/her disability rating the Social Security decision was not based on the service connected disabilities. This is not to say that a favorable Social Security decision cannot be very persuasive in helping the VA correctly determine the severity of a disability and assist them in deciding whether a veteran can perform gainful activity.

Thus, neither the Social Security Administration, nor the VA can simply disregard a prior favorable disability determination by another government agency. It is important to know how the decisions of one agency can affect the other, therefore we recommend obtaining advice from an attorney who is experienced in both areas of law to help you understand the rules and regulations that determine the types of benefits you may be eligible to receive.