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What Happens in a VA Rating Reduction?

What Happens in a VA Rating Reduction?

Many Veterans are nervous that they could potentially lose their disability benefits in the future. If the VA thinks a disability potentially reduced in severity over time, they may send a notification of rating reduction. This does not mean your rating will be reduced without first having a chance to prove your disability has not improved.

There are several different approaches the VA can take to reduce benefits. However, if they do propose reducing your disability rating, this is not final. You can still do certain things to maintain your current disability rating. Of course, the possibility of a rating decrease is heavily dependent on whether the case is protected or unprotected.

Can the VA Reduce Your Disability Rating?

In some cases, the VA can decrease or reduce your disability rating. However, this is not true for every disability rating in the system, nor is it necessarily true for you.

From time to time, the VA may schedule re-examinations by a contracted physician in the private sector. Those re-examinations will determine the nature and extent of your service-connected disabilities, including:

  • Whether you still have the same disabilities
  • Whether your symptoms are the same or at the same severity level
  • And more

The VA does this to ensure that only Veterans who need disability compensation receive it. Note, however, the VA is not legally allowed to reduce your benefits without giving you written notice via Due Process

So, is your disability rating certain to go down? Not at all. That said, some conditions can and do get better over time with medications, treatment, and simply time passing. This can include conditions like PTSD, obesity from a disability, back pain or other pain, limited range of motion in your limbs which can improve with physical therapy, and more.

Even if you are worried about your disability rating decreasing, you should not skip a re-examination if it is ordered by the VA. That will almost guarantee that your disability rating will go down without a chance to defend yourself.

Can You Prevent the VA from Reducing Your Disability Rating?

In some cases, yes. You can prevent the VA from reducing your disability rating if you attend your re-examination appointment and you show that you still require the same disability benefits you’ve been receiving. 

Furthermore, legal assistance from knowledgeable attorneys can help you manage your re-examination appointment properly and provide supporting evidence if necessary.

PROTECTED RATINGS

The Requirement of Sustained Improvement

If a rating has stabilized or continued at the same level for five years or more, the VA must show that all evidence of record indicates a sustained improvement in the disability. This means the medical history for the disability in question must be considered when reviewing records for a possible rating reduction. If the VA cannot show sustained improvement, it cannot reduce a Veteran’s rating.

The VA must also review the entire record of examinations to determine whether such examinations are full and complete. If not, they may not be considered in a VA rating reduction.

If the disability has shown temporary or episodic improvement, it cannot be reduced unless all evidence clearly shows sustained improvement. The VA must also consider whether the material improvement shown “will be maintained under the ordinary conditions of life.”

The Requirement of Fraud

If a Veteran’s disability has been rated at the same level for 20 or more years, the VA cannot reduce it unless it can show that the disability rating was based on fraud. This is known as the 20 year rule, and protects Veterans from a reduced rating.

The Requirement of Material Improvement

When the VA considers reducing a 100% rating (including TDIU based on individual or combined rating), it must determine whether there has been a material improvement in the physical or mental condition evaluated at 100 percent. An examination is necessary for the VA to do this.

Additionally, if the Veteran has experienced material improvement on a schedular rating, VA must still consider whether he or she qualifies for TDIU.

UNPROTECTED RATINGS

When Veterans have unprotected disability ratings, there is a potential that their disability rating could be reduced. This does not mean the VA can reduce your rating for no reason. Even if a Veteran’s rating has not been in place for five years or more, the Court of Appeals for Veterans Claims has established the following:

  • Proposed reductions must be based on review of the entire history of the Veteran’s disability.
  • The VA must make a determination as to whether there has been an actual change in the disability.
  • Improvement in the disability must be shown in the Veteran’s ability to function under the ordinary conditions of life and work.
  • Examinations reporting any such improvement must be thorough.

If the VA cannot prove any of the above, your rating should not be reduced.

DUE PROCESS PROTECTIONS

When the VA determines a rating reduction is proper, due process protections also apply. The VA must provide prior notice to the Veteran of the proposed reduction. The Veteran must be given 60 days after the notice to submit evidence to rebut the proposal (the 60-day notice requirement is not enforced in cases where the Veteran’s compensation will not be altered as a result of the reduced rating).

The Veteran also has a right to a predetermination hearing, which must be requested within 30 days of notification of the proposed VA rating reduction. The proposed reduction, if implemented, would not take effect until after this hearing has taken place.

In the event a Veteran receives a proposed VA rating reduction, it is important to provide any and all evidence to fight the VA’s proposal. If the VA schedules an examination, attendance is critical. Failure to do so will result in an automatic reduction. If you recently received a notification of a rating reduction, you should ensure you are prepared to use evidence to demonstrate that your disability has not improved over time.

The Importance of Attending Re-Examinations

Simply put, you must attend re-examinations if they are ordered by the VA. Otherwise, the VA could decrease or discontinue your benefits coverage and payments. Some disabilities are unlikely to improve, such as missing limbs or disabilities with symptoms that of persistent without improvement for five or more years.

Going to your exam gives you the chance to help prevent your disability rating from decreasing by:

  • Being brutally honest about your symptoms and their severity
  • Discussing pain flareups or discomfort you experience due to your service-connected disabilities
  • Bringing a friend or spouse who can support your evidence and claims that you still require the same disability rating
  • And more

Continuous Ratings and Incarceration

If you have a disability or condition and it has been rated at a certain level for 20 years, it’s considered a continuous rating. The VA cannot reduce continuous ratings. 

For instance, if you have had a disability rating for back pain at 30% for 20 years, the VA will never decrease that rating. The VA can still increase your disability rating if necessary, however.

If you are incarcerated, the VA may reduce your benefits to just 10%, regardless of what your rating and benefits may have been before you entered the system. Therefore, it’s important to avoid incarceration as a disabled Veteran at all costs, as you can lose most or all of your disability benefits as a result.

Veterans Serving Veterans

If the VA reduces your rating, don’t give up. There are many ways to fight this decision. One of them is hiring Berry Law’s team of Veterans’ law attorneys.

With many Veterans counted among our attorneys and staff, we know firsthand the struggles service members face when they return home with injuries and disabilities. In fact, many of the Veterans on our team have current disability ratings. Our firm has worked closely with Veterans for over fifty years and we have recovered millions of dollars in back pay awards on their behalf.

If the VA has reduced your disability rating, contact Berry Law today. Your consultation is free. Don’t go to battle alone. Let Berry Law help you fight the VA for the disability compensation you earned.

Sources:

Chapter 2 VETERAN’S RIGHTS, RESPONSIBILITIES AND DUE PROCESS 2.01 Introduction 2.02 References and Resources 2.03 Providing GE | VA.gov

VA COMPENSATION & PENSION – Understanding Review Examinations | VA.gov

About VA Disability Ratings | Veterans Affairs

Berry Law

The attorneys at Berry Law are dedicated to helping injured Veterans. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals.

This material is for informational purposes only. It does not create an attorney-client relationship between the Firm and the reader, and does not constitute legal advice. Legal advice must be tailored to the specific circumstances of each case, and the contents of this blog are not a substitute for legal counsel.

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