Proposed Reduction from 100% to 40%

[VietNamVet1969]

What is advisable to do following the receipt of this letter of proposed reduction in disability rates?

 

After 3 1/2 years and just visiting an outside, C&P doctor, (QTC Medical), I received a letter from the VA to reduce my 100% temporary disability. 3 1/2 years ago I underwent a radical prostatectomy, (surgery removing all they could find of prostate cancer).  A week after visiting this outside doctor that the VA ordered, came this reduction letter. When I read the conditions under which the VA can reduce a disability it reads as follows:

1. The VA must determine whether there has been an actual change in the disability since the last rating decision.

Prior to surgery my PSA reading reached a high of 5.6 and for the last 3 1/2 years there has been only the very slightest of changes varying from  >0.10 and <0.10 and nothing more or less than these numbers and symbols on myhealthevet.

2. The VA must determine whether there has been an actual change in the disability since the last rating decision

Again, only the slightest changes, as above, have occurred since my surgery

3. The VA must outline the time period during which the condition is said to have materially improved

I cannot find in their letter any specific range of time for improvement. Directly below is their letter in full without actual dollar amounts:

We have enclosed a copy of our rating decision for your review. It provides a detailed explanation about our proposal, the reason for it, and the evidence considered.

We have reviewed medical records concerning your service-connected conditions and noted some improvement in your Malignant growth of genitourinary system. Based on this evidence,we are preparing to reduce your prior evaluation of its overall disabling effect. The combined evaluation for all of your service-connected disabilities will drop from 100% to 50%. This proposed action does not affect your entitlement to treatment for service-connected conditions. We propose to reduce your monthly rate of compensation from $$$$ to $$.

We have reviewed medical records concerning your service-connected disabilities and noted some improvement. We propose to reduce our evaluations of the disabling effects for conditions as follows

        Malignant growth of genitourinary system    100%    40%

Please keep in mind I have a 5" scar, which was re-measured at this outside C&P exam, ED and incontinence at 5-6 Depends daily and the same number of bathroom visits nightly.

What's my next step? If I've missed anything just ask please

 

Edited December 18, 2020 by VietNamVet1969

[GBArmy]

Brother, it's a tough row you have to roe. 100% after surgery is a temp rating. After a period of time, in your case 3 1/2 years (which is longer than most granted by the VA after that surgery), they are to eval your current symptoms and rate you accordingly. Those factors you refer to are for normal disability ratings; your 100% rating was a temp one. So, IMHO, I don't believe you should be challenging the conditions for reducing. You probably should be arguing the symptoms of your residuals. You must reply to the letter from the VA right away that you are challenging the reduction. There are several posts on this subject here on Hadit. Going from 100 to 50% is like $2 grand on the table. Personally, I would get good legal help. IMHO it would be a good investment. Other may argue you can do it yourself. Yup. But if not successful, and you appeal and eventually win, just the anxiety of not knowing when/if you're going to get a high rating back alone might be worth it. Don't forget to apply for SMC(k), loss of use (ED) in any case.

[VietNamVet1969]

1 hour ago, GBArmy said:

Brother, it's a tough row you have to roe. 100% after surgery is a temp rating. After a period of time, in your case 3 1/2 years (which is longer than most granted by the VA after that surgery), they are to eval your current symptoms and rate you accordingly. Those factors you refer to are for normal disability ratings; your 100% rating was a temp one. So, IMHO, I don't believe you should be challenging the conditions for reducing. You probably should be arguing the symptoms of your residuals. You must reply to the letter from the VA right away that you are challenging the reduction. There are several posts on this subject here on Hadit. Going from 100 to 50% is like $2 grand on the table. Personally, I would get good legal help. IMHO it would be a good investment. Other may argue you can do it yourself. Yup. But if not successful, and you appeal and eventually win, just the anxiety of not knowing when/if you're going to get a high rating back alone might be worth it. Don't forget to apply for SMC(k), loss of use (ED) in any case.

Thanks very much GBArmy

I am educated and I appreciate your reply. With 40% left I am thinking they are paying me (40%) for my SMC's no? ED, incontinence and scar? If I were to hire an attorney would that be for the express purpose of a higher rating for these SMC's?

BTW I was only going by the requirements that I read here, (https://hadit.com/va-ratings-reduction/) on the numbered references in my post.

[GBArmy]

VietNamVet1969 Good question. When they pay you 100% temp, they are not paying you for SMC's because your 100% isn't permanent. No, not for the scar; that would also have to be submitted as a new claim. Look up the criteria for scars, by the way. It isn't as straight forward as one might think. You could submit for those when you get a permanent rating, 100% , 40% whatever. They are independent. Since they are new, your lawyer wouldn't get anything I should think because it isn't an appeal. The legal beagles are paid on a % of your back pay won which accumulates over the time period of the appeal. I should think you should submit those now if you wish. The VA is supposed to apply SMC's when appropriate, but that doesn't mean you can't ask why they didn't if it isn't awarded. Understand, if you are awarded another extended period of temporary, you wouldn't get the smc(k) for ED yet because it is already a symptom for the 100% temp. That would be pyramiding; paying twice for the same symptom  under two different disabilities. Incontinence, the frequency and number of pads are part of the criteria for determining your rating if you slip from 100%. Also, consider an additional  MH disability for anxiety and or depression if you situation warrants it. Possibly 30% right there.

[Buck52]

  You have some things in your favor and that is being a boots on the ground in Vietnam from years ago...

for the VA presumptions diseases caused or related to the Agent Orange Chemicals.

You should request your C-FILE and find out what records they viewed and what the Dr's have said in their reports.to see what has actually improved.?.

This is the only way they can send a proposal to reduce, you need to look at your medical records and see if the VA declared you P&T permanent & total disabled.  AND I AM ONLY GUESSING HERE BUT YOUR AGE IS OVER 55.  Because your age becomes a factor after turning 55.  in your favor.

Gather up all your medical records that pertain to this surgery you had 3  1/2 years ago   and you may also want to go get a IMO Independent medical opinion for a specialist  to rebute what these VA Dr's are saying your condition has shown improvement.

They have to prove your condition has improved with two different C&P Exams  and the improvement must shown it has improved under normal /ordinarily conditions of life  or something close along these lines.

Remember as long as your in Appeals with this  you will get your 100%  if it takes them years   so in the mean time gather up all your medical records and get your self an IMO from a Veteran friendly DR  ( HIGHILY RECOMMENDS A SPECIALIST)  IN THIS FIELD OF MEDCINE.

Ask the specialist to read your medical records/& examine you and have him/her to give their medical opinion as to your condition showing improvement or basically worse or bout the same.  ect,,ect,,,  take him''her your Myhealthvet notes....and try your best to get your last C&P Exam report  to see what and why the C&P Examiner has said you have shown Improvement.

YOU HAVE 60 DAYS AFTER YOU RECIEVED YOUR PREPOSAL TO REDUCE, TO SEND IN YOUR NOD  (NOTICE OF DISAGREMENT) BE SURE YOU DO THAT...THIS WILL PUT YOU IN YOUR APPEALS TIME-LINE.

OTHER  HADIT MEMBERS CAN CHIME IN HERE,  EVERY BIT OF INFORMATION WE CAN GIVE THIS VETERAN THE BETTER.

Edited December 18, 2020 by Buck52

[pacmanx1]

My suggestion would be making sure you fully understand what is going on. If this is a proposal to reduce then file for a hearing if you disagree and if this is a straight-out reduction, then file a NOD, there is a big difference.  As Bronco pointed out to me the other day, a veteran can not file a NOD on a proposal to reduce but the veteran must request a hearing if the veteran’s symptoms does not warrant a reduction. As to your combine rating. You should consider all other conditions/disabilities that you may be experiencing in filing additional claims. Mental health disorders, respiratory disorder, heart disorder or disease and any other condition that could be link to your military service or your already service-connected disabilities. The way it was explained to me is that when a person goes through some type of chronic issues, they most likely have some type of depression issues. Depression issues does not mean that you are mental, but it means that you have extra stress that the average individual does not have and since it was/is military related, you should be compensated for it. A lot of veterans overlook the mental health part because they do not want to be labeled but it is a legitimate condition/disability/handicap that a veteran should consider in filing a claim for.

Also, if you a not currently working and if you can not work due to your service-connected disabilities you should consider filing for TDIU(TOTAL DISABILITY INDIVIDUAL UNEMPLOYABILITY) and SSDI (SOCIAL SECURITY DISABILITY INSURANCE).

Agent Orange Exposure | Veterans Affairs (va.gov)

[Marine Corp 69/70]

Did you do the claim yourself or did you used a VSO or somebody else with the prostate cancer claim, because you should have had SMC K from day one. I would talk to a lawyer that deals with Agent Orange claims ( good luck)