Question:

I am currently rated at 90% disability but I am paid at 100% based on unemployability This rating is considered total and permanent by the VA. If one of my medical disabilities becomes worse should I file for increase?

Jim's Reply:

Great question! Thanks.
 

The best answer is...maybe. In most circumstances we don't want to open our P & T file because bad things can happen at your somewhat accident prone VA.
 

In very broad terms once you're at a permanent 100% rating whether TDIU or Schedular we let that sleeping dog lie. That's because most of the little additions we may make won't raise the rating above 100% due to VA math.
 

If there is a circumstance when your increase may propel you into SMC territory, then you should consider filing for the increase. 
 

I can't help but remind you that the 100% Permanent TDIU rating is the same in every way as the 100% Schedular rating. All your pay, dependent benefits and such are exactly the same as the 100% Schedular rated vet. As the rating is rooted in your unemployability due to your service connected disabilities, should you be able to return to work (gainful employment) you may lose the 100% TDIU rating.
 

Good luck sir!