It is a common source of worry and confusion for veterans…wondering if and when the VA will try to reduce their service-connected ratings and benefits. Understandably, a loss of needed disability benefits due to a rating reduction can put a huge strain on a veteran. In this post, we are going to explain when, how and why the VA can reduce ratings and what can be done in response.
Re-Evaluation & Re-Examination
The VA evaluates whether there is a chance of service-connected conditions and disabilities improving over time. If they believe there is a chance those disabilities or conditions could improve as time passes, they may schedule a re-examination. The VA is required to give prior notice of the re-examination. It is crucial to show up for this appointment! Missing the appointment, or not calling and explaining why you cannot attend, is likely to result in reduction or even termination of benefits.
The most common times the VA wants to re-evaluate conditions are 2-5 years after a disability rating is given, 6 months after leaving military service, or when they feel a condition or disability may have steady improvement.
How Do They Determine if Ratings Reduction is Warranted?
The VA is supposed to follow certain rules for this process. It is important that the veteran be aware of these rules and guidelines, as unfortunately, mistakes happen in this process:
- The VA must review the veteran’s entire medical history and records.
- The re-examination must be thorough.
- There must be proof that the condition has improved over time and that this improvement or change has positively affected the veteran’s ability to work and/or function in daily life. As most veterans have experienced, disability symptoms can temporarily decrease. The VA has to show proof that the symptoms are deceasing steadily and not temporarily. This is called “sustained improvement”, meaning the disability or condition is improving steadily over time and daily life and/or work function capabilities are improving as a result.
What Happens Next?
The VA has to send a letter (as a proposal) for reduction of benefits if it will affect monthly compensation amounts. This isn’t a final decision, and it allows the veteran the chance to respond by submitting evidence against the proposal or to request a hearing:
- If the veteran wants to request a hearing, that must be done in the first 30 days after the date of the proposal letter.
- The veteran has 60 days from the date of the proposal letter to submit evidence.
What Kind of Evidence Should be Submitted?
The VA already has the examination reports, so what can be sent as evidence to argue against the reduction?
- The best evidence is a report and medical opinion from an independent medical professional that gives thorough evidence that contradicts what the re-examination noted.
- Statements from family, friends, colleagues and employers who regularly observe the veteran’s ability to function in daily and work life can be very helpful.
Protections Against Re-Examinations and Re-Evaluations
There are some factors that influence the VA (typically) to not order a re-examination of a veteran’s disabilities. These are:
- A rating that has remained the same (stabilized) for 5 or more years. This means that the condition has not steadily (not just one medical visit or report) improved in a way that positively affects the veteran’s ability to function in work and daily life. The VA sees a disability that has been stabilized for 5 or more years as unlikely to improve or change.
- Being over the age of 55
- A total disability rating; 100%
- A permanent disability, as this means there is little to no chance for improvement over time.
- A continuous rating for 20+ years. Once a rating has been at a certain level for 20 or more years, it’s considered continuous and the VA may not reduce the rating.
**Please note that these aren’t concrete and the VA can re-evaluate and order re-examinations on an individual basis.**
What If I Submit Evidence or Request a Hearing and the VA Still Reduces my Rating?
If the 60 day time period after the proposal letter has passed and the VA makes a decision to reduce your rating, you can file an appeal via Notice of Disagreement, Higher-Level Review or Supplemental form options.
Read our blog post that’s all about supplemental claims!
Connect with Us
Many veterans aren’t getting accurate ratings for their disabilities and conditions in the first place, so further reductions can negatively affect their life. Our team works with veterans to determine if they are receiving accurate ratings for their service-connected disabilities. The consultation is free! Take a step by clicking the button below and learn if you can change your rating and life for the better!Click Here for Info on Your Free Consultation