If you’re a veteran and have obtained benefits for a service-connected disability from the United States Department of Veterans Affairs (VA), you may think the process is over. However, a number of potential changes can take place in the years following your initial award that are important to understand. As an approved applicant, you have the right to request a rating increase if you have evidence proving that your illness, disease, or condition has worsened. At the same time, except under special circumstances, the VA can re-evaluate your claim to increase, decrease, or completely terminate your benefits at any time. If the VA has medical evidence that shows your condition has improved, the agency can decrease your rating or stop compensating you for your disability entirely.
Because the process for appealing a VA rating reduction can be tricky, it’s helpful to hire an attorney who has experience working with VA applications, appealing claims, and dealing with proposed rating reductions. You may need an attorney’s skill and expertise to understand the best way to navigate the many VA processes.
When the VA Proposes a Reduction in Your Rating
The VA has the authority to require that you report for follow-up medical exams, especially if the agency is looking into your claim. Like the initial Compensation and Pension (C&P) exam, it’s important that you show up for this exam on the day it’s scheduled. If you fail to report and you don’t have a satisfactory reason for missing the appointment, the VA can reduce compensation or sever it completely.
If medical evidence is obtained by the VA that shows your condition has improved, the agency has the right to reduce your disability rating. However, before the rating is changed, here are some specific steps in the process:
- The VA must follow a formal process that proposes the reduction before the agency actually reduces your rating.
- The VA must send notice to the claimant of the proposed reduction.
- The VA must ensure that there is accurate medical evidence from a legitimate medical exam to support a reduction in the rating.
- The VA must determine that there’s been a real change in the claimant’s disease or illness, not just a limited or short-lived improvement.
- The VA must have enough evidence to support a decision to reduce an entire history of the claimant’s condition.
- The claimant has the right to challenge the reduction and send evidence to refute it.
- The claimant must respond within 30 days to prevent a change in his rating.
Additionally, it’s possible for the VA to terminate your claim. While this action doesn’t happen often, the agency may determine that the initial rating was awarded based on an error, fraud, or some type of illegal or unlawful action. If this happens, the claimant has the same right to challenge the proposed termination of compensation.
Challenging a Proposed Ratings Reduction
If you receive notice from the VA of a proposed rating reduction, you’ll likely want to appeal this proposal. It’s important to understand what can happen during this process. Here is a brief look at some critical points you may want to consider:
- You may have to repay money to the VA if your appeal is not successful.
- If the VA finds that your disability rate was too high, an “overpayment” will be generated that you’ll have to pay back.
- The amount of the overpayment could be significant.
- If you’re unable to repay the overpayment, the VA will likely withhold some amount from any future benefits checks until there is resolution of the overpayment.
Some disability ratings are considered “protected” from a VA proposed reduction; however, no claim is 100 percent secure. In general, veterans have protected benefits if they:
- Have received benefits at the same rating for over five years
- Have reached the age of 55 or older
- Have received their disability compensation for over 20 years
- Have a disability that will never improve such as the loss of an arm or leg
- Have a 100 percent disabled rating or are considered totally and permanently disabled
It is possible for the VA to lower a protected rate, but it’s a more difficult process. It usually doesn’t happen unless the VA can prove there was fraud connected with your initial claim.
We Can Help
If you’re a veteran whose disability rating might be decreased, contact Cuddigan Law at (402) 933-5405. We can help you with the appeals process to ensure that you receive the fairest possible rating. Call us to schedule a consultation to discuss your specific situation.