Added on top of any rating, even 0%. Covers loss of use of a creative organ, including ED secondary to a service-connected condition or its medication. The single most commonly missed benefit; claim it explicitly, and up to 3 can stack.
Permanent & Total = no future re-exams, plus dependents' school benefits (DEA Ch. 35), CHAMPVA, and state property-tax breaks. If your conditions are static, ask for P&T explicitly, the rater won't always volunteer it.