Rating Reductions

[pacmanx1]

12.3. Rating Reductions

There are circumstances where the VA can reduce your disability benefits. When the VA proposes to reduce a Veteran's disability compensation, it is of the upmost importance that the Veteran act quickly by seeking the services of either an aggressive Veterans Service Organization or an Attorney accredited by the VA.   The law is very clear that to assist a Veteran in the preparation, presentation, and prosecution of a claim for VA benefits, the individual must be accredited by the VA as an agent, attorney, or representative of a Veterans Service Organization, VSO, 38 U.S.C. §§ 5901-5902, 5904; 38 C.F.R. § 14.629.   There is a onetime only exception for a non-accredited individual to assist a Veteran in processing a claim under 38 C.F.R. § 14.630. 

To verify the VA accreditation of an Attorney, Claims Agent, or VSO Representative, go to website:  http://www.va.gov/ogc/apps/accreditation/

Some of the most common reasons for the reduction of you VA disability Compensation are:

  I.   Failure to Report for the "Pre-Reduction" Examination.

 II.  Unprotected Benefit Rating and Your Condition Improves

Rating Reductions (vetsfirst.org)

 

Yes, it is more to a reduction that a veteran can do but the VA can just deny the claim base on failure to report to an examination. 

Edited December 1, 2021 by pacmanx1

[john999]

I have delt with worker's compensation doctors and I did not have a problem, but I think if WC keeps sending you to doctors every year you will eventually find one that decides you are perfectly OK and should return to work.  When I first started appealing my initial low ball rating from the VA way back in 1973 I was up against doctors that just looked at previous rating and continued it.  No matter what I said I just got the same denial of an increase.  The VA exam doctors would just ask me the same question..."  Are you working?"  If I said "Yes" no increase.  These guys just rubber stamped the previous opinion over and over.  If your disability is not a real slam dunk then when you see these C&P doctors you never know what will come out of it.

[pwrslm]

If you have a decent PCP you should be able to document your condition before you ever put in a claim. Bring the condition to your PCP and ask for evaluation if you think your condition got worse. Usually, VA will be fine to do this every 12 months. By doing this you have documentation already in the VA medical records of anything that needs to be documented for an increase.

I have done this over and over for my lumbar and cervical spine conditions, arthritis in my hips/knees, and 2 years of work with neurology diagnosing my neuro condition. It works because you have evidence from within the system. The only time I got a non-VA IMO/IME was for my 1st claim.

If you ask your PCP about hypertension or diabetes or kidney/liver problems, get them to note their answers in your records. The PCP is out to insure that you stay healthy, and typically will refrain from anything to do with claims, so do not try to drag them into a claim statement unless they volunteer. All they need to do is enter the professional opinion of what caused the condition in the VA system, the rest is downhill from there.

[broncovet]

I remember when Carlie was called for re exam, and she was well over 55.  She threw a fit, and, Im not sure who she called but the re exam was cancelled.  I dont remember all the details, it may be here in hadit under Carlie.  

[pwrslm]

I did something similar to this. The VA 800 rep told me that she cannot do anything about the 3rd exam they ordered for radiculopathy of my LLE in 6 months. I told her that the VBA gave Vets no other option but to communicate through the toll free number, and if she did not have an answer for me, I would like to speak to her supervisor. The supervisor understood what I told him and sent a message through to the RO which was answered in 24 hours. The Exam was cancelled due to my age (56) as well as the fact that it was a 3rd exam is such a short period of time. I think this was in 2017.

 

Y8 CFR 3.327 Reexaminations...

(b) Compensation cases -

(1) Scheduling reexaminations. Assignment of a prestabilization rating requires reexamination within the second 6 months period following separation from service. Following initial Department of Veterans Affairs examination, or any scheduled future or other examination, reexamination, if in order, will be scheduled within not less than 2 years nor more than 5 years within the judgment of the rating board, unless another time period is elsewhere specified.

(2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled: (i) When the disability is established as static;

(ii) When the findings and symptoms are shown by examinations scheduled in paragraph (b)(2)(i) of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more;

(iii) Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement;

(iv) In cases of veterans over 55 years of age, except under unusual circumstances;

(v) When the rating is a prescribed scheduled minimum rating; or

(vi) Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions.