Responding to a Proposal to Reduce or Terminate Benefits

Occasionally, the VA will send a military service member a proposal to reduce or terminate their benefits. The VA does this to ensure that they are compensating a Veteran for their current level of disability, often because they believe the Veteran will recover from the disability over time or they have received evidence (such as medical records) indicating that the Veterans disability from active duty has improved. When this happens, they will schedule a VA disability re-evaluation.

Why Would the VA want to Reduce my Benefits?

The VA operates on the basis that it wants to give disabled Veterans exactly what they need for their disabilities. Sometimes, they need to increase their VA compensation and VA disability benefits to match what the Veteran needs. That’s why the diagnostic codes exist; to ensure that Veterans get what they need in proportion to their disability. The different percentage values coincide directly with the level of need and care that Veterans require and receive. They are carefully decided by professionals to try and formulate exactly the amount of income that is required to supplement any lack of income or disability that a Veteran might have. 

The VA would want to reduce or terminate a Veteran’s benefits for those reasons. If a Veteran has a condition that has progressively got better, or easier to deal with over the years, the VA will likely want to take a second look at the disability. This can come in the form of examinations, hearings, and tests to see where the Veteran is at in terms of physical ability to self-sustain, as well as sustain any dependents that they might have. 

If the VA does its due diligence to the Veteran in terms of finding out how they are doing and finds that their condition has improved, they will likely start to try and find a way to decrease or terminate benefits. This can come in the form of lowering the percentages of the disability or disabilities that the Veteran has. Seeing as most disabilities in the diagnostic book have varying ranges of percentage that apply to the condition, the VA will often lower the level of percentage to a lower tier to match the current level more closely. 

How to Appeal A VA Decision

The idea behind these actions is that the Veteran should be more likely to work sustainably, and would need less income to supplement their disability. The reductions happen because the VA believes the Veteran can now make their money in another way. 

If the decision reached by the VA is inaccurate to what a Veteran feels is their actual condition and life circumstance, then it is important to make an appeal. This can be done through the supplemental disability claim lane. To do this, the Veteran will need to bring new evidence to the VA that is both new and relevant to the specific circumstances. It has to be something that will forward their case against the VA decision, and will show them a more accurate representation of the situation that they are in. 

Some ways to do this are to look outside of their own world, and bring in some outside voices. This can mean getting a Nexus letter from a healthcare professional, to give a professional medical opinion on the current state of the medical condition. The Veteran can also bring in the statements of people who they are in close proximity to, to get their thoughts and opinions. Having people’s statements to show the day to day impact of the condition can mean a lot for the Veteran’s case. 

Another option, and perhaps the most important option, is to seek outside legal counsel and help. Here at Berry Law, we are professionals who know and understand the Veteran’s affairs system of disability compensation. It’s one of our specialties, and we know how to work virtually any case that we need to, to make sure that Veterans get exactly what they need. If you or any other Veterans you know aren’t getting the benefits and compensation they need and deserve from the VA, don’t hesitate to reach out to us for help. 

What Ratings Are Protected from Reduction?

Some ratings are protected from reduction. It’s important for Veterans to know which ones they are, so that they can put time and effort into knowing what problems they do and don’t need to fight. 

  • If a VA disability rating has been in effect for at least five years, the VA will address that condition as having “stabilized.” This means that the rating will stay the same because it appears that the condition itself isn’t changing. This creates stability for the Veteran.
  • If a condition is known as a “static disability,” it will not go down. A static disability is a condition or injury that won’t get better, like an amputation, blindness, or any other condition that is not possibly able to get better. Those ratings are permanent and will not change.
  • If a Veteran has been receiving disability compensation for twenty or more years, the Veteran’s rating will not go below what the lowest rating was. This is because a condition or set of conditions that last that long are unlikely to go away. And as a Veteran ages, their likelihood for long standing injuries and conditions to improve goes down drastically.
  • If the Veteran is permanently disabled with a rating of 100%, their rating will not go down. Their rating will have to stay where it is, because it is very likely that the condition cannot get any better. 

What Are VA Disability Reevaluation Examinations?

VA Disability Reevaluation Examinations are tests to check up on the physical and mental wellness of the Veteran. These are examinations to see if the Veteran has improved, gotten worse, or stayed the same. The condition of the Veteran is looked at by a professional within the jurisdiction of the VA, and the compensation is assessed from there. 

The VA is supposed to look at the entire medical history of a person before they make any final calls of judgment on the change of a Veteran’s disability compensation. For example, if the vast majority of the test results that a Veteran has don’t show signs of improvement, but one randomly does, the VA likely won’t make any decisions until it’s looked further into the medical history and condition of the Veteran. If the VA makes a decision without fully acknowledging the rest of a Veteran’s history, the Veteran should reach out to get help from a legal team, such as Berry Law

Hearings

If you receive a proposal to reduce, you have a couple of options. One option is to ask for a hearing within 30 days from the date you received the letter. This will stop any reduction or termination until you have exercised your right to be heard.  This option will keep you at the same rate of pay until after the decision from the hearing.  This can be a formal motion or a request written out on a Statement in Support of Claim—VA Form 21-4138. The VA will not be able to make the proposed reduction in pay until after the evidence has been adduced and a decision was made at the hearing.

Evidence

Your second option in response to a proposal to reduce benefits is to forego a hearing pending a decision on the proposal to reduce, in which case you have 60 days to file evidence showing the eligibility factors which entitled you to the benefit continue to exist.  If the VA doesn’t receive your certification that these factors continue to exist within the 60-day period, the proposed reduction or termination of benefits will be put into effect. For compensation purposes, the reduction in pay will begin the last day of the month following 60 days after notice was given.

Failure to Appear for an Examination

If you miss your examination, your benefits will be reduced or terminated unless you can show good cause for missing the appointment. If the Veteran shows good cause, they have 60 days to indicate willingness to report to a re-examination or show evidence why their benefits should not be reduced or terminated.  It’s very important that you attend your examination, as missing the exam gives the Department of Veterans Affairs an easy path to reduce or terminate your benefits.

Veterans Appeals Lawyers

At Berry Law firm, we are dedicated to helping Veterans in their fight for disability benefits. We are a Veteran owned and operated business that is committed to fighting on behalf of our fellow Veterans and the Veterans service and keeping a great attorney-client relationship. If you have been denied disability compensation benefits by the VA regional office or were given too low of a rating level, we may be able to help get a better VA claim based on the Veteran’s ability. Contact the experienced, VA-accredited attorneys at Berry Law today to see if we can help you.

 

Sources: 

https://www.vba.va.gov/pubs/forms/VBA-21-4138-ARE.pdf

https://www.disabilitycarecenter.org/veterans/va-benefit-reductions/