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VA Rating Decision: How to understand what VA is saying

VA Rating Decision: How to understand what VA is saying

A VA Rating Decision is the first decision you will receive after filing a claim for service-connected compensation.  The VA Rating Decision will inform you that VA has reviewed your case and determined whether your claimed conditions are related to service.  If service connection is granted, the Rating Decision will also establish a disability rating for each condition and an effective date.  A disability rating is the percentage VA assigns to each condition based on severity and according to the Schedule for Rating Disabilities.  Furthermore, the effective date VA assigns will correspond to the date in which the claim was filed.  Importantly, this is also the date that VA will use as a start date for the payment of disability benefits.  The Rating Decision is almost always issued in conjunction with the VA award letter, which indicates a veteran’s disability ratings along with the corresponding amount of monthly compensation.

How is a VA Rating Decision Structured?

A VA Rating Decision is broken down into several sections as follows:

Introduction

In the introduction section, VA provides a brief overview of the veteran’s service and claim history.  Most commonly, it will include the veteran’s dates, locations, and branch of service.  For example, it could state, “The records reflect that you are a veteran of the Peacetime and Vietnam Era.  You served in the Army from October 1968 to June 1972”.  Furthermore, it will typically indicate the date that VA received the veteran’s claim: “You filed a new claim for benefits that was received on September 20, 2017”.  After this short narrative, a VA Rating Decision will move into the actual decision portion.

Decision

The decision section will be in numbered format and go through each condition individually.  For each condition, it will indicate if service connection was granted and if so, what rating was assigned along with the effective date for that rating.  For example, if you were granted service connection for PTSD and tinnitus, the decision section might look like this:

  1. Service connection for posttraumatic stress disorder is granted with an evaluation of 50 percent effective December 27, 2016.
  2. Service connection for tinnitus is granted with an evaluation of 10 percent effective December 27, 2016.

However, if you were denied service connection for a particular issue, the decision section might state the following:

  1. Service connection for obstructive sleep apnea is denied.

Either way, it is very important to pay close attention to the decision section in order to determine whether you agree with VA’s findings.  Here, you may feel as though your condition deserves a higher rating, or the effective date is incorrect.  If that is the case, you will likely want to file an appeal to indicate you disagree with the decision.  However, when appealing a decision, it is helpful to know why VA made that decision in the first place.  The following sections of a VA Rating Decision provide insight into VA’s decision-making process.

Evidence

The evidence section of a VA Rating Decision is very straightforward as it simply lists all of the evidence VA looked at when making its decision.  Examples of evidence that VA may use include: service treatment records, VA Medical Center treatment records, Compensation and Pension examinations, lay statements, and previous arguments.

Reasons for Decision

This portion of the decision is the most detailed and informative because VA provides rationale and bases for their decision.  It will go through each condition and provide an analysis of why service connection was granted, why a certain disability rating was assigned, and where the effective date came from.  If service connection was denied, it will explain why.  In offering these explanations, VA will often cite to the evidence referred to in the previous section.

What is a Rating Code Sheet?

At the end of a VA Rating Decision, there is a final document called a rating code sheet.  This sheet will display all of the conditions that are subject to compensation.  In doing so, it will also provide the Diagnostic Code of each condition used to assign the disability rating.  Below the name and diagnostic code for each condition will be information about the effective date of both past and current individual disability ratings.  Following the section of each condition and its individual disability rating, the rating code sheet also provides information regarding the effective date of both past and current combined disability ratings. The rating code sheet might display the following:

Subject to Compensation

9411                       Posttraumatic Stress Disorder

50% from 12/27/2016

70% from 10/20/2018

 

6260                       Tinnitus

10% from 12/27/2016

 

Combined Evaluation for Compensation

60% from 12/27/2016

70% from 10/20/2018 

What if I Disagree with my VA Rating Decision

As mentioned above, if you disagree with your VA Rating Decision you will have the opportunity to file an appeal known as a Notice of Disagreement (NOD).  The NOD must be filed within one year of VA’s decision.  Importantly, this date comes from the date of the VA award letter, which you will receive alongside the VA Rating Decision.

Category: Veterans Law

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