Great! You received a 70% disability rating from the VA. But does your rating last forever? What if your disability improves over time with treatment or therapy? Can the VA reduce your disability rating?
Not always. When a veteran’s service-connected medical diagnosis improves, the VA has the right to reduce the original rating, potentially lowering that veteran’s disability payments. To reduce a veteran’s disability rating, the VA must conduct a thorough review of the veteran’s medical history and determine a significant improvement in the rated medical condition.
But some veterans have “protected ratings,” meaning the VA cannot reduce their ratings even if the medical condition improves. More than a perk for veterans, protected ratings help cut down on expenditures of VA resources and processing time, eliminating the need for regular, 2 to 5-year C&P evaluations of every veteran’s medical condition.
Who Qualifies for VA Rating Protection?
In all situations, if VA can prove that a veteran provided false information on their claim, the VA can reduce the veteran’s disability rating. But for legitimate VA benefits claims, the following VA rating protections apply:
- Veterans over age 55
- 100% Disability VA Rating Protection
- TDUI Rating Protection
- Permanent and Total Disability Rating Protection
- 20 Year Disability Rating Protection
- 10 Year Disability Rating Protection
- 5 Year disability rating protection
Veterans over Age 55
Veterans who receive a disability rating at the age of 55 or greater are protected from a decrease in that rating, as long as they were age 55 at the time of the C&P exam that the VA used to assign the rating.
100% Disability VA Rating Protection
Veterans who obtain a 100% disability rating are protected from the VA lowering that rating automatically. But VA can still reduce a disability rating from 100% if they are able to obtain extensive evidence of medical, physical, or cognitive improvement to a level that enables the veteran to work and care for themselves. Such evidence might include medical exam results, employment reports, and witness statements.
TDIU Rating Protection
Veterans who collect total disability based on individual unemployability (TDIU) benefits are also protected from a reduction in their disability benefits. Your TDIU status can only be terminated when the VA can show clear and convincing evidence of actual employability – meaning you have held some form of employment for at least one full consecutive year and earned more than the federal poverty threshold for that year.
Permanent and Total Disability Rating Protection
Veterans with medical conditions that qualify as both total and permanent are protected from a reduction in their disability rating. Permanent and total medical conditions are those that have been assigned the maximum rating and are known to be chronic conditions unlikely to improve. Examples include paralysis or amputation. In rare cases, the VA may be able to reduce a total and permanent disability rating if they can provide evidence showing that the medical condition has improved significantly.
20 Year Disability Rating Protection
In general, VA cannot reduce disability ratings for veterans who have maintained a constant disability rating for at least 20 years – combined ratings included. Even if that veteran’s C&P exam shows that the veteran’s condition has improved drastically with some new treatment regimen and suggests a lower rating, VA cannot reduce a continuous 20-year rating.
Only the 20-year rating percentage is protected. For example, if a veteran held a 50% disability rating for 20 years, then had their rating increased to 70% for three years, the VA can always reduce that 70%, but not any lower than the 20-year 50% rating.
This 20-year rating protection also applies to retroactive benefits. Veterans who just received a 70% disability rating last week are protected from reduction as long as the effective date is at least 20 years before the rating decision. And veterans who win an appeal for a higher rating than they argued should have been granted 20 years ago can obtain a higher rating protected from any rating reduction.
Only the original service-connected diagnosis that received the 20-year rating is protected, because a change in the diagnosis generates a new effective date for that diagnosis, breaking the continuous 20-year span. Even when the new medical condition developed because of the 20-year medical condition, it is considered a new medical condition, and its rating is not protected.
10 Year Disability Rating Protection
Veterans who maintain a disability rating for at least 10 years are protected from termination of their benefits at any time. But the VA can reduce their disability rating if they can prove that the veteran’s health condition has improved substantially.
5 Year Disability Rating Protection
Veterans who maintain a disability rating for at least five years are protected from a reduced rating unless the VA can prove that the veteran’s medical condition has shown sustained improvement across the years. If an improvement is just temporary, it doesn’t count. You are still protected.
To prove sustained improvement, the VA must evaluate the veteran’s medical history and new C&P exam results or evaluate the evidence provided in your VA disability claim. If the VA decides to reduce your rating, they must submit a detailed account of the evidence suggesting that your medical condition will continue to improve with time.
Can I Fight a Disability Rating Reduction?
If a veteran does not have disability rating protection, the VA can propose to reduce their rating at any time. A rating reduction is often prompted by either a regularly scheduled C&P exam report showing a medical improvement or some other notice that the veteran’s medical condition has improved. If “some other notice” alerted the VA to a possible improvement, the VA can order an updated medical exam to confirm the information.
VA will provide notice ahead of time saying they propose reducing your disability rating. Once you receive this notice, you have some time to dispute it. If a veteran disagrees with the proposed rating reduction, the veteran has 30 days to request a hearing or 60 days to supply evidence to dispute the reduction.
If VA has already reduced your disability rating and you feel you have received an unfair reduction, you may file an appeal to obtain your desired rating at any time. An appeal can be won by supplying evidence like an expert medical opinion, medical history, or witness statements showing medical, physical, or cognitive function at a level that prevents you from performing work or supporting yourself and essentially demonstrating that your condition has not improved. In many cases, you may actually have evidence that the condition has worsened.