As the nation ages, so does the population of aging veterans. The number of veterans who are 65 or older is expected to double by 2039. The Department of Veterans Affairs has repeatedly announced its intent to expand plans that deliver healthcare services to older veterans who qualify for VA healthcare.
The VA must provide nursing home and similar care to veterans who have a service-related disability rating of 70% or higher. Covered care may include short- or long-term nursing home facilities, respite care, VA community living centers, private assisted living facilities, state veterans’ homes, and the Medical Foster Home (MFH) program. The MFH program gives disabled veterans the opportunity to live in a home with a licensed caregiver who provides meals and helps with the activities of daily living, such as bathing, eating, and getting dressed.
Nursing home and related services are also available to older veterans who qualify for Total Disability Individual Unemployability (TDIU) benefits. Veterans can receive TDIU benefits when they have a 60% service-connected disability rating if their disability renders them unemployable.
TDIU Benefits for Veterans
Veterans who qualify for TDIU benefits receive the same veterans’ benefits as veterans who have a 100% disability rating. About 350,000 veterans receive TDIU benefits. About 200,000 veterans who receive TDIU benefits are over the age of 65. However, the VA is not allowed to consider age when it determines eligibility for TDIU benefits.
Instead, eligibility is based on the veteran’s inability to obtain or maintain “substantial gainful employment” because of a service-connected disability. “Substantial gainful employment” is essentially a steady job that allows the veteran to earn a threshold income. That income threshold is the federal poverty level for a single person. In 2022, earnings above $13,590 will disqualify a veteran from receiving TDIU benefits.
While earnings above the threshold demonstrate that a veteran is not eligible for TDIU benefits, the unemployability standard requires the VA to determine whether the veteran is capable of earning the threshold income. Veterans are not regarded as capable of substantial gainful employment simply because they perform an occasional odd job, help with a family business, or work in a sheltered workshop. However, if veterans could find employment that meets the income threshold, they are not classified as unemployable and will not qualify for TDIU benefits.
Vocational experts engage in a comprehensive assessment of evidence to decide whether a veteran is employable. That assessment begins with a review of medical evidence, including functional capacity evaluations. Significant limitations may rule out jobs that the veteran would otherwise be capable of performing.
Vocational experts also analyze the veteran’s educational background and work history. If a veteran has been fired from a series of jobs, the expert will determine whether those employment terminations are linked to a single factor. For example, a veteran who suffers from post-traumatic stress disorder (PTSD) that was caused by military service might have difficulty maintaining the calm demeanor that most employment requires. A vocational expert might find that the veteran’s condition makes it unlikely that any employer will regard the veteran as an acceptable employee.
TDIU benefits are paid on either a temporary or permanent basis. The VA will require periodic reexaminations of the veteran’s eligibility if it awards temporary benefits. However, TDIU benefits automatically become permanent when the veteran reaches the age of 70.
Unemployability and Older Veterans
Since VA regulations prohibit consideration of age in deciding whether TDIU benefits should be awarded, a vocational expert cannot draw a direct connection between age and employability. That regulation runs counter to the conventional understanding that older workers have a much more difficult time finding employment than younger workers.
Labor market researchers recommend that all workers endeavor to develop a “sustainable career.” Sustainable careers are occupations that can be pursued until retirement age or beyond. A sustainable career maximizes the employability of seniors. Of course, workers who have developed a sustainable career might become unemployable as the result of a service-related disability. For example, a pilot whose vision is impaired by shrapnel might lose the ability to pursue a career in commercial aviation. Other careers might continue to be sustainable if technology can help the worker cope with a disability.
Unfortunately, not all members of the military will pursue a sustainable career after their active duty ends. Jobs that depend on physical labor become more challenging as workers become older. While the VA regulations do not allow consideration of age as a barrier to employment, age often correlates with physical deterioration that is associated with aging. A service-related disability may therefore have a greater impact on an older worker than a younger one because of the older worker’s physical condition as opposed to the worker’s age.
Barriers to Employability
When a service-related disability would not prevent a worker from pursuing a sustainable career but the worker cannot find a job because of the worker’s age, the VA regulations impose a burden on older veterans. The veteran may be unemployable as a matter of job market reality, but the VA will not consider age as a factor that impairs employability.
The system would be more fair to older workers if the VA were permitted to recognize that age is relevant to employability. Opponents of that change argue that TDIU is not a retirement benefit, like Social Security. However, many older workers choose not to retire but nevertheless collect Social Security. A TDIU benefit recognizes that, regardless of age, a veteran who cannot work because of a service-related injury should be treated as if the veteran were 100% disabled. Acknowledging that age is relevant to the ability to find employment does not transform a disability benefit into a retirement benefit.
Some members of Congress want to do away with TDIU entirely when a recipient reaches retirement age. They want the recipient to collect Social Security in lieu of TDIU. In fact, the Executive Branch included that proposal in its recommended budget in 2018. Fortunately, Congress did not agree with the administration’s approach.
Social Security is available to every eligible worker, regardless of whether they are disabled. There is no reason to take TDIU benefits away from older workers simply because they become eligible for Social Security. The point of TDIU benefits is not to force older workers into retirement but to recognize that they would have the option to continue working if not for a service-related disability that makes them unemployable.