What Are Staged Ratings?

What Are Staged Ratings?

Staged ratings are when the VA changes a disability rating based on the severity of the condition over a period of time. Since claims can take multiple years to be resolved, the VA looks at how the severity of a condition changed during that period of time, and rates the veteran accordingly. There are three main types of staged ratings that the VA uses.

 

Staged Ratings Based on Changing Severity

The first type of staged rating can occur when the Veteran’s condition has worsened or bettered from when he or she initially filed the claim, and when the claim was adjudicated.

For example, a veteran filed a claim for an increased rating above 10% for his back condition in 2009. He was then granted an increased rating in 2013, but his back condition progressively worsened throughout those four years. The VA granted him an increase from 10% to 30% from 2009 to 2011 based on the severity during that period, and they then granted him 40% from 2011 forward.

The VA assigns effective dates of staged ratings like these based off the medical records and lay evidence in the Veteran’s file when they make their decision. For the example above, the Veteran’s medical records showed that his back condition worsened between 2009 and 2011, and then worsened further after 2011. The VA then granted him multiple increases based on the facts found in his medical records.

 

Temporary Total Evaluations

The VA allows veterans to be compensated at the 100% rate during a hospitalization in excess of 21 days due to a service-connected condition, and for the period following the hospitalization. The VA calls these “convalescent ratings.” Convalescent ratings can span for up to three months following hospital discharge or release from outpatient treatment. Veterans can apply for convalescent ratings longer than those three months, but the VA decides those claims on a case-by-case basis.

Following a temporary total evaluation, the VA will rate the Veteran’s condition based on the new level of severity. The VA will assess the new level of severity based on medical records from the period of convalescence. However, if they are unable to adequately assess severity from the records, they will schedule the veteran for an exam to assign the appropriate rating.

 

Prestabilization Ratings

Prestabilization ratings are a type of staged rating applicable to service members who are separated from service with an unstable disability. These ratings are designed to compensate newly separated service members for the impact of their disability on their capacity to work. There are only two possible prestabilization ratings: 50% and 100%.

However, VA instructs employees to assign a rating higher than 50% if the Veteran’s disability would be rated higher based on VA’s rating criteria. The VA also instructs them not to assign a 100% rating if it is apparent the veteran would be rated at 100% based on the VA’s rating criteria, or if a rating of Total Disability Based on Individual Unemployability (TDIU) would be more appropriate.

When VA assigns a prestabilization rating, they will schedule the veteran for an examination between 6 and 12 months in the future to assess the severity of the veteran’s disability at that time.

 

VA may assign incorrect ratings in any of these three staged rating scenarios. If you believe you were rated incorrectly by the VA, our office may be able to help.

Category: Veterans Law

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