Is Re-Examination inevitable?

[DisplacedCoastieinCanada]

Hey there. I'm just trying to get an idea of what to expect over the next few months. I'll summarize my situation briefly here.

I have 2 VA-rated disabilities. 70% for Major Depression and Anxiety, 40% for a back injury. Both of these are listed as not permanent.

I was discharged in January of 2015. May 2015 I received my ratings. I was bumped up from 70% to 80% in December of last year when I had my back re-examined. Prior to the re-examination last year, my back was only rated at 10%. 

I know that the VA likes to re-exam at the 5-year mark. I'm wondering if I should be expecting a re-exam for depression and anxiety early next year. I'm very much hoping that I'll slide under the radar because I live in another country and I was just seen a year ago for my back, but I know this is unlikely. I'm guessing the VA has an automated system that shows a glaring red mark for people coming up for re-examination. Honestly, I think my depression and anxiety has gotten worse and has further affected my quality of life, but I will have major issues affording the trip down to the VA, and if they did drop my rating, I stand to potentially lose my house since I have to re-qualify for my mortgage next year. Side worries, I know, but big ones for me.

Anyways, is there any chance that I might not be called in for a re-exam, or is it pretty much inevitable these days?

Thanks!

[GBArmy]

2 hours ago, broncovet said:

 

 

When you get a decision, they often state something like, "no future exams are scheduled".  This is VA's way of saying you are P and T.  The trouble is, your tax office that gives you a tax exemption if you are P and T, is unfamiliar with VA lingo, and they don't know what "no future exams are scheduled" means.  

 

Bronc, when it says "no future exams are scheduled", do you call Peggy,find it somewhere on ebenies,e or whatever to get the P&T statement? Must be something can be done. I mean, it means $ to veterans and it isn't a new problem.

[broncovet]

No, you dont call Peggy, and you may not find it on ebennies.  Its either on the decision awarding benefits or not.  

However, VA makes it clear:  EVEN when it says "no future exams scheduled" there can still be a future exam if the VA has reason to believe your condition has improved.  Its not a guarantee, it just means they have (or have not) keyed into the computer for a scheduled future exam down the road.  

[Richard1954]

7 hours ago, paulstrgn said:

As stated above, if your condition has gotten worse then file for an increase.

I would suggest not worrying about something that has not happened.

Excellent advice

[Vync]

Additional information about rating protections. There are some situation where the VA may not opt to re-examine you.

 

[DisplacedCoastieinCanada]

On 11/22/2019 at 4:45 AM, broncovet said:

The VA isnt supposed to order an exam for no reason.  If you have been going to the doctor, then your symptoms should be already documented.  

While its true the VA is well aware of 5 year, 10 year and 20 year protections, (See https://www.law.cornell.edu/cfr/text/38/3.344  ) and, of course, the VA recognizes these deadlines.  

I have heard someone say that if you give a 7 days to do a 1 day job, he will often put the job off until the seventh day.    If you go to the post office on April 14, you will see lots of activity and people filing their taxes before the April 15 deadline.  At least some post offices remained open until midnite on April 14, so that last minute filers can still get an april 14 post  mark on their tax return, saving them penalties.  

In a similar way, there is no doubt VA "tracks" people who are about to reach their 5, 10, and 20 year protections.  Alex has mentioned in his writings that an unsual number get Proposed reductions just shy of these deadlines.  

One rating specialist reported, on another website, that they flag a Veteran at 5 years whenever they award a non p and t rating.  Probably about six months before that 5 year protection someone is assigned to "look at" your case to see if you should be reduced.  Like most stuff at VA this may or may not happen, but this ex va employee did mention the computer flagged this so that it could be reviewed in order to meet the 5 year, 10 year, or 20 year deadline.  

When you get a decision, they often state somthing like, "no future exams are scheduled".  This is VA's way of saying you are P and T.  The trouble is, your tax office that gives you a tax exemption if you are P and T, is unfamiliar with VA lingo, and they dont know what "no future exams are scheduled" means.  

 

Hi there Broncovet, thanks so much for your input! With what you mentioned about potentially being "flagged," I will make sure I am monitoring my email, physical mail, etc, in case they do reach out to me. But as others advised too, I will do my best not to hold my breath and stress about whether or not they do reach out or not.

Could you tell me what P and T means? (Permanent and something or other I'm assuming...?) 

Thanks!

 

[DisplacedCoastieinCanada]

On 11/22/2019 at 6:02 AM, Vync said:

Great advice from the other members who responded.

Before filing for an increase in your MH rating, I recommend you familiarize yourself with the rating criteria for the next higher rating tier which happens to be 100%. If you happen to be employed, you're likely not going to be approved. The "Total occupational and social impairment" basically means you SC MH disability is so bad that it precludes you from working. However, if it does worsen and prevent you from working, indeed consider filing an increase. I included an excerpt from the MH rating criteria below.

If you are unable to work due to your SC disabilities, and don't happen to meet the criteria for the 100% MH rating, consider filing for Individual Unemployability (IU). Each year you have to submit an income statement. They would pay you as if you were 100%. Eventually, or if your doc says your conditions are not expected to improve, you could request it be made permanent (TDIU) and that is pretty much the same thing as being rated 100% P&T, but cannot work. If you work, but are in a sheltered environment, you might qualify for TDIU and still be able to work. More information about IU/TDIU can be found elsewhere on this site.

Further below, I included some additional reference links that you might find interesting. They involve how rating increases work and how to get secondary SC. Both contain information which can be helpful on your journey to get a 100% rating.

 

§4.130   Schedule of ratings—Mental disorders.

 

 

 

Thanks very much for the very helpful info, Vync! Based on the breakdowns of what 100% and what 70% look like in real life, I'm definitely a solid 70%. If there were a rating between 70 and 100% I'd probably fit there, but I definitely have persistent, noticeable, documented areas in my life that are affected by my mental health situation.

Thanks everyone else who has replied and given your two cents. I'll stay posted for a potential re-exam, but I won't stress about whether or not it does happen. I don't think I'll apply for the increase since I am still able to work and be somewhat productive there.

Hope everyone is having a great weekend!