What are VA disability reduction methods?

[Jake206th]

HLR for EED was returned for duty to assist error based on; 38 CFR §4.70 Inadequate examinations.

The Higher level review return says that the c&p examiner did not specifically address the board remand directives even though the c&p examiner did specifically and explicitly address all of the noted board remand instruction directives.

 

They are questioning all of the basis that the original C&P examiner gave that the VA used to grant the increased evaluation of 100%, even though it was clearly sufficient.

They are questioning the diagnosis, the frequency, the symptom severity level, and the duration.

 

What are their options to reduce in this scenario?

Difference of opinion? Cue? Reduction process?

Can they bypass all of those option and just re adjudicate it at a lower rating because the decision was less than 1 year ago?

 

Does this mean that the favorable findings laws and cue laws don't apply and that they can just issue a new rating decision to revise my 100% rating without any CUE or reduction due process?

 

 

I am not a lawyer and nothing I write is legal advice. It is just how things appear to me based on my limited understanding. and I may be incorrect.

Edited February 3, 2023 by Jake206th

[allansc2005]

@john999, I tend to agree.

 

In my 25+ years of battling the VA and helping other veterans, I've never known the VA to go on "witch hunts" to reduce veteran's compensation.

Something I have noticed though is it seems harder to get from 70-80-90% to 100% these days.

On the other hand I've seen a trend of getting TDIU much easier than days gone by.

I think with the VA now "sourcing" out the C&P exams, we will see a slow rise in cases won.

Time will tell.

 

As I've stated many times, today's veteran needs to educate him/her self on the do's and don'ts of the entire system.

I've seen it time and time again where a veteran will sit around until the end of time waiting to see what someone else does or doesn't do about their case, only to find out nothing has been done!

 

OK, off my soap box 

Allan 2-2-0 HOOAH!

 

 

[Jake206th]

On 1/25/2023 at 1:30 AM, john999 said:

VA has so many new claims to deal with I don't think they go on witch hunts to reduce 100% vets.

Of course they would never do that...

Costa Raises Concern with U.S. Dept. of Veterans Affairs Over Unexplained Disability Benefits Reductions on an apparent spike in disability cuts for veterans.

 

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

 

 

The Office of Inspector General for the Department of Veterans Affairs (VA) said the Veterans Benefits Administration spent $10.1 million on unwarranted reexaminations during the March-August 2017 review period, according to a report in the Washington Post. The 19,800 cases out of 53,500 classified as unwarranted reexaminations accounted for 37 percent of total cases, or more than one-third.

While the report noted that reexaminations are important for ensuring taxpayer dollars are spent appropriately, unwarranted reexaminations result in unnecessary costs for Veterans and unnecessary work for VA employees. The Office of Inspector General report found that 15,500 of those 19,800 unwarranted reexaminations – or 78 percent – did not have an appropriate pre-exam review.

 

https://ptsdlawyers.com/va-reductions-of-disability-benefits/

 

 

I am not a lawyer and nothing I write is legal advice. It is just how things appear to me based on my limited understanding. and I may be incorrect.

Edited February 3, 2023 by Jake206th

[Whodat]

One of the new tactics. 

[john999]

If VA opens my claims up because I make a new claim I think that would be dumb of them since all my SC conditions are probably worse now then when I claimed them.  I did make a new claim for HBP due to AO exposure.  Let them open my claims back up I say. I will make them pay for it.  

[allansc2005]

IF the VA "opens new claims" unnecessarily, then file an IG complaint, notify your local Patient Representative's office, and let the chips fall where they may.

 

IF you're over 55, not getting compensation for *mental issues, except PTSD, then grab a bag of Doritos and a 12 pack of you're favorite beer, and sit back and watch the fun!

 

* Mental issues such as depression, anxiety disorders.., which are controlled by medications and/or therapy, can actually be "cured", thus targeted by the VA reduction minions; just ONE entry by a medical professional that your mental condition has "improved", could trigger the VA to reduce your compensation %.

 

Seen it a hundred times!

 

Allan 2-2-0 HOOAH!

[pacmanx1]

On 12/9/2022 at 3:27 PM, Jake206th said:

Update

So I received my decision. And now have a clearer picture of what happened.

Starting from the beginning;

Earlier Effective Date HLR appeal filed > EED HLR closed and returned for duty to assist error for new c&p medical exam > Becomes a supplemental claim and a new Exam for a DBQ Medical Opinion was ordered > DBQ medical opinion completed saying my condition hasn't changed, and that the previous exams were complete and for adjudicator to refer to them > I recieve a new VA Decision.

New VA decision stating that new and relevant evidence had been received, and that my claims had been reconsidered, and the 100% rated condition was continued. No comment on the earlier effective date for that 100% awarded condition because that Earlier Effective Date HLR claim was closed when they found a duty to assist error and returned it, and it turned into a supplemental claim. SMC for 100 plus 60 confirmed and continued. EED for SMC denied, of course because they didn't consider the EED for the underlying intertwined 100% rated condition. Education benefits confirmed and continued, EED for Education benefits denied, of course because they didn't consider the EED for the underlying intertwined 100% rated condition.

Timeline: HLR filed May 2022, HLR returned and closed June 2022, new exam completed in October 2022, supplemental claim decision in November 2022. Delay was the on the exam side.

My observations: This was all under the AMA. There were no favorable findings listed in the decision letter, or rating notification letter. Or at least not stated as such.

I have a year to appeal to the board. I may not risk appeal for the 100% EED back pay because I have minimal medical record and medical findings in my exam DBQ's to support 100% severity level back to 2010. Plus the stress it causes me. It could just end up being remanded for another c&p exam and it would be back at the regional office for re adjudication.

I hope I am getting this right, but it seems that the simplest thing to do is to file an appeal to the BVA. It appears the veteran filed an appeal/HLR for an EED in which the VA would most likely request a new or an additional exam. The problem seems to be that the VARO ignored the examiner’s opinion that the prior exam was adequate and suggested that the VARO review it to determine the veteran’s severity, but the VARO ignored it and continued the veteran’s current rating as is without considering or adjudicating the veterans appeal/HLR for an EED.

Your claim your decision, I just won an EED last year for increased rating and TDIU and the VARO screwed up my effective dates and I filed an appeal which was also ignored, and I decided to get a lawyer and file an appeal to the CAVC. I was recently contacted by my lawyer that the VA lawyer did not have an argument with my requested appeal and now I am waiting on a new joint remand. You do not need a lawyer until your appeal goes to the CAVC and then it is free under the EAJA. For whatever reason the VARO denied my request and appeal then the BVA did the same thing, but the VA lawyer at the CAVC did not disagree and conceded my points of facts, and I should be getting a new decision soon.

Edited January 29, 2023 by pacmanx1