Anytime a Veteran requires surgery OR extended hospitalization (21 days or more) for a service connected disability (commonly referred to as Chapter 29/30 benefits – a reference to CFR 38 4.29/30 that detail the requirements and entitlement benefits), there is an associated convalescent period. The convalescent period for hospitalization will apply for as long as the Veteran is hospitalized beyond the initial 21 days. For all convalescent periods, a total disability rating (100%) is assigned “without regard to any other factors when it is established by a surgical report from a hospital or outpatient release letter that verifies entitlement for such convalescence is warranted.” It is important to note that at least one of the following criteria must be met in order to receive this entitlement: the surgery must necessitate at least one month of convalescence (most outpatient surgical procedures qualify), OR the surgery has severe postoperative residuals such as incompletely healed surgical wounds, stumps of recent amputations, therapeutic immobilization of one major joint or more, application of a body cast, or the necessity for house confinement, or the necessity for continued use of a wheelchair or crutches; OR immobilization by cast, without surgery, of one major joint or more.
The effective date for the convalescent rating will be the date of hospital admission or outpatient treatment and become effective for pay purposes from the first day of the following month. Depending upon the type and purpose of the surgical procedure, the rating for the disability will either return to the previous rating or a physical examination will be scheduled and considered prior to assigning a new rating. For example, the typical convalescent period for a simple knee debridement for a 10% service connected knee condition would result in a one month total disability rating (100%), then return to its previous rating of 10%, assuming no complications with the procedure.
Extensions of Convalescence Ratings
The VA has charts for convalescence periods associated with differing surgical procedures affecting all their disability ratings; therefore, regardless what a Veteran’s doctor may prescribe as a convalescence period at discharge doesn’t necessarily mean the VA will grant that same period for a total disability rating (100%). Nonetheless, convalescent ratings may be extended by 1, 2, or 3 months beyond the initial period if there are complications that warrant continued convalescence AND it is deemed by a doctor that such convalescence is necessary. For extensions of 1 or more months up to 6 months beyond an initial 6 months period (or more, such as a 13 month convalescence period for a major joint replacement), a doctor’s statement AND approval of the Veterans Service Center Manager is necessary to continue a total disability rating (100%).
Potential Effect of Convalescent Ratings on the Veteran’s Overall Combined Rating
It is important to note that if a Veteran has a surgical procedure or qualifying hospitalization on a service connected disability and has OTHER service connected disabilities (either singularly or combined) that equal(s) 60% disabling or higher, then that Veteran is entitled to special monthly compensation called Housebound for the duration of the convalescence period. This consideration is automatically calculated and paid at the time of the VA Notification letter / Rating Decision that granted the convalescence.
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