Received my VA letter, it says they're planning to reduce, letter contains no useful information. What now?

[dsteele713]

First things first: It wasn't a large yellow packet, it was a normal-sized white envelope with 4 pages inside, only 1 of which was actually correspondence. Is this normal for a denial/reduction? Or should I be expecting another envelope?

So I posted a week back (post is here). I filed for an increase, but I got a letter from the DAV that the VA plans to reduce two of the ratings I applied for an increase on. I finally got a letter from the VA this morning.

1. Reactive Arthritis - 60% to 10%

2. Facial scar - 10% to 0%

Except the letter contains no details whatsoever. The entire relevant portion is "We have reviewed medical records concerning your service-connected conditions and noted some improvement in your Systemic lupus erythematosus and Scars, head, face, or neck. Based on this evidence, we are proposing to reduce your prior evaluation of it's overall disabling effect"

Then they list the percentage proposals, what the new combined rating would be (40%, xxxx that noise), what my new payment would be, and then they let me know I have 30 days to request a hearing and submit evidence. It also says "We have enclosed a copy of a rating decision for your review", but that's it. The closest thing to a rating decision is what was stated above.

So how do they expect anyone to be able to respond to this? They don't actually tell you what the basis for their decision is. This experience is exactly the opposite of my first claim. VA took forever, and not only denied the increased but proposed a reduction but didn't explain why. Also, they continue to refer to it as lupus even though my claim was for reactive arthritis, my diagnosis is for reactive arthritis, etc. And looking through other cases I know it should be rated under 5009 (arthritis, other, rated as by analogy to 5002, Rheumatoid arthritis)

[Guest L]

Hi dsteele - I do not have an answer to your question per say, but if you look up "Reactive Arthritis" it is not a chronic condition.

It gets better with treatment. I would think that is the reason for the reduction - educated guess. 

Scarring without a Keloid or constriction too,gets better. 

My expertise is Occupational Therapy but this is basic knowledge.

Good Luck

[dsteele713]

While reactive arthritis can be a one-time thing, it can also be chronic, and in my case it seems to be. About 2 years after the first attack (was on humira until a few months prior). I had a 2nd attack that caused some pretty severe uveitis. Really bad photophobia, couldn't look at any source of light, couldn't work because that required looking at a monitor, etc. They were able to bring it under control with a lot of steroids, and put me back on humira as well. That was the basis for the increase request. I certainly don't see how it would be a decrease.

And while I do seem to do fine on the meds, if the diagnostic code doesn't consider the effects of medication (and mine, DC 5002, doesn't), then the VA can't use the beneficial effects of meds to justify a lower rating. They're supposed to rate the condition based on how it is without meds.

[Buck52]

Obviously they checked your VA Treatment Records , you need to get those and look for your self to see what the VA Dr Mention about your reactive arthritis.???

if they put down you showed improvement  and you don't feel it has improved , then NOD this & Request a DRO Review  or Hearing so you can go face your decision maker face to face   you will need new and material evidence

If you disagree with the decision to reduce you back to 10% You may need to get an IMO/IME to rebut what ever the VA Dr' mention in the treatment notes about your ''improvement''

Did you have a C&P Exam? did you read the report?

This kind of thing happens a lot  you just  need a specialist to opine the contrary.

and your lay statement/spouse as to how it effects your everyday life.

I hate it they denied your increase  but don't give up  this can be fixed.

The NOD Appeal will keep your original effective date if you file within 1 year.

I know nothing about reactive arthritis, but sounds like it can be painful, I have regular old arthritis in both knees  from falling off the old 2-/1/2 ton ''Duce & Half  military front truck bumper on both knees bruised them up pretty bad  I never went to the medics about it  just limb around for a week or two  but  the VA won't S.C. it  ...no medical records  or buddy statements.

but good luck to you.

[Gastone]

You had best get a "MOVE ON." Notification by the VA of an "Intent to Reduce your current Ratings" requires immediate action on your part.

You'll have to look up the exact time frame and steps necessary to oppose the "Intended Reduction." I've never had a VA "Proposed Reduction Notification" but if memory serves, there are steps you can take to put the "Reduction" on Hold. You could still end up getting the Reduction and the VA would "Claw Back" any Comp overpayment, back to the Date of the Proposed Reduction.

Discuss the above necessary actions with your VSO-Rep and verify your Locked & Cocked. In the end, it's your responsibility for all Disagreement Filings to be made in a timely manner. Failure to meet a Filing Deadline is your Financial Loss, not your VSO's.

Semper Fi 

[Buck52]

I think in a proposal to reduce the veteran as 60 days to notify the VA after receiving the proposal  or it use to be 60 days  maybe changed?

so yes Gastone is correct you need to ''Move on''  this ASAP.

Edited March 7, 2017 by Buck52

[dsteele713]

Hey guys, thanks for the advice. As far as timelines, according to the letter I have 30 days to request a personal hearing, and 60 days to reply or submit evidence. The letter also states that they will continue with payments at the current rate if I request a hearing, but that it does run the risk of overpayment if they proceed with the reduction. I mostly already knew that, but apparently they continue payments by default as opposed to you having to ask for it explicitly.

So I was surprised by the lack of detail, so I gave the VA a call at their 827-1000 number and asked for more info. Apparently there is a "narrative" letter that goes into detail about how they came to their conclusion, and the representative printed a copy and dropped it in the mail for me. He also mentioned that it may have been sent out separately, so I might already have a copy coming, but in any case I should find out soon what their reasoning is. Of course I'm surprised/pissed that the letter wasn't included with the original notification I received yesterday, but that's the VA for you.

Has anyone ever done a personal hearing? I'm trying to figure out if I should request it