Proposed To Reduce Ratings Discussion....

[rpowell01]

I am just wondering about something. How many people here are currently going through this?

Somebody told me in a PM that he was at the DAV and there were 8 vets that came in complaining of being proposed to reduce. Is this something the VA does every so often? Or is this something that is coming from the top?

I wonder, are vets now being targeted like what happened with the IRS issue? Kind of makes you think...

Also, why would the RO need samples of my blood from my biyearly blood tests I get and then send the blood samples to me stating they have no way to store that type of evidence? I didn't send them no samples. This doesn't make any sense IMO because they don't never explain anything.

[broncovet]

Ok, Harleyman, I do have a couple questions:

1. Is it true that a "separate" department does reductions? Here is what I am getting at. If you apply for an increase, and are denied, there is an excellent chance your C file will be somewhere in appeals for the next 4 years. And, since there is only ONE paper copy of your file, you are highly unlikely to be reduced while your file is sitting at the Board of Veterans Appeals. The BVA does not do reductions. Only the RO. So, my hypothesis is that you are actually LESS likely to be reduced if you apply for and increase and appeal. But if you do nothing..and your file is at the RO, then the RO can do a reduction proposal. In other words, if you think you should get an increase, go for it and dont worry about a reduction as your chances for a reduction are no greater if you ask for an increase, and could actually be lower if you appeal.

2. Reductions for over age 55. The VA is not supposed to do C and P exams for reductions for Vets over age 55, but what if they do order a C and P exam anyway?

3. Can benefits be reduced on a "regular" doc appointment, or does it have to be an official "C and P" reduction exam??

[COOL BREEZE]

Same questions I have. Can't wait for the response!

[harleyman]

Broncvet and Coolbreeze:

Ok, Harleyman, I do have a couple questions:

1. Is it true that a "separate" department does reductions? NO. The same peope who work your claims day in and day out,also handle proposals to reduce, dependency, apportionment, all your claims issues and probems are handled by the team VSRs and RVSRs. What team handles your claim is decided by how many issues, and type of claim opened.

Here is what I am getting at. If you apply for an increase, and are denied, there is an excellent chance your C file will be somewhere in appeals for the next 4 years.NO. Your file can be worked by all types of teams and all types of claims concurrently. We just have to each do our work and then move the file to the next team. So if you have an appeal working at the same time you opened a new claim, the Appeals team will do thier action, and then route the file to the team handling the new claim.

And, since there is only ONE paper copy of your file, you are highly unlikely to be reduced while your file is sitting at the Board of Veterans Appeals. NO. The VA claims software prorams can track UNlIMITED actions regarding ALL your VA claims, or APPEALS, or Proposals. You can have unliimited End Products and they are all being tracked at the same time, and the Management Analysts send out emails to Coaches to find out why "such and such" has not been worked or processed. Also if your file is at the AMC or the BVA or CAVC, the VA makes a "working" file that is called a temp file. Most everything can be worked through your temp file, and if it cannot we ask the VBA, or CAVC to send us copies of anything needed to keep working your file. It takes more time but do not thing the VA will forget about a proposal to reduce. The BVA does not do reductions. Correct, the BVA does remands and tells the Regional Office of jursdicton to take a relook, or fix it, or tells the Veteran they agree with the RO and they "uphold the VA decision". Only the RO. YES. So, my hypothesis is that you are actually LESS likely to be reduced if you apply for and increase and appeal. NO

But if you do nothing..and your file is at the RO, then the RO can do a reduction proposal. The VA only proposes to reduce when the VA has received EVIDENCE that the Veteran's condition has improved, healed, or been cured (such a cancer), were treatment is stopped, and the Cancer is in remssion and the VA rates residual conditions. Or the VA gets an examination of the Veterans condition becuase the Veteran filed a claim and the examination is showing improvement since a rating decision.

In other words, if you think you should get an increase, go for it and dont worry about a reduction as your chances for a reduction are no greater if you ask for an increase, and could actually be lower if you appeal. You need to explain this to me, I am not sure what you are asking.example please.

2. Reductions for over age 55. The VA is not supposed to do C and P exams for reductions for Vets over age 55, but what if they do order a C and P exam anyway? If a Veteran is oer 55 and is service connected for a condition, there was something that triggered a re-exam. Either it was set up to be re-examined at the time of the decision original decison and the Vet turned 55 bewteen the time of the decision an the date set up in the computer, or the Vet asked for an increase and the C&P exam showed improvemnt. VSRs and RVSRs do don't go around looking for files to reduce previous rating decisions. Something is triggering the reduction proposal. (If I was a veteran over 55 years old and someone wants to reduce my benefit, I would call a service officer and have them find out why the proposal is being done. All the SO has to is walk up to the desk of a VSR or RVSR and ask and the will find out the reason.

3. Can benefits be reduced on a "regular" doc appointment, or does it have to be an official "C and P" reduction exam?? yes any medical evidence that shows improvement. But usually it is due to a C&P examination, completed on one of the new DBQ's that plug information into the evaluation builder. The evaluation builder shows improvement in a condition, it printss out the fact there is improvement and then the RVSR has to abide by the guidelines for reduction. If they ignor and don't do the proposal, they will get a quality error in the rating. .ugh! _ Harleyman

Edited September 9, 2013 by harleyman

[broncovet]

Wow, Harleyman..great, in depth answer, tho not the one I wanted/expected. I posted, and you responded:

In other words, if you think you should get an increase, go for it and dont worry about a reduction as your chances for a reduction are no greater if you ask for an increase, and could actually be lower if you appeal. You need to explain this to me, I am not sure what you are asking.example please.

Ok, I will explain. Some VEts "forego" asking for an increase, even when deserved, out of FEAR. They are worried about a possible reduction. Some VSO's perpetuate this, getting Veterans to "settle" for less than what they deserve because they fear a reduction if they ask for an increase. Its the "dont rock the boat" syndrome, and it often condems older Veterans to a life of poverty accepting less than what they deserve. Please dont get me wrong. Im not advocating applying for undeserved benefits. If you do not meet the criteria, such as no current diagnosis dont waste the VA's resources by clogging the system unnecessarily.

Edited September 10, 2013 by broncovet

[rpowell01]

Be patient doctor Bash will provide what he says he will. I have used doctor Bash myself. He had you fly in and do an exam in the airport because he knows that an exam carries more weight than just an opinion review of records. (IMO). You will be getting an exam with an opinion (IME) and that will trump the VA exam, because Dr. Bash has better credentials than any of the VA examiners. Hang in there it is to your benefit, and Dr. Bash also stands behind his work, if it goes to an appeal he will win in court over a VA examiner any day of the week..- just saying :)

Actually he didn't and he has forgotten ALL about me and my DBQs. I called him last week and he told me he forgot. I know he may be busy but you don't forget like that. I mean how many physicals or DBQ exams are done in a airport? You also have to understand that I am over the 60 day mark Dr. Bash told me to write on the letter to the RO for him to submit more evidence...Understand where I am coming from?

What is going to TRUMP the VA examiner is all the diagnosis of VA doctors that has diagnosed me with the same issue Dr. Bash did. He did it back last year while they waited until AFTER the C&P exam...Now, I have Dr. Bash's IMO from last year along with TWO other MDs who says the same thing. Then on top of this, I just had an EMG on my legs about a week and half ago and the EMG report shows I have bilateral radiculopathy with negative neuropathy ( I am not diabetic btw). The C&P examiner stated I just had "muscle spasms" in my leg....What I find appalling is I NOW have NO feeling in both my feet from the midfoot forward and she had the nerve to say I had muscle spasms. Well, if I don't get any feeling back on them I will be upset with the medical side of the VA for waiting so long to do anything. I just had 2 epidurals last one last week and well my legs hurt worse actually and the numbness is still there in my feet. I knew they wouldn't work...And the MRI shows something different than the EMG. The MRI didn't show the pinched nerves like the EMG does...JBasser told me NOT to believe MRIs and well now I understand why he said that....

[harleyman]

Wow, Harleyman..great, in depth answer, tho not the one I wanted/expected. I posted, and you responded:

In other words, if you think you should get an increase, go for it and dont worry about a reduction as your chances for a reduction are no greater if you ask for an increase, and could actually be lower if you appeal. You need to explain this to me, I am not sure what you are asking.example please.

Ok, I will explain. Some VEts "forego" asking for an increase, even when deserved, out of FEAR. They are worried about a possible reduction.

I understand what your saying here. If the condition is truely worsening since the last time they were examined and were granted a service connected disability then if they should reopen a claim for increase, BUT they ARE opening themselves up for a possible reduction in the level of the disability.

If the Veteran truely thinks his condition has worsened then he should file for an increase. If the condtion is musculoskeletal, such as a back condition, I would be very careful, because the criteria for backs has changed from 10 years ago, and the criteria is a higher level of symtoms now. So a veteran who was s/c for back at 40% before, might now only qualify for 10% or 20% under the newer examination findings guidelines and the ratings schedule. I would recommend the Veteran have his private doctor fill out the DBQ and then compare the findings to the schedular and see if the percantage would go up or down.

People are a really good judge of if something is worsening, the problems lies in whether or not the doctor concurs that a condition has worsened. Personally, I don't trust VA doc's to take the time needed in documenting a condition. They get paid by volume of examinations done, so they are going to always be in a hurry.

Some VSO's perpetuate this, getting Veterans to "settle" for less than what they deserve because they fear a reduction if they ask for an increase.

There are very few VSOs that I trust. Most think they know more than they do. I use a VSO once in a while to look something up in the computer for me and they can be useful if you have a question you want answered by a VA employee, rater or VSR. Also, if the Veteran is worried he could use the VSO to find out if the rating decision the Veteran currently has is protected, since he was rated under the "old" criteria. Then if he is protected, he could file a claim for increase without worry of being reduced.

It is important to know if the rating criteria has changed since a veteran was initially rated, and if he would fall under the protection clause, "kind of like being grandfathered in", on a new law going into effect. Then contact with a VSO would be a good thing, as they can ask the rater directly to find out before the claim for incease was opened.

Its the "dont rock the boat" syndrome, and it often condems older Veterans to a life of poverty accepting less than what they deserve.

Older Veterans with older s/c decisions need to be careful. I would recommend they talk to a service officer or find out if the condition they are service connected for has changed criteria for disability such as the spine ranges of motion.

Please dont get me wrong. Im not advocating applying for undeserved benefits. If you do not meet the criteria, such as no current diagnosis dont waste the VA's resources by clogging the system unnecessarily.

Unfortunately, the veteran's subjective complaints are difficult to docuent unless the examiner finds and documents Objective findings. If the exam is on a day when your feeling good, the examiner is going to say he could not find the condition the Veteran complaned of. On the other hand, if the exam is done on a day when the Veteran has lots of symptoms and they are present the examiner can document those findings.

I find with older Veteran's, they "play down or dismiss" important symptoms, thinking the examiner will understand and just give him the benefit of the doubt. THAT DOES NOT HAPPEN. The VA examiner does not give the Veteran the benefit of the doubt, and the VA examiner does not know the Veteran as a patient, so how much credibility is the examiner going to give the veteran.

It is always better to have your PCP fill out forms or write a letter or complete DBQs, (even if the PCP is a VA doctor).

VA doctor PCPs, are required to fill out DBQs for thier patients, if the Veteran asks them to. They are the PCP and they should start acting and providing treatment as a doctor and not a hourly employee.- IMO

Edited September 11, 2013 by harleyman