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Lost benefits


bobbyq
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Question

Got 100% back in 2018 for Non-hodgkin's lymphoma. One march 2020 I get a letter for reexamination.  I live in the sticks no VA so I get sent to a Winnebago 60 miles away for an exam. Go into the Winnebago they draw blood I go home. No exam. Two weeks later I get a decision that I am being lowered to 20%. Effective 1 May. Kick in the butt for serving in Nam.

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The VA "has" to send you a letter of "proposed reduction", AND you have a right to a hearing.  If the VA does not comply with the rules, you can get the decision void "ab initio".  

First, you should read what Im about to post a half dozen times or until you understand it.  :

Quote
§ 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.

If you have been rated 5 years or less and were NOT P and T, then you dont have all these protections.  Remember this:

If your condition is similar to that of 2018, they cant reduce you!  They need to show you actually improved "under ordinary condtions of life".  

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What does the denial letter say? Thats the first thing, then, you'll have to refute their contentions. You can appeal before you actually have the exams but you have to do it within 30 days, and they can't reduce you until the hearing has been adjudicated and they have looked at your new evidence. 

https://cck-law.com/blog/what-happens-when-va-proposes-to-reduce-my-disability-rating/

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  This could be your 2 year exam  they check you to see how your s.c. disease/injury  is  if its worse or improved ? or stay the same.

 or Maybe VA has got word your  s.c.condition/disease  or injury as improved, you may want to check your Myhealthyvet notes to see what Dr as said about your  s.c.condition?

 if you get a letter proposing to reduce your benefits  they should let you know what to do and your time line to do it.....Most veterans get an IMO to rebute what ever the VA  Dr mention in his/her report  or read your denial?

I believe brokensoldier 244th is correct on the 30 days to respond to the propose letter  and 60 days to set up a DRO Hearing  or DRO Review

Edited by Buck52
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  • HadIt.com Elder

Reply within 30 days, provide evidence within 60. So long as your rebuttal is pending they can't reduce you, and with the way things are now, thats going to be awhile. 

 

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Thanks guys. I have no computer nor access to one. Small town virus has us shut down I am not really literate. That's why I am screwed any call I make they are working from home.

The decision says the evaluation of left tonsilhigh-grade diffuse large B cell Non-hodgkin's lymphoma is based on Inactive disease (38 CFR 4.311)

I have up coming exam in Sept

Edited by bobbyq
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They are still taking mail at the RO's, there are still limited staff there to receive those items and scan them in. Its based on the postmark date and the received date. Once its scanned into the system when it comes to the mail room/receiving, the system automatically updates your claim that it was received, so even if your case itself is worked slower because of people being at home the important part- stopping the reduction due to inaction- is still done. VSRs are still working, just under different conditions, so there are some limitations since no one can just walk downstairs or down the hall. 

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Hey I was reading the proposed reduction AND it says it shows SOME improvement not that it is definite. I sent in my dissatisfaction on SOME improvement.  I guess that will tell them I am to have a follow up in September with a real oncologist.  This site and vets are awesome

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You I have to tell the truth, fighting with VA really racks my nerves. I am 45 years old and I loose my S&%T at the drop of a hat and don't remember half of what I say or do at these times. It's horrible.

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