The VA is trying to reduce ratings of Vets with PTSD who show improvment from medication.

[kent101]

I'm reading this VA Citation :NR 1231506 and the VA is saying that because a Veteran with PTSD is getting improvement from his psychiatric medication, that he's showing less symptoms because of it, that he is having his rating reduced from 70% to 30% for PTSD. The VA did reverse the reduction at the BVA. Is this still something to worry about? At a C&P exam does the Veteran have to make it clear that the medication is the reason for improvements and needed to sustain them?   

 

Citation NR: "

An October 2009 VA medical record reflects that the Veteran reported that the medication he had been prescribed helped with ability to be out in public and that, while leery about being around people, he could go out in public much more easily.  His mood overall was good, and he indicated that he continued to enjoy dining out with his wife and stopping by the VFW to socialize with friends.  The examiner assigned a GAF score of 76-80".

 

Over at Veteran's Law Blog it says

"As an example, say a Veteran has been able to service-connect Irritable Bowel Syndrome (DC 7319).

Undiagnosed, the symptoms of IBS might be a component of Gulf War Illness

With prescribed medication, our hypothetical Veteran’s condition moderates from a severe form of the disease to a milder form.

The severe form of IBS is rated at 30% and the moderate form of IBS is rated by the VA at 10%.

Let’s say the VA gives the Vet a rating of 10%, claiming that the Veteran’s medication limits her symptoms.

Is that 10% rating correct?

No . The Diagnostic Criteria in the VA Rating Schedule for Irritable Bowel Syndrome does not specifically list the effects of medication.

Therefore, the VA is not allowed to consider the relief it provides when determining the degree of disability.

Has this happened to you?

When have you seen the VA use “improvement due to medication” as an excuse to give a lower rating"?

https://www.veteranslawblog.org/va-disability-claim-medication-reduce-va-ratings/

 

https://www.va.gov/vetapp12/files5/1231506.txt

[Vync]

@Grumpbox

Glad to help!

When I filed my first claims in 1995, the system was a lot worse than it is today. Thank goodness for sites like Hadit and the Internet...

[broncovet]

Yes, I have posted the "reduction" regulations before.  I will do so, again, along with a "thumbnail" summary:

    As long as your rating has been at least 5 years, OR you are P and T, you dont have much to worry about unless:

1.  You have "actual improvement" and you have gone back to work.  

2.  If you stop going to the doc, that could be a problem, but even that is okay if you can document you sought treatment elsewhere.

3.  If your rating is "temporary" or less than 5 years (that is not P and T), then, yes, you can be reduced.  

end of thumbnail summary, beginning of regulation.  

§ 3.344 Stabilization of disability evaluations.

(a)Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b)Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c)Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

[allansc2005]

Bronco, hate to beat this thing to death, but when does this "5-10-20" year rule begin?

In other words, me for example, I'm P&T IU, and have conditions that are included in the IU that date back to 1990, and those conditions have SC worsened over the years.

Does the VA go back from the start of the conditions-1990, or the last date the conditions were SC increased when considering a reduction?

 

Allan

2-2-0 HUAH!

[Buck52]

rotected Ratings - Veterans Benefits Administration - Veterans Affairs

https://www.benefits.va.gov/warms/docs/admin21/.../m21-1mriii_iv_8_secc.docx

1.  

Measure the 20-year period of 38 CFR 3.951(b) from the earliest effective date of ... for a continuous period of 20 years, include periods during which recoupment or ... is protected whether or not the Veteran elects to receive the compensation.

In my opinion the go back date  its the date first service connected for that particular claim.

Rather or not your rated for it. service connection means it happen while in the military.  but the date would be when the claim was first established.

Just what triggers a reduction?

Again my opinion

It's what the VA Dr's write up in there examination reports during regular clinical visits and or the VA Dr directs his report to the R.O.

The R.O. does a random selection and reads these reports,.some veterans never get singled out.

So its a good Ideal to never make a VA Dr pissed off at you.

just my opinion.

Edited November 28, 2017 by Buck52

[Buck52]

Although this is not exactly  made clear?

Some say the protection rules  5-10-20 year protections start at the beginning of the Award date.

some say at the beginning when the claim  was first filed by date

some say when Service Connetion was first established.

as I understand the M-21 IT Says when a veteran has a 50% or higher rating  all his other disability's rating are protected, for the 20 year rule same for combined ratings  with the exception of pyramiding .

[Guest L]

On 11/25/2017 at 3:12 PM, broncovet said:

Alex answered this question some time ago.  The 5 year time is from the effective date.  

You should spend your time worrying about other stuff.  For example, you should worry about North Korea dropping a bomb on the US.  Or, worry about Yellowstone in Wyoming erupting and wiping out man kind.  

Or, you COULD just "give up" on worrying and enjoy your life, instead.  

Worry is a prison you put yourself in, voluntarily.  

Well said! Excellent advice - Since I have done this my perspective has shifted and no more wasted time in my life.