1 in 3 PACT Act Claims Have Received a 0% Disability Rating, Prompting a VA Review

[Dustoff1970]

Recent interesting article from Military.com news site.

"

The Department of Veterans Affairs has approved nearly 80% of the 570,000 claims it has adjudicated under the PACT Act, distributing more than $2.2 billion in disability compensation to veterans or survivors since it began accepting claims last year.

Of the total claims, however, 34% have received a 0% disability rating, meaning that affected veterans have at least one service-connected condition under the law that is not disabling -- for example, hypertension, which has been linked to Agent Orange exposure, that is controlled by medication.

 

 

The VA is now reviewing its ratings schedule to determine whether it can revise it to address medically controlled conditions such as hypertension, VA Under Secretary for Benefits Joshua Jacobs told reporters Thursday."

 

[broncovet]

I like the improvement. (lol)   2/3 or more of the previous claims were just denied.  A zero percent rating and a denial pay at the same rate:  $0.00 per month.  

I applied, was denied.  After 3 years at the BVA and a successful appeal, the VARO "awarded" zero percent.   That was even more frustrating than a zero percent "award" straight away.   But that was before the pact act.  Some things dont change much.  

[Dustoff1970]

In 2012 the U.S. CAVC veterans court issued a decision prohibiting VA raters from using the moderating effect of treatment drugs for a disability to reduce a vets evaluation rating level.  Here is more info on this from Veterans Law Blog.

"By law, when determining the percentage for your rating the VA can only consider the criteria contained in the Diagnostic Code for the given disability – – to do otherwise is error.

Unless the effects of medications are specifically included in the impairment rating criteria for your condition, the VA is NOT allowed to consider whether a particular medication moderates a Veteran’s condition in determining the degree of disability.

It’s that simple.

Let’s take a look at a Sample VA Disability Claim:

As an example, say a Veteran has been able to service-connect Irritable Bowel Syndrome (DC 7319).

Undiagnosed, the symptoms of IBS might be a component of Gulf War Illness

With prescribed medication, our hypothetical Veteran’s condition moderates from a severe form of the disease to a milder form.

The severe form of IBS is rated at 30% and the moderate form of IBS is rated by the VA at 10%.

Let’s say the VA gives the Vet a rating of 10%, claiming that the Veteran’s medication limits her symptoms.

Is that 10% rating correct?

No . The Diagnostic Criteria in the VA Rating Schedule for Irritable Bowel Syndrome does not specifically list the effects of medication.

Therefore, the VA is not allowed to consider the relief it provides when determining the degree of disability."

Has this happened to you?

When have you seen the VA use “improvement due to medication” as an excuse to give a lower rating?

 

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

 

 

 

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[broncovet]

Good info, dustoff.    Its still another reason its tough for VA to reduce your rating, once you are P and T or over 5 years, especially.  

But, you would be suprised at how many vets worry about a reduction, and many wont even apply for an increase of benefits even when they deserve it, out of a fear of reductions.  

It would be helpful for some vets, if you could cite the decision in case a Vet needs to appeal.  I assume this decision was precedential, that is, either an en banc or panel decision.  

Edited September 25, 2023 by broncovet

[Guest]

I have a brother in law who has gotten worse and told me he did not want to cause waves.

I said but it is getting worse and you should go back in.  He said a person a knew got a reduction, but his issue was the VA messed up by giving him something that was not wrong with him.  He just did not say anything and they changed it.  

I asked if all of his where legit and he stated yes, but was so stuck on this that he feared a reduction not matter what he was told ever again.

I think too many vets get stuck on this with no clear eveidece, just the crap that has been put on us from the start.

 

If I would have stuck with it I would be at 40% and never moved forward.  That is what the DAV wanted me to do.  I will never stop fighting them!

[broncovet]

I agree with shrek.  "Applying for an increase" is NOT in the criteria for reductions.  Instead, VA can reduce you AT any time, whether or not you applied for an increase or went to a Bon Jovi Concert, in a blue and white tie die tshirt.  The VA does not reduce your benefits for wearing a blue tie die tshirt, and they dont reduce them for applying for an increase either.  Instead, Va goes by its own set of criteria, generally, that your condition has acutally improve under ordinary conditions of life, AND that improvement is sustained and will continue.  

If you are missing a leg, its highly unlikely to grow back.  If you have PTSD, you probably are not going to wake up tommorrow cured.  Yea, you may have a great day tommorrow, maybe you can take your grand daughter to disney world.  But that does not mean you improved, every one has good days and bad days.  

[Rattler]

Great decision brothers. Dustoff1970 I would like to read 2012 the U.S. CAVC case if you have it. I usually print them to a pdf file and save it.