[When can the VA reduce my rating "again" after reduction?]

8 hours ago, Vync said:

Hey JayO,
I know what you mean. I have family who was an EMT and said it can get physical at times.

The VA is famous for falsely assuming that all veterans get care only from the VAMC. In my case, I still work and have private insurance through my employer. The VA tried to use the presumption that "no news is good news", which is why they often try to reduce people in this fashion.

 

By the way, you can get albuterol from any pharmacy, not just the VA. You just need a prescription. The benefit of getting it from the VA is that it is free if you are SC for asthma.

 

Reducing your asthma rating from 100% to 0% seems wrong, especially if you are still taking asthma medications. If they really did reduce your asthma rating to zero, I strongly recommend you look at your medications. There is a chance that someone at the VARO screwed up and reduced you too far. You likely will not get back to 100%, but could get 10%, 30%, or maybe even 60%. However, 10% or 30% are most likely.

1. Check your VA prescription history for the past 12 months
2. Look for albuterol inhalers.
-- If you use them regularly, you should have a 10% rating.
-- If you use them daily, you should have a 30% rating.
3. Look for anti-inflammatory inhalers (advair, asmanex, mometasone furoate, etc...). If you use them daily, you should have a 30% rating.
4. Look for prednisone, medrol, etc... If you received 3+ courses over 12 months, you should have a 60% rating and this will be considered temporary.

 

Until you maintain a rating for 20 consecutive years, there is always a chance they might reduce you. After 5 consecutive years, they must be able to prove sustained improvement. However, in reality you may have to actually prove to the VA that you have not improved. Basically, that means that if you continue to have problems, and then have one "good" day, they are not supposed to use that good day against you. Keep in mind that the VA often does incorrectly do this.

If you have a good asthma doctor, they should have given you a peak flow meter. I recommend you use it daily and keep an "asthma diary". When you have an attack, use the meter (if you can) before and after, and log the results too. I submitted a copy of my asthma diary to the VA when they tried to reduce me. I know it's not the same as digital spirometry, but it's the cheap solution you can do from home.

 

Thank you Vync,

I don't take my asthma medications at all anymore, actually, I was not able to show them that I have been using it. I pretty much do natural approach with my asthma and this was recommended by my mother who is a nurse. Thing is, it took I think 2 years or so until I have no longer use my albuterol too much (there are days before that I use them but its like 2 a week or so). 

As of now, I stay away from too much stress and allergies which might exacerbate my asthma, but not too much now. I don't use my albuterol as regular or none at all at times.

Yeah, I know what you mean about the good day but as the medical officer looked at my civilian medical sheet, my asthma was presumed "controlled" now that I also work with  a strenuous job which I defended that I do not do anything on it except Lift, Drive, and poke people out with a needle (yeah, kinda hurts me because I'm trying to get financial backing by injuring my job-credibility as an exchange lol.). I tried to attempt to get a 10% or so rating by providing a asthma diary but EMT life is so busy I barely manage to get my diary done (and often I forget because I don't use albuterol as much or at all).

 

So would they still reduce my 40% over all rating even though that was the minimum that I could get now without asthma?

[When can the VA reduce my rating "again" after reduction?]

5 hours ago, Cobra4v said:

I'm happy you're better, sorry for the decrease though. I think on the issues which aren't temporary and are chronic they are less likely to reduce. Raises the question though.

How often do they try to reduce ratings? If you are constantly at VA about you SC disability getting treatment does that keep them off your back?

Thank you. I know I'm quite happy that I do not have to puff albuterol everytime I run or just play outside (not a lot though). But it saddens me that I won't receive that money anymore... I knew and expected that one day this will be like this.

I am not constantly in the VA, I dont want to be their favorite patient and have them look at my improvement as a case of reduction but ALAS... they reduced mine from my tricare records and medical checks from EMT.

 

Now, Would they still reduce my last 40% though? it is the minimum I could get but I want that protected for the rest my life. Hopefully.

[When can the VA reduce my rating "again" after reduction?]

12 hours ago, Vync said:

I'll try to help as I have had an asthma rating for 20+ years and also have been victim of an improper reduction.

Broncovet is right that they can pretty much attempt to reduce at any time.

Keep in mind that here are the way the protections work (not counting fraud or jail). Basically, there are three thresholds which help define "protection from reduction":

5 years = Rating is stabilized, must show sustained improvement to attempt reduction
10 years = SC status is protected
20 years = Percentage protected if held continuously for 20 years
 

I have already been through the ringer with the VA about reducing my asthma rating. I had a 60% rating and the VA sent me a "proposal to reduce" letter in the mail stating my 60% asthma rating was only temporary. This is your alert that it is time to fight the reduction, in most cases. I submitted medical evidence along with justification for continuance and figured that would be no problem. I got a letter in the mail stating that it was reduced to 30%. I filed a NOD and eventually saw a DRO for this and other issues. Everything was reversed because they didn't read the rating table correctly and most importantly they ignored the evidence I submitted.

 

I recommend you take a deeper look at what makes the asthma rating special. It contains different criteria for each rating level:

6602   Asthma, bronchial:
FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications	100
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids	60
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication	30
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy	10
Note: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.

The VA loves to look only at the FEV-1/FVC values from spirometry and overlook all the other possible ways to be rated for asthma.

Take a look at the 100% criteria:
- FEV-1 less than 40-percent predicted, or;
- FEV-1/FVC less than 40 percent, or;
- more than one attack per week with episodes of respiratory failure, or;
- requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications

That's 4 different ways to qualify for 100%. You don't have to qualify under all four conditions. You need only qualify under one of those conditions. The same goes for the rest of the rating percentage levels. If you qualify under different percentage levels, then they are supposed to grant you the highest percentage.

Additionally, for FEV-1/FVC ratings, they are supposed to take a baseline reading first, have you inhale your rescue medication (i.e. albuterol), and then take another reading. Whichever is lower is what the FEV-1/FVC component that should be used.

Also, keep in mind that when they state "systemic (oral or parenteral) corticosteroids), that means things like prednisone, medrol, solumedrol taken orally in pill or injected form -- not inhaled corticosteroids like Intal. This is important because the 60% and 100% rating levels can be met with just being treated with these medications over time. In my case, I have consistently been prescribed 3-6 courses of these meds every year. The VA totally missed this because I also am treated by a private doctor and they did not have access to the records. Yes, I sent form authorizing release and copies of the form. Once verified, they backed off and reinstated the rating. If you got lots of meds like this over the years, dig up the records, prescription history, etc... and show the VA.

You mentioned they completely erased your asthma rating. If your breathing is better than "FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent" and you do not use any rescue inhalers, then that would be the only way they could do that. If you still use an albuterol inhaler "intermittently", they screwed up and you should have at least a 10% rating. If you take inhaled anti-inflammatory inhalers daily, like Asmanex, mometasone furoate, Advair, etc..., then they screwed up and you should have at least a 30% rating.

Check your original award letter and C&P exam. It will specifically tell you exactly why you were given a 100% rating. Then look at your reduction letter and C&P exam and compare them.

 

 

 

 

 

 

 

Thank you Vync,

Yes I looked at my award letter but it says that I got reduction from 100% to 40%. It is not actually permanent but total is what the medical officer at VA said. Asthma can be controlled they said and this time I have shown improvement (I have to or I will fail any acceptance to EMT jobs because they require proper pulmonary functions at a certain level). The reason they also can monitor my status is that albuterol cannot be procured anywhere without prescription of the VA. So I have to go to VA to get mine, which ofcourse they monitor to know if I improve or not. This is in Tennessee by the way. 

The VA here is quite on the spot with their care, and I even received my ID card too. Sad part is... well, no more 100% but 40% now. Quite a big reduction. I went to VRO yesterday, he himself told me that my case may be hard to disprove because I got good medical results- kind of saddening that when you receive good results, you will receive less money. 

 

Anyways, I have moved on... I got a job and a life. Nothing could replace that. Now my question is.... 

Would they also lower my 40% from my other ratings any time in the future?

Thank you again you answer helped me so much. 

[When can the VA reduce my rating "again" after reduction?]

On 5/30/2016 at 11:36 AM, Navy04 said:

Sorry to hear of your issues, as I too have Asthma bud. I am so tired of the VA coming after us. I just went thru this last month. I too am 100% P&T, yet the VA called me on 2/29 to come in for a Review on my 40% for Bladder issues. Well we drove over 300 miles round trip for a 10 min exam. Well what happened next, they continued my 40%, but then the Damn VA lowered my 30% for Scars down to 10%, even though I never had an Review Exam for my Scars and the Doc never asked me anything about it. Luckily it did not affect my 100% P&T. 

Thats good to hear they did not reduce your 100%. Me on the other hand, got reduced because they saw improvement in my records (I am an EMT) and my spirometry test came normal. 

Actually, my original was 70% but when they saw my active duty files, they figured I have that OIF/OEF gulf war sickness... so they put 100% on me.

Now the question is, after reducing my 100% to 40%, can they reduce me again in the Future?

My 40% rating was composed with eczema, back pain and something else. Thanks for the help :(

[When can the VA reduce my rating "again" after reduction?]

On 5/30/2016 at 1:30 PM, broncovet said:

Va can/does lower your rating at any time.  How long ago did they reduce you?  You may still be able to appeal.  You see, VA can NOT reduce 100% P and T Veterans, UNLESS they can show "actual improvement" under "ordinary conditions of life", that is, while working.  If you are not working, then you should appeal.  

Well, when I went there I tried my best to technically tell them that I still have some issues with Asthma but there is an "actual improvement" because my spirometry test came out normal parameters (both using albuterol and non.) Well, also, I tried to hide the fact that I work (because I became an EMT and I did medical on it) but its hard, so I just told them the truth that I work.

Yes, The Va could reduce me any time, though its my 100% P and T. My times was not 5 years yet and I only receive my benefits for about 4 yrs. So I kind of expected this. However... I am unsure if they would reduce my other disability ratings after getting done with my asthma? The reduction proposal happened 4 months ago but it came in effect last week this May. I cannot appeal because my records actually say that I improved including the spirometry test.

Now my question is, they terminated my asthma from the disability, would they reduce my rating AGAIN after reducing my 100% to 40%?

I just don't want to lose my last 40% from my back pain to asthma, eczema, and there is another one but I have to look for my record again :( Please help.

[When can the VA reduce my rating "again" after reduction?]

Good morning my fellow veterans, I hope that you may answer this humble request for advice with my particular reduction of rate.

You see, I have been diagnosed with Asthma induced from my OIF/OEF deployments before which included backpains, eczema, fatigue. etc... well, they gave me 100% (though it says P&T also) but now reduced my rating upon seeing improvement of my asthma. Technically, they terminated my whole asthma rating which  now I could only receive an overall 40% from my other symptoms which where before "does not need further evaluation" I held the 100% for 4 years but this last one the 3rd examination, my asthma was deemed improved- so called for the reduction of my rate which was kind of sad because from 2900$ now I receive 587$. So if I may ask,

If I was reduced from my 100% rating to 40%... When can they reduce my rating AGAIN? or would they reduce my rating again in the future time after they gave me this 40%?

 

Thank you very much.

[Overpayments/debt From Va And Pft Asthma Test.]

ah I see. thanks for the info mr. philip. It was enlightening.

If they reduce rates such as that... how does overpayment happen then? or what are the reason some veterans have overpayment that they have to pay back to the VA once they get a reduction? other than fraud or Social Security compensation not being declared?

Once again. Thank you.

[Overpayments/debt From Va And Pft Asthma Test.]

Yes, that's exactly what boggles my mind really. How they perceive us and what they should perceive us is contradictory to what they really want from us (quotas). That's why I was thinking are they really biased based on their assumptions that all veterans lie and cheat?

I read online that we veterans have the "benefit of the doubt" regulation for our claims on which it provides the scale to tip to us claimant's favor.

How true is that extent if we are actually being screened by proctors/examiners/doctors/raters whom should give us a benefit of the doubt as far as our claim support evidence is concerned?

For example: Patient A gave them a proof she have asthma from service certified by the military hospital, but the asthma was "rated" later on for C&P a re-exam as null due to PFT test being normal. Could the evidence she gave be enough stand point on which should prove SHE HAD ASTHMA? then should she be rated with an award without reduction?

[Asthma C&p Re-Exam Inquiry With Past (Negative) Pft Results.]

it's gonna be my 2nd visit to VA (since my 2011 C&P) and I never had to get more supply from them because my former command and doctor in military pretty much provided me a supply that would last up to now. So would that factor anything on their decision?

[Hello I'm New Member Here.]

Thank you for the kind reply guys. I appreciate the help.

Just kind of worried of what they will ask and question you know. I just want to be prepared.

I usually take my corticosteroid or symbicort whenever I feel a tightness or shortness in my breath, and ofcourse prednisone when it persist. almost everytime I have it in control because I take them before I even feel a flare up.

also one thing, it's gonna be my 2nd visit to VA (since my 2011 C&P) and I never had to get more supply from them because my former command and doctor in military pretty much provided me a supply that would last up to now. So would that factor anything on their decision?

Thank you.

[Asthma C&p Re-Exam Inquiry With Past (Negative) Pft Results.]

so they were actually planning to reduce my rating already then? hmm... so about... 2 years? ever since i got out there's really just one time where I went to them for the breathing test which was on my initial C&P and then this incoming re-exam.

I usually control my asthma with those corticosteroids though and take precautions to not make them to be an emergency so I take m meds whenever I have shortness or breath as first initial sign of flare up.

I also have related cond. to asthma such as eczema and a chest pain associated with it too. But those where superceded when they gave me 100% due to OIF/OEF they indicated.

This is gonna be my 2nd visit to VA after my initial C&P before on which I was awarded 60% (2011 ago)

[Asthma C&p Re-Exam Inquiry With Past (Negative) Pft Results.]

what is asthma regs location? I have seen that the 60% for asthma is for intermittent use of corticosteroid regardless of the PFT. (it says OR) But just a question though, I had that rating also before when they first gave me an award... but then a few months later on they gave me another change of the award to 100% due to my OIF/OEF gulf war. (I was stationed in horn of africa and oman and gulf of aden for my deployments).

Do they still deduct on that?

Thank you for the kind reply.

[Asthma C&p Re-Exam Inquiry With Past (Negative) Pft Results.]

I use symbicort by the atleast once or twice a week depending on the extent of my flare up.

Does that still count for a percent?

[Asthma C&p Re-Exam Inquiry With Past (Negative) Pft Results.]

acutally yes, I'm still using symbicort when I have symptoms of an offset of asthma, then albuterol if I have to do something strenous (prep) activity and also they gave me before a naproxene for pain in the chest when I actually have an attack which is I would say very rare because like I always follow up with my meds even before it becomes an emergency.

is it ok though if I used my meds from my last service? because I haven't had supply yet from the VA because I still have a lot of inhalers and meds?

Thank you for the reply :)

[Overpayments/debt From Va And Pft Asthma Test.]

Dear fellow veterans.

I have seen a couple of stories about such things going on with the VA claims and I just want to know what makes these overpayment/debt happen? I researched it online and still didn't figure out the whole detail of it.

For example: does having an employment affect 100% SC disability (Not TDIU)? or If the C&P re-exam (after 2 years) proved to be better from your first C&P exam (claiming stage), and they deducted your rating from say 100% to 40%, would it mean paying for that past or changed rating also? (is that overpayment?)

Also how about things that was the VA's fault? for example if the beneficiary had a PFT for asthma for first C&P exam, and it's results were normal, but due to a medical documents such as doctors report from military and official hospitalization with prescribed asthma medication, the veteran received 100% OIF/OEF asthma condition--- What do you think it would be? is it something the VA had messed up? because what if the C&P routine re-exam proved to be normal also but the beneficiary is still taking medicines without a notion that he/she is getting better?

Could anyone please enlighten me on why as far as debt from VA is concerned (overpayment or so), what are the cases on which we as veterans might get LABELED as gaming it? because from what I see it looks like a double-standard?

And that kind of frightened me because *what if* the VA THEORETICALLY thinks we are playing the game? Because, by God, If we have given them all they need for documents and they were certified too by the Navy hospital, would it be a case a beneficiary wins regardless of say the PFT test?

Afterall,they probably won't give anybody an award in the first place if they think those documents were false i.e medical records and visits to the doctor for asthma in the military hospitals. Or I'm probably just paranoid too and stressed.

Such for this case is my asthma on which I have normal PFT test when I first claimed, then they verified if I was actually using cortisteroid inhalers for my asthma giving me a 60% with matching depression overall. Then it also went to 100% once they verified that I was an OIF/OEF recipient due to the nature of my deployments.

What do you guys think about this matter?

Thank you for the kind reply and thank you for giving light to my question. I appreciate it very much.

[Asthma C&p Re-Exam Inquiry With Past (Negative) Pft Results.]

I have a schedule for the Regional office after I take my breathing test, that's why I was thinking of asking the rater not the examiner I should have been clear with that. Well, the thing was I had a breathing test before and this was done prior to my discharge in the military and that's all they needed when I applied for compensation the first time. So after 6 months that time, they gave me an approval and initially gave me 60% with matching depression which was included as 30%. Then my breathing test came out normal but the fact I was using cortisteroid inhalers/medicines and my documented emergency hospitalization qualified me for a disability and my record did indicate I had asthma that made me discharged from the service.

Though after 2 months of my award, they gave me a change in my rating to 100% for they have a clear and unmistaking error that says

they found on the record that i was affiliated with OEF/OIF/ Gulf war. all my deployments afterall are in oman, horn of africa, and gulf of aden.

*As of now, I am really controlling my asthma with medicines and to tell you honestly, I feel a lot better now than before when I got out from the service. That's the whole reason why I never had to go to the VA medical for check up because I just kept following up with my medicines. Like I said also, I haven't run out on inhalers yet and I went to an outside pharmacy to get one inhaler (one time) because I forgot to bring one when I was having a long trip.

I have not received any appointment check up til now from the VA for the asthma that I have. But my medication lasted me atleast this year from my separation (my former command was so kind to give me their supply of albuterol) and just one left for symbicort.

So can I tell that also to the VA rater/examiner who's gonna check me for my health? it's just that I haven't gone check with them because after my award, they did not direct me anything else. No doctor or what needs to be done next for my asthma. Just the funds that they gave me for compensation (I used it to buy medicines too).

So long story short, I'm going to the breathing test, get to the RO for another C&P test with my above statement on my sleeve.

So I was thinking, what if my breathing test was normal again? I was thinking of giving them the medicine and record that I still do use inhalers and medicines to CONTROL my asthma?

Would those suffice for me to retain my 100% rating? or should I just tell them honestly that I'm controlling it with medications and that makes my condition better? (risk of losing the 100%)

Thank you for the support my fellow veterans.

[Hello I'm New Member Here.]

I'm Joe and I have been awarded 100% on my claim due to OIF/Gulf war asthma. I hope we could all help each other out on seeking VA questions and answers. Thank you.

My case:

I have a schedule for the Regional office after I take my breathing test, that's why I was thinking of asking the rater not the examiner I should have been clear with that. Well, the thing was I had a breathing test before and this was done prior to my discharge in the military and that's all they needed when I applied for compensation. So after 6 months that time, they gave me an approval and initially gave me 60% with matching depression which was included as 30%. Then my breathing test came out normal but the fact I was using cortisteroid inhalers/medicines qualified me for a disability and my record did indicate I had asthma that made me discharged from the service.

Though after 2 months of my award, they gave me a change in my rating to 100% for they have a clear and unmistaking error that says

they found on the record that i was affiliated with OEF/OIF/ Gulf war. all my deployments afterall are in oman, horn of africa, and gulf of aden.

*As of now, I am really controlling my asthma with medicines and to tell you honestly, I feel a lot better now than before when I got out from the service. That's the whole reason why I never had to go to the VA medical for check up because I just kept following up with my medicines. Like I said also, I haven't run out on inhalers yet and I went to an outside pharmacy to get one inhaler (one time) because I forgot to bring one when I was having a long trip.

So long story short, I'm going to the breathing test, get to the RO for another C&P test with my above statement on my sleeve.

So yeah, what if my breathing test was normal again? I was thinking of giving them the medicine and record that I still do use inhalers and medicines to CONTROL my asthma?

Also, could you educate me on why as far as debt is concerned, what are the cases on which we as veterans might get LABELED as gaming it? because I have read news about them guys who fake stuff and that kind of frightened me because *what if* the VA thinks I'm playing the game? Because, by God, I have given them all they need for documents and they were certified too! they probably won't give me an award in the first place if they think those documents were false i.e medical records and my visit to the doctor for asthma in the military hospital last 2011. Or I'm probably just paranoid too and stressed.

Thank you for the kind reply and thank you for giving light to my question. I appreciate it very much.