proposed lowering of a rating after only less than a month of the award (from 60% to 10%

[rita glenn-copeland]

On May 26 was awarded 60% for a skin disorder affecting majority of my body.  Before the award, was at C&P examination for skin disease and shaving issue. During the exam the dr. ask questions that led me to talk about knee injury and hearing loss. Although the exam was only for skin disorder and shaving (pscudo) she examined me for the knee and hearing.  However, after the examination, I was awarded 60% for the skin disorder and 10 % for the shaving.  Not less than 30 days, I received another examination request for my knee and hearing.  Went to the examination for knee and hearing only. Received within 10 days a letter reducing my rating from 60% to 10% supposedly from the exam conducted from the knee.

Also, let me point out that the skin disorder that is over the majority of my body new rating is including my shaving

[brokensoldier244th]

Has your knee/hearing improved? Unless you had a hearing exam they can't just reduce based on the say so of a C&P examiner without a hearing exam. Did they measure movement of the knee? If they didn't then then didn't do an adequate examination. Log onto MyHealthVet- if it was a VAMC exam those usually show up in the Blue Button/Download my records within a few days to a few weeks depending on how long it took the doctor to transcribe them. Then you look at the denial and see exactly why they denied/reduced. In the mean time file request a hearing immediately- it freezes the reduction from happening until you have a hearing if you file it within 30 days of the proposal to reduce. If you file it within days 31-60 then they can reduce, but you can still get a hearing and if the hearing is in your favor they reverse the previous decision.

Also, somewhere in there you would have gotten a proposal to reduce before the reduction, those don't usually take effect until something like 60 days after notice of proposal to reduce. If you didn't get the letter and can show that your address hasn't changed then its a due process violation, also. If you did get the letter and ignored it, well, thats a different thing. You need to file a supplemental claim for the decision of the reduction (20-0995, or 20-0996). 20-0995 lets you submit more/additional new/and or relevant evidence. 20-0996 is a review only of the information of record. I would do an -0995.

 

In short. 

1. Did they propose to reduce or actually reduce? 

    a. If a proposal, file a request for a hearing- that freezes the proposal until the hearing, plus you can still gather evidence. Private doctor, VAMC appt, whatever.

2. If they DID already reduce then you missed the proposal to reduce letter in there somewhere.

     a. Now you have to file a supplemental claim for the decision that reduced, providing new and relevant evidence. Depending on how long you have been rated for the knee and hearing (thats what they reduced/proposed to reduce, right?) if its 5 yrs or older from the decision they have to show actual improvement, and 1 c and p is not enough to do that. Plus, if you didn't get a hearing examination they have no diagnostic on which to base their opinion anyway. Same with knee- if they didnt actually measure range of motion, they screwed up. What EXACTLY does your denial say? Without an accurate timeline its kinda hard to advice you. If you can, scan your denial letter and block out the parts with your name and SS# and address. 

Edited June 19, 2021 by brokensoldier244th

[broncovet]

I agree with broken spoke.  Its unlikely this "improved" in that short of a period of time.  Your condition may be subject to "episodic" improvement.  Read this:

Quote

38 CFR § 3.344 - Stabilization of disability evaluations.

• CFR

prev next

§ 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.

Based on the bold portions, above, me thinks your proposed reduction wont fly if you protest it.  

[Berta]

You said: " Received within 10 days a letter reducing my rating from 60% to 10% supposedly from the exam conducted from the knee.

Also, let me point out that the skin disorder that is over the majority of my body new rating is including my shaving."

This seems to be  a very bizarre decision-

can you scan and attach the decision and attach it here? to include their evidence list?

Cover your C file #, name, address prior to scanning it.