Congressman Jim Costa, "spike in disability benefits reduction"

[Rivet62]

Congressman Jim Costa (D-CA) has raised concerns over what appears to be a spike in the reductions of veterans disability benefits and has made an inquiry to the VA. Included in the concerns raised is the VA proposed changes for how VA rates tinnitus, sleep apnea, and mental health.

In addition, Costa is responding to concerns that veterans have that cause them to avoid medical care for fear of reductions.

https://costa.house.gov/media-center/press-releases/costa-raises-concern-us-dept-veterans-affairs-over-unexplained

 

I know that my personal experience with VA healthcare or VA paid care (Community Care program) is the sense that I am seeing claims adjusters. I don't think I am imagining it. I have spoken to other vets who feel the same. I often experience a line of questioning or statements made in such a way as to frame things as less than they actually are. This is why I keep a close eye on my VA medical records so that everyone's on the same page, so to speak. Where I see narratives veering off-course I'll request referrals to others.

 

 

[deedub75]

I have concerns about reductions too. Currently, I only see the allergy, sleep, and ENT clinics at my VAMC. I used to see primary care there but the doctors were so terrible and rude that I went back to seeing a private doctor. 

I'm 100% P&T(effective date 2/24/15) and I'm service connected for chronic rhinitis (30% effective date 1/3/14), chronic sinusitis (50% effective date 1/3/14), and sleep apnea (50% effective date 2/24/15), among other service connected disabilities. All of them are static. I underwent immunotherapy injections for rhinitis and my allergies are stable but I still have to take flonase and certirizine daily as the immunotherapy didn't completely get rid of my allergies. My sinusitis is stable as well but I still have issues with swollen sinuses and polyps. I also have a CPAP for sleep apnea.

I'm afraid, whether I should be or not, that one day that they are going to 'randomly' pull up my name and 'review' my records in search of reductions. 

[Whodat]

I don't know about that Deedub. I thought that once you have p&t, you are good to go. 

If that was to happen, it would really mess things up for you and your family. 

[deedub75]

36 minutes ago, Whodat said:

I don't know about that Deedub. I thought that once you have p&t, you are good to go. 

If that was to happen, it would really mess things up for you and your family. 

They can take it away if you lose enough percentage to drop you below the threshold  

I was very close to losing my 100% P&T right after I got it. From my calculations, I could have afforded to lose 20% without being reduced 90%. If I lost 30% then my rating would have been 94% and they would have rounded me down to 90%. I ended up losing 20% because they reduced my ankle from 20 to 10% and a scar from 10 to 0% after I had ankle surgery. 

[pacmanx1]

Let's get real here, there are some veterans that are not educated in VA procedures and regulations and some of these posts that claim a veteran can lose his/her benefits are not likely to happen and especially P & T. Keep in mind that the VA can send out a letter of proposed reduction at any time and the veteran can request a hearing to argue that his/her rating should stay the same. At the same time, the VA can reduce a veteran’s rating and the veteran has a right to file an appeal to argue that his/her rating should stay the same. I have a remand that has been pending for well over two decades and I have been rated 100% P & T for at least a decade and a half and the VA has never brought up the status of my P & T rating. VA only wins when the veterans fail to file a disagreement or a request for a hearing and fight for his/her benefits. 

Here we go again, please read really carefully.

To hold otherwise would leave the door open for a possible "chilling effect" in the administrative appeal process, whereby veterans might be afraid to seek higher disability evaluations on appeal, for fear of having already awarded benefits reduced by the Board during the appellate process.  See, e.g., 38 C.F.R. § 3.2600(d) (2013) (except in cases of clear and unmistakable error (CUE), a decision review officer "may not revise [an AOJ] decision in a manner that is less advantageous to the claimant than the decision under review").  Such a result would be wholly 2 inconsistent with the non-adversarial claims system.  See Douglas v. Derwinski, 2 Vet. App. 435, 439 (1992) (noting the "basic principle of the VA claims process that claims will be processed and adjudicated in an informal, non-adversarial atmosphere"); see also Comer v. Peake, 552 F.3d 1362, 1369 (Fed. Cir. 2009) ("The VA disability compensation system is not meant to be a trap for the unwary . . .").

Proposed changes to 3 disabilities - Page 8 - VA Disability Compensation Benefits Claims Research Forum - VA Disability Compensation Benefits Forums - HadIt.com Veterans

Edited March 18, 2022 by pacmanx1

[Whodat]

That was my point pacman. You have hit the nail on the head. 

[Dustoff1970]

VA regs are very clear on this.  If you have held a rating for 20 or more years then they cannot reduce or terminate your rating unless fraud is discovered.  This also applies to TDIU ratings that are also protected after 20 years.

If you have held a rating for 10 or more years your rating cannot be terminated but it may be reduced that is unlikely IMHO.

Google search will give you the actual 38 CFR regulation on this issue.

This comment is not legal advice as I am not an attorney, paralegal or VSO.