What to do if you get a proposed reduction letter from VA.

[broncovet]

 Take these steps:

1.  Dont ignore the letter, it wont go away.

2.  Dont Panic.  Most Proposed Reductions that are timely disputed by the Veteran or his representative  can be quashed, regulations (provided by links below) are in the Veterans favor.  

3.  Get help.  You can ask questions on hadit, seek help from a VSO, or even seek legal help in extreme cases.  

4.  Consider asking for a hearing to tell your side.   If you do get a hearing, then explain why your stituation "does not fit" the reduction criteria.   I did great "WITHOUT a hearing", on 2 separate occasions.   Its my opinion that the VA "hopes" you just forget about the letter, and dont miss the money, or learn to live without the money.  

5.  Dig in.  Read your medical file/records, and review the regulations, below. 

6.  Understand these things:

    A.  If you have been rated for 5 years or more, OR, are P and T, You have protections.  

    B.  With these protections, the VA has to show "your condition has actually improved" under ordinary conditions of life (and NOT with prolonged rest!), and, that the improvement is not "episodic".  This means we all have good days, and on one day you go to the doc and feel great, and tell him so, the improvement needs to be "sustained", not just you feeling better on one day.  Mostly, the VA has to show that you have gotten better over time.  This is unlikely!  (This is my paraphrase of the regulations cited below).  

   C.  You can get your doctor (such as an IMO) to refute VA's position you have actual sustained improvement under ordinary conditions of life.  

   D.  The VA "is not supposed to do a reduction re exam" FOR Veterans over 55, "except under unusual circumstances".  At least one Veteran, when called in for a reduction c and p, (over age 55), made some calls and the exam was cancelled.  You can ask, "What is so special about my circumstances that the "over 55" rule was ignored? "

7.   Also remember this.  You do NOT need to show that you meet the applicable rating criteria NOW.  Instead, you need only show that you did not improve "since the last rating decsion" because, that decision either awarded your benefits, or was silent and continued them.  So, the VA can not send you a decision letter on your PTSD and continue your bad knee rating (even without mentioning the knee issue), then later decide your knee had improved.  The decision becomes final after a year, and you can hold VA to that!   This would put VA decisions in conflict with themself.  So, they said your PTSD was "continued", and they are gonna have to show you improved "after that" exam where you were awarded benefits or they were continued at the same rate.  

8.   Write a letter citing medical evidence in conflict with a rating reduction, and explaining why you dont meet reduction criteria.  

Protections are here:  https://www.law.cornell.edu/cfr/text/38/3.344. Some examples:

 

   

Quote

 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. ...

...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

Quote

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.

Did you notice all the "will not be used for reductions", above?  Use these to your advantage.  

As explained by the regulations, the above does not apply to temporary ratings, only P and T or over 5 years.  

 

[Sgt. Wilky]

I received one of these letters back in 2020. They proposed to drop me from my 70% to 30%. After an hour of panicking, I set to work, including seeking advice from Hadit.com. I ended up 8 months later getting 100%. 

One of the biggest keys for me was to know where you stand with the VA and its own rules and regulations. As @broncovetsaid, if P&T applies to you, or the 5, 10, 20 year rules apply, seek out and know your position.

I requested a hearing. The only evidence I sent in was a letter asking why they proposed a reduction on a condition the BVA said was static, and that I was protected under the 10 year rule. Never heard from them except to say the proposal was in error.

Know your rights, try to learn the rules, and research your standing within the vast mass of the VA.

Semper Fi,

Sgt. Wilky

Edited June 21, 2023 by Sgt. Wilky
Freddy-fat-fingered the whole thing

[Dustoff1970]

Very good advice as usual from Broconvet and also Sarge.  I would also send them any new and also old evidence (again) to support vets continued current evaluation that nothing has changed in vet's disability level and in fact vet feels their medical condition has worsened since last evaluation.  Since vet is not filing a claim for increase then there should be not another C&P exam triggered by this response. 

Most proposed reductions are sent after a recent C&P exam. Like others said quote the 38 CFR rules and 38 U.S. Codes that support vets continued entitlement to present rating.

If vet has recent strong medical evidence of worsening condition, then include the evidence and ask for increase in addition to filing a claim for the increase. As Bronconvet said the vet cannot ignore the proposed reduction notice.

File the important response by Certified Return Mail and many years ago the U.S. Court of Vet Appeals has ruled that this is proof of vet sending said evidence/response in spite of misleading advice by some VA DROs and advisors that say this proves nothing.  I have always used CRR mail for important documents, claims and appeals.  Works for me.

My comment is not legal advice as I am no lawyer, paralegal or vso.

Edited June 29, 2023 by Dustoff1970

[broncovet]

Good for you, Sargent.  The VA "shoots" with regulations, and we have regulations, too, to shoot back.  The link, above, as has regulations which favor the Veteran.   When the VA comes after you with guns (a proposed reduction letter), then dont leave your gun unloaded in its case.  Instead, pull out this regulation and hold VA to it.  

You also want to hold VA responsible for compliance with 38.CFR 3.105, for example:

Quote

(e) Reduction in evaluation—compensation. Where the reduction in evaluation of a service-connected disability or employability status is considered warranted and the lower evaluation would result in a reduction or discontinuance of compensation payments currently being made, a rating proposing the reduction or discontinuance will be prepared setting forth all material facts and reasons. The beneficiary will be notified at his or her latest address of record of the contemplated action and furnished detailed reasons therefor, and will be given 60 days for the presentation of additional evidence to show that compensation payments should be continued at their present level. Unless otherwise provided in paragraph (i) of this section, if additional evidence is not received within that period, final rating action will be taken and the award will be reduced or discontinued effective the last day of the month in which a 60-day period from the date of notice to the beneficiary of the final rating action expires.

 

Make no mistake:  If the Veteran of a proposed reduction, "does nothing", the reduction will happen.  You need to take action and explain why a reduction should not happen, citing evidence.  

[Dot09]

I too had a bugus reduction. However they never submitted a proposal to reduce as they stated it was not required because it didn’t change my tdiu rating. I called them on the bluff and failure of due process and submitted a imo of rom that I had sitting around they quickly resolved it with my vso and dro and changed my decision date back to it original rating and date.

Edited November 1, 2023 by Dot09