What Happens in a VA Disability Rating Reduction

Protected vs Unprotected Ratings

When you successfully file a VA benefits claim, you’ll receive either a protected or unprotected rating.

A protected VA disability rating means that the VA won’t independently expend any resources to check on your condition, making it much less likely or even impossible for your rating to be reduced. An unprotected VA disability rating is much more vulnerable to a rating reduction.

Protected VA disability ratings come in a few major types:

  • Stabilized ratings are those that have been the same for five years or more. It’s very difficult for the VA to force a rating reduction on stabilized ratings. The VA must prove a sustained improvement in a veteran’s condition and provide a detailed explanation for why they are certain that their condition will continue to improve in the future
  • 100% total disability ratings are not permanently protected, but they are difficult to reduce since the VA must prove that there is a material improvement in the veteran’s overall condition
  • 10-Year ratings are those that have been rated the same for 10 years. The VA is not able to terminate veteran benefits unless they can find evidence of fraud. Rating reductions are still possible, though they are quite difficult
  • Continuous ratings are those that have been at the same or a higher disability rating than the initially assigned rating for 20 years or longer. The VA can’t reduce a continuous rating below the original rating level

VA Rating Reduction Appeals Process

If you’re ever put in a situation where you have to fight a disability rating reduction, you can follow an appeals process by filing a Notice of Disagreement or NOD. The appeals process will allow you to fight to the rating reduction by providing medical evidence that:

  • Your condition has not improved as the VA office claims or
  • Your condition has actually gotten worse rather than stayed the same

In either case, a successful appeals process will result in your disability rating returning to its original level or your disability rating increasing to a higher level.

Good news – if the appeals process is successful, you’ll be able to acquire backpay for your disability benefits based on the correct rating.

Say that your primary disability had an original rating of 60%, but the VA office then reduced the rating to 40% for a period of six months. During the appeals process, you prove that your condition has not improved, restoring the rating back to the 60% rate.

When that occurs, you’ll get back pay for the six months where your rating was 20% under where it should be. In this way, you can eventually get the benefits you’re entitled to even if the VA office makes a mistake.

What Evidence Do You Need?

When fighting a VA rating reduction, it’s important to gather as much evidence as you can during the appeals process.

  • Lay evidence can come from you or anyone who witnesses the effect that your disability has on your life, such as friends or family members
  • Private medical opinions are also important. They can provide medical evidence that your condition has not improved or has gotten worse. They may also be able to provide evidence of a secondary disability as a direct result of your primary disability

In some cases, it may be beneficial to find other medical conditions that you can tie to your active military service. With the assistance of knowledgeable attorneys, you may be able to get your total disability compensation back to the former level even if your primary condition is not restored to its original rating just by getting compensation for new claims.

But keep in mind that you’ll need the same amount of solid medical evidence to file successful claims for further disabling conditions.

Are Some Disability Conditions More Likely to Have a Rating Reduction Than Others?

Yes. The VA uses specific diagnostic codes when they assign ratings to veterans initially. Depending on the diagnostic code, your condition or mental health claim may be flagged as more or less liable for a rating reduction in the future.

Codes are compiled based on a variety of factors, such as the actual condition, the circumstances that triggered the condition, the length of your service, and more.

 

Sources:

https://strategicveteran.org/va-proposal-to-reduce-veteran-rating/#:~:text=You%20start%20this%20by%20filing,in%20your%20entire%20medical%20history.

https://www.govinfo.gov/content/pkg/CFR-2012-title38-vol1/pdf/CFR-2012-title38-vol1-part4.pdf

https://www.va.gov/disability/about-disability-ratings/