What is a Staged Rating?
It is both unfortunate and frustrating, but the VA appeal process can drag on for several years. During that time your health due to your service-connected impairment can change—it may improve or it may deteriorate. After medical treatments your health may be restored or left with residual issues due to the impairment itself or because of the treatment for your condition. When this happens you may be entitled to different ratings for different periods of time. These different ratings are called "staged ratings." Medical records and other evidence can show changed symptoms that determine the rating for each period of time. Staged ratings may mean a higher retroactive benefit payment when it takes a long time for your claim to get awarded.
The VA uses three main types of staged ratings.
- Staged Ratings Based on Changing Severity
- Temporary Total Evaluations
- Prestabilization Ratings
Staged Ratings Based on Changing Severity
This type of rating may apply when your condition has gotten worse or improved from the time when you initially filed your claim for benefits and when you finally get a decision on your appeal of a denial. For example, let’s say you filed a claim for an increased rating above 10% for a service-related knee injury in 2018. Then you were granted an increased rating in 2022, but the condition of your knee got progressively worse during those four years. In this case the VA may grant an increase from 10% to 30% from 2018 to 2020 (based on the severity during that period), and they then approve a rating increase to 40% from 2020 forward.
Clear and convincing medical evidence of the changes in your condition is the key to winning increased benefits through staged ratings. That is why it is important to regularly see VA doctors or your private physician to document the progression of your impairment. The VA will be looking for the facts of your case found in test results, medical records, and letters from your healthcare providers.
Temporary Total Evaluations
Under VA regulations your rating can be set at 100% if you are hospitalized due to your service-connected condition for more than 21 days. Additionally, the VA allows for what they call a “convalescent rating” of 100% for up to three months following your discharge from the hospital. (In some cases you may be able to extend the period of the convalescent rating, but the VA decides extended convalescent claims on a case-by-case basis.)
After the end of temporary total evaluation, the VA will rate your condition based on the severity of your condition at that time. The VA will review your medical records and may also schedule a medical exam to set this new rating level.
A prestabilization rating may be assigned if you recently ended your active military service and you have a service-connected injury or illness that is considered unstable. For example, while on active service, an Air Force Sergeant was diagnosed with non-Hodgkin's lymphoma and began chemotherapy that continued during and after her medical discharge process. She continued to get treatment through her local VA medical center. The VA gave her a prestabilization rating of 100% for one year from her date of discharge.
To be eligible for a prestabilization rating you must meet both of these requirements:
- You have a severe service-connected disability that is unstable (meaning an illness or injury that will change or hasn’t yet been fully treated), and
- Your disability is expected to continue for an unknown amount of time.
There are only two possible prestabilization ratings: 50% and 100%. When the VA assigns you a prestabilization rating, they will schedule you for an examination six to twelve months later to re-assess the severity of your disability.
In any of these three staged rating situations, the VA may assign incorrect ratings. If you believe your rating is not correct, you have the right to appeal the VA’s decision.
Contact Cuddigan Law
We know exactly how much disability benefits can mean for you and your family. If your service-connected disability is making it impossible for you to keep a job or live the life you want or if you believe your impairments have not been properly rated, send us an email or call the VA disability attorneys at Cuddigan Law at (402) 933-5405 for a free evaluation of your specific situation. We will fight for your rights.