What Are Staged Ratings?

CCK Law: Our Vital Role in Veterans Law

A staged rating is when VA changes a veteran’s retroactive disability compensation based on how the condition changed between the veteran’s effective date and when the back pay was finally awarded. Applying staged ratings may increase a veteran’s back pay if the condition was worse in the past.

Key points in this article include:

• VA is required to assign a staged rating when there is evidence of a material change in the severity of a service-connected condition over time.
• Staged ratings directly impact effective dates, which, in turn, directly impact any back pay VA may owe the veteran.
• There are several ways in which a veteran may be able to appeal an unfavorable VA staged rating.

Why Did VA Create Staged Ratings?

In the U.S. Court of Appeals for Veterans Claims’ (CAVC) landmark decision in Fenderson v. West (12 Vet. App. 119, 1999), the court held that VA must consider whether the evidence supports assigning different ratings for different time periods, rather than applying a single rating across the entire claims period.

Today, a staged rating is when VA changes a disability rating based on evidence that a veteran’s service-connected condition was more or less severe at different points in time. VA will assign a different rating percentage for each of those periods before paying back pay.

Effective dates determine when a veteran’s VA compensation payments should have begun. Staged ratings, in effect, establish multiple effective dates, because each rating level carries its own start date.

For example, a veteran might receive a 10 percent rating for their lower back condition from their effective date in 2015 through 2019, and then a 50 percent rating from 2019 forward, reflecting a documented worsening of their lower back condition over the course of those years since the claim was initially filed.

What Are the Types of Staged Ratings?

VA uses three main types of staged ratings:

• Staged ratings based on changing severity—This type is used when the veteran’s condition worsened or improved between the time the claim was initially filed and when it was adjudicated. For this type of staged rating, VA assigns effective dates based on medical records and lay evidence in the veteran’s claim file.
• “Temporary Total” evaluations—Also called “convalescent ratings,” VA uses this type to compensate veterans at the 100 percent rating level during a hospitalization that lasts 21 days or longer due to a service-connected condition. This 100 percent rating typically continues for up to three months following the hospital discharge or release, but VA decides these claims on a case-by-case basis.
• Prestabilization ratings—This type applies to veterans who were recently discharged from service with a severe, unstable condition. Prestabilization ratings are designed to compensate newly separated service members for the impact of their disability on their ability to work. Per 38 CFR § 4.28, this type of rating can only be 50 percent or 100 percent and is generally valid for 12 months after active service discharge.

VA may also apply staged ratings in the context of 100 percent disability ratings, including permanent and total (P&T) ratings. However, staged ratings and P&T ratings interact in important ways (see FAQ section below).

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When Does VA Assign Staged Ratings?

VA must assign a staged rating when there is evidence showing a material change in the severity of a service-connected condition over time. This can happen in several situations, including:

• Initial claims—If medical records spanning several years show that the severity of the condition fluctuated significantly, VA should assess whether different ratings apply to different periods.
• Increased rating claims—When a veteran files a claim for a higher rating and VA reviews historical medical evidence, it may assign an earlier effective date at a lower level and a later effective date at a higher level.
• Appeals—The Board of Veterans’ Appeals and the Court of Appeals for Veterans Claims can both assign staged ratings when reviewing the record.
• Temporary total evaluations—After certain surgeries or hospitalizations (see below), VA may assign a temporary 100 percent rating and subsequently decrease the rating after a period of recovery.

VA is obligated to consider staged ratings whenever there is evidence that supports them. If VA fails to do so, it can be grounds for an appeal.

What Are Temporary Total Evaluations and How Do They Relate to Staged Ratings?

One of the more common staged-rating situations, a temporary total evaluation is when VA assigns a temporary 100 percent disability rating, typically while a veteran is recovering from treatment.

Under 38 CFR § 4.29 and § 4.30, VA must assign a 100 percent rating in two situations:

• Hospitalization—A veteran who is hospitalized for a service-connected condition for more than 21 days is entitled to a 100 percent rating for the period of hospitalization.
• Surgery and convalescence—A veteran who has surgery for a service-connected condition and requires a period of convalescence is entitled to a temporary 100 percent rating during recovery.

After the hospitalization or recovery period ends, VA must reassess the condition and assign a new rating based on the veteran’s current level of disability. This post-recovery rating forms its own “stage” in the rating history.

How Can a Veteran Challenge an Unfavorable Staged Rating?

If VA assigns a staged rating that a veteran believes is incorrect — such as assigning a lower rating for an earlier period when the evidence does not support it — the veteran has the right to appeal.

Common legal arguments in staged rating appeals include:

• Failure to consider favorable evidence—VA must weigh all evidence in the record. If it ignored medical records supporting a higher rating for a given period, that is reversible error.
• Inadequate examination—If VA’s rating was based on a Compensation and Pension (C&P) exam that did not address how the condition presented during earlier periods, the exam may be inadequate.
• Fenderson error—If VA assigned a single rating across an entire period without analyzing whether staged ratings were warranted, that is legal error under Fenderson v. West.
• Incorrect effective date—Even if VA assigned a staged rating, it may have used the wrong start date for a higher rating level.

What Evidence Supports a More Favorable Staged Rating?

To obtain a more favorable staged rating or establish an earlier effective date at a higher rating level, veterans should gather the following forms of evidence:

• Private medical records and treatment notes that document symptom severity over time
• Buddy statements from family members, caregivers, or fellow veterans describing how the veteran’s condition affected the veteran during a specific period of time
• Nexus opinions from independent medical experts addressing how the condition presented during an earlier period
• VA treatment records, including any VA hospitalizations or surgeries that would trigger a temporary total evaluation under 38 CFR § 4.29 or § 4.30
• Employment records or lay statements showing how the condition limited the veteran’s ability to work or perform daily activities during the period in dispute

Have Concerns About Your VA Staged Rating? Contact CCK Law

Staged ratings can be a complex area of VA disability law. Getting the right rating and the right effective date for every period in your claim’s history can significantly affect the total VA compensation you receive.

If you believe VA failed to assign an appropriate staged rating, assigned one with the wrong effective date, or used a staged rating to reduce your benefits without proper justification, you may have grounds for an appeal.

The dedicated team of attorneys and veterans advocates at CCK Law may be able to help. Call us at 800-544-9144 or contact us online for a free case evaluation.

Frequently Asked Questions

Can VA apply staged ratings on its own, or does a veteran need to request them?

Under Fenderson v. West, VA is required to consider staged ratings whenever the evidence supports them, regardless of whether the veteran formally requests one.

However, in practice, VA does not always do this. Veterans and their representatives should raise the issue explicitly during the claims or appeals process if the evidence supports different rating levels for different periods.

What happens if VA did not assign a staged rating and should have?

This is a legal error that can be raised on appeal.

• To initiate an appeal, veterans can request a higher-level review, supplemental claim, or appeal to the Board of Veterans’ Appeals with a Notice of Disagreement (NOD).
• If the BVA rules incorrectly on the law, it may also be possible to take the claim before the Court of Appeals for Veterans Claims (CAVC).

If the appeal period (typically one year) has expired, a CUE motion can sometimes be used to correct a past failure to apply a staged rating in a final decision.

Can a staged rating affect my TDIU eligibility?

Yes, it can. Total Disability based on Individual Unemployability (TDIU) typically requires a veteran to meet certain rating thresholds as defined in 38 CFR § 4.16(a). These thresholds are generally 60 percent for one condition, or 70 percent combined, where one condition is rated at least 40 percent.

Therefore, if a staged rating changes the applicable percentages for a given period, it can also affect a veteran’s TDIU eligibility and the effective date of any TDIU award.

Note that this primarily applies to schedular TDIU, which has rating threshold requirements that may not be required by extraschedular TDIU.