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What Happens When VA Proposes to Reduce My Disability Rating?

When a veteran suffers from a service-connected disability, the VA assigns them a disability rating between 0% and 100%. Veterans are paid a set monthly amount that corresponds to their combined disability rating based on VA compensation rates.  In many cases the VA is able to reduce a veteran’s rating and therefore the amount of compensation they receive each month. Throughout this post, we will be discussing why this occurs, VA’s process for implementing rating reductions, and what you can do to fight a proposed rating reduction.

 

 

Why Does VA Reduce Disability Ratings?

The Department of Veterans Affairs reduces veterans’ disability ratings to ensure that each veteran is being compensated for their current level of disability. If VA anticipates that a veteran’s condition will improve over time when initially rating them, they will schedule a re-evaluation of the veteran’s condition and can potentially reduce their disability rating. The purpose of a re-evaluations is to ensure each veteran is being compensated at the proper amount for their condition’s current level of severity.

How Does VA Initiate the Rating Reduction Process?

There are two primary triggers for VA to initiate a rating reduction. The first is that if VA receives new evidence, such as medical records indicating a change in the veteran’s disabling condition, it will schedule an examination to evaluate the veteran’s current level of disability. Next, if VA saw potential for improvement in your condition when initially rating you, your decision will note that you are subject to future evaluations. If your disability is subject to re-evaluation, VA may reduce your rating following an examination. Veterans must attend this exam if they wish to fight their proposed rating reduction, because if they do not attend, VA will likely reduce their disability rating.

What Rules Must VA Follow to Reduce Ratings?

There are due process laws that VA must follow in order to reduce a veteran’s rating. To initiate a rating reduction, VA’s first step is to send a notice to the veteran that VA has proposed to reduce his or her rating. This notice is not a rating decision. You cannot appeal a proposed reduction using a Notice of Disagreement (NOD) as you would a rating decision.

If a veteran does not agree with the proposed reduction, he or she has 30 days to request a hearing (although this step is not necessary to fight a reduction). If you do request a hearing, VA cannot reduce a veteran’s rating until it is held. Requesting a hearing can supply the veteran with additional time to submit new evidence to fight the proposed reduction. Whether you request a hearing or not, veterans have 60 days to submit new evidence.

If the VA issues a decision reducing a veteran’s disability rating, the veteran should follow the traditional appeals process by filing a Notice of Disagreement (NOD). Note that once VA has issued a decision reducing your rating, it will go into effect and your benefits will be impacted.

In order for VA to reduce a veteran’s disability rating, it must prove through medical evidence that there has been an actual change in the veteran’s disabling condition since he or she was last rated. In addition, there must have been improvement in the veteran’s condition using the evidence provided throughout the course of their entire medical history.

What Kind of Evidence Should a Veteran Submit to Fight a Rating Reduction?

Upon receiving a proposal to reduce from the VA, a veteran should respond to this notice in some form and submit evidence in support of maintaining their current rating. Some useful forms of evidence can include:

  • Lay evidence from those who witness the effect that your disability has on your daily life. Lay statements can be completed by the veteran themselves, a spouse, family members, co-workers, etc.
  • Private medical opinions that show that the veteran’s condition has not improved.

Are Certain Conditions More Vulnerable to Rating Reductions?

Yes. VA uses diagnostic codes when assigning your rating, some of which require re-examinations by nature. For example, VA often will attempt to reduce the ratings of veterans who suffer from cancer, as the cancer is expected to improve with treatment. Active cancer usually warrants a 100% disability rating, whereas someone who is in remission and only suffering from the cancer’s residuals may only be rated at 20%. However, if medical evidence shows that the cancer has not improved, your disability rating should not be reduced.

Are Some Ratings Protected from Being Reduced?

There are certain circumstances in which your disability rating is afforded certain protections:

  • Stabilized ratings are for conditions that have been continuously rated for 5 years or more at the same disability level. In order for the VA to reduce stabilized ratings, they must show that your condition has exhibited sustained improvement. The threshold of evidence is higher in this circumstance as VA cannot rely on only one C&P examination to implement the reduction of a stabilized rating.
  • 100% Ratings may be reduced if the VA can show that your condition has shown material improvement. Material improvement means that there has been a significant change in the veteran’s ability to function in daily life.
  • Continuous Ratings are disability ratings assigned to conditions that have been in effect at or above the same level for 20 consecutive years. These are also referred to as “protected ratings.” The only way the VA can reduce a continuous disability rating is by demonstrating that it was obtained by fraud.
  • Permanent and Total disability ratings are assigned to veterans with totally disabling (100%) conditions that are not anticipated to improve over time.

Category: Veterans Law

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