While you don’t really apply for P&T, there are some steps you can take to secure Permanent and Total Disability status. If you have a 100 percent VA disability rating and believe your level of impairment is reasonably certain to continue throughout your life, you can write a letter to your VA Regional Office requesting a permanent VA rating. With your letter, you should include medical evidence (like treatment records) showing that your medical condition cannot be expected to improve in the future. You may be able to obtain a VA permanent disability letter from your doctor as well, which highlights in their medical opinion, whether your disabilities are likely to improve in the future. You can also open a new claim inside eBenefits or VA.gov and type the disability of “Request for 100% Permanent and Total VA Disability” and upload medical evidence, buddy letters, and a letter from a doctor.