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]

VietnamVet1969 I wouldn't word it that way. If a veteran is granted a disability and has it at that rate for 5 years or more, the VA can't call you in for a C&P, find that you have" improved," and propose to reduce you without another exam or other evidence. If a veteran prior to 5 years, doesn't go for exams for treatment and otherwise doesn't show any signs of reaching out for medical help, the VA "assumes" that since he didn't seek treatment, he MUST be better. That is why it is important for veterans to continue seeing their doctors. If the veteran does go to a non-VA doctor, he should be providing progress notes into his medical file. If you are over 55, or, your disability is considered to be "static", it offers somewhat the same type of assumptions; that is, you also shouldn't be called for an exam then. You could call 800-827-1000 and ask the rep is your particular disability is static or if you will be scheduled for another future exam.

[Marine Corp 69/70]

GBArmy you are correct, but I think it say mark improvement after Five years

[VietNamVet1969]

5 hours ago, GBArmy said:

VietnamVet1969 I wouldn't word it that way. If a veteran is granted a disability and has it at that rate for 5 years or more, the VA can't call you in for a C&P, find that you have" improved," and propose to reduce you without another exam or other evidence. If a veteran prior to 5 years, doesn't go for exams for treatment and otherwise doesn't show any signs of reaching out for medical help, the VA "assumes" that since he didn't seek treatment, he MUST be better. That is why it is important for veterans to continue seeing their doctors. If the veteran does go to a non-VA doctor, he should be providing progress notes into his medical file. If you are over 55, or, your disability is considered to be "static", it offers somewhat the same type of assumptions; that is, you also shouldn't be called for an exam then. You could call 800-827-1000 and ask the rep is your particular disability is static or if you will be scheduled for another future exam.

Thank you GBArmy. I will make that call. I am over 55 and I have never missed an appointment for a C&P. And now have proof that my PSA reading is above the level I have had for 3 1/2 years. I am very cooperative other than allowing for radiation or chemo. Thanks again

[VietNamVet1969]

5 hours ago, Marine Corp 69/70 said:

It take more than one C&P exam after you s/c disability is over the Five year mark to be reduced, after the Ten year mark the s/c is permanent but the % can be reduced to 0%.

Again I am not clear when you say "It take more than one C&P exam after you s/c disability "  Not sure what s/c means, my apology I just don't have all the acronyms down yet

[GBArmy]

S-C means service connected. You need 3 things for a successful claim: 1) a current diagnosis by a doctor of an illness/disability; 2) an event or exposure or injury with evidence that it occurred while in the service; and the 3d which is a connection or SERVICE CONNECTION that links the two. A doctor can usually provide that link by a nexus or Independent Medical Opinion, IMO, that the current disability was caused by the worsening of the original injury for example. 

[VietNamVet1969]

11 hours ago, GBArmy said:

S-C means service connected. You need 3 things for a successful claim: 1) a current diagnosis by a doctor of an illness/disability; 2) an event or exposure or injury with evidence that it occurred while in the service; and the 3d which is a connection or SERVICE CONNECTION that links the two. A doctor can usually provide that link by a nexus or Independent Medical Opinion, IMO, that the current disability was caused by the worsening of the original injury for example. 

Thanks for the clarity GBArmy

I'll assume that since it has been determined that it is service connected, and they have been paying a monthly disability for 3 1/2 years, that this is indeed S-C. And that I have just recently provided a blood test for a higher PSA reading than the past 3 1/2 years, and it is accompanied by a letter from the VA staff that confirms that, that I have an adequate NOD combination and chance at maintaining the 100% temporary disability rating. If that sounds correct, I thank you and the others here for their experience in assisting. If not please let me know.