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In this post, we’re going to explore the ins and outs of the VA 10 year rule.
Did you know the VA can always make changes to your VA disability benefits through a re-evaluation?
Yep, it’s true.
The VA always retains the right to conduct a re-examination to determine if your disability has improved, worsened, or stayed the same.
Important: VA Raters must consider whether a veteran’s current disability is static and/or permanent before making a re-examination request.
And, the VA can’t eliminate a rating that’s been in-place for 10 years or more (VA 10 year rule).
- Understanding the VA 10 Year Rule!
- What is the VA Ten Year Rule Effective Date?
- What are the Protected VA Ratings Not Subject to Re-Examination?
- Why Does the VA Re-Evaluate VA Disability Ratings?
- When Does the VA Re-Evaluate Disability Ratings?
- How Will the VA Notify Me of a Re-Examination?
- What Should I Do If I Get a Proposed VA Rating Reduction?
- How Does the VA Decide to Re-Evaluate an Existing VA Disability Rating?
- About the Author
Understanding the VA 10 Year Rule!
What is the 10 year rule for VA disability?
The VA 10 year rule means the VA cannot eliminate a rating that’s been in place for 10 years or more.
Note: The rating can be reduced if medical evidence shows that the disability has improved.
Pro Tip: There are 3 important exceptions to the VA disability 10 year rule:
- Fraud: The original rating can be eliminated after 10 years if the VA determines that the original disability rating was based on fraud.
- Permanent and Total VA Ratings: Veterans who have been granted a Permanent and Total (P&T) Rating are exempt from the VA disability 10 year rule. The P&T rating signifies that the service-connected disability won’t improve and can’t be eliminated.
- Disability Conditions Not Expected to Improve: Veterans with service-connected disabilities that are deemed permanent and not expected to improve are also exempt from the 10 year rule. These conditions are typically characterized by their permanent nature, such as the loss of a limb or a chronic, progressive illness.
What is the VA Ten Year Rule Effective Date?
The effective date for the 10 year rule for VA disability is 3,650 days (10 years) from your last VA rating decision.
Important: If your existing VA disability rating has been continuously in-place for 10 years or more, it is highly unlikely the VA will re-evaluate you (although it’s still possible).
What are the Protected VA Ratings Not Subject to Re-Examination?
There are 7 types of protected VA disability ratings not subject to a re-evaluation:
- The disability is “Static,” without material improvement for 5 years or more.
- The disability is “Permanent” and there is no likelihood of improvement.
- The disability has been in place for 10 years or more. Note: Your VA rating can still be reduced (not eliminated) if medical evidence shows that the disability has improved.
- The disability has been continuously in effect for 20 years or more.
- The veteran is over 55 years of age (except under unusual circumstances or where required by regulation).
- The veteran has a 100% VA rating that’s deemed a “total” disability. *Note: The VA can only reduce the rating if the medical evidence demonstrates “material improvement.”
- The disability is rated at the prescribed schedular minimum within its Diagnostic Code (DC)
- The disability is rated at 10% or less, or
- The combined evaluation would not change even if the VA re-evaluation resulted in a reduced evaluation for one or more disabilities.
Why Does the VA Re-Evaluate VA Disability Ratings?
The VA conducts re-examinations of VA disability ratings primarily because not all service-connected disabilities are considered permanent.
As a result, the VA has the authority to review the cases of veterans whose conditions are anticipated to improve over time.
However, veterans who are protected by a Permanent and Total Rating or those with conditions deemed to be unchangeable are exempt from the 10 year rule.
For instance, a veteran with a permanent service-connected disability, such as a missing arm, or a PTSD rating that’s been in-place for 10 years or more, fall into this category.
When Does the VA Re-Evaluate Disability Ratings?
If you have a disability condition that’s expected to improve over time, such as a mental health condition that’s had a rating for less than 5 years, the VA can re-evaluate your disability condition within 2 to 5 years of your initial examination.
Keep in mind VA re-evaluations aren’t necessarily a bad thing.
For example, the VA is trying to determine if your disability rating should be increased, decreased, or kept the same based upon your Frequency, Severity, and Duration of symptoms.
The VA may also reexamine your VA disability rating if there’s obvious evidence that your condition has improved or even disappeared.
If your VA rating has been continuously in-place for 10 years or more, the VA can’t eliminate the rating; however, it can still be reduced if medical evidence shows your disability has improved.
How Will the VA Notify Me of a Re-Examination?
The VA initiates a re-examination by scheduling a C&P exam to assess the extent to which your service-connected disability impacts your work, life, and social functioning, to include the severity of your symptoms.
It is crucial that you attend this appointment or reschedule it for a more suitable time.
Failure to do so may provide grounds for the VA to reduce or terminate your VA disability benefits.
Receiving a re-examination notice from the VA does not automatically mean that you should panic about losing your VA disability benefits.
If your condition has remained unchanged, it is highly likely that the VA will confirm the accuracy of your current VA disability rating and not eliminate or reduce it.
What Should I Do If I Get a Proposed VA Rating Reduction?
If the VA proposes to reduce an existing VA disability rating, you have 60 calendar days to respond.
If you disagree with the proposed reduction, you must provide the VA with medical evidence showing that the disability has not improved.
It’s best to get your treating physician to write a letter on your behalf, upload specific sections of medical evidence that shows your condition has not improved, or upload any other medical reports or evidence to prove your disability has not gotten better.
How Does the VA Decide to Re-Evaluate an Existing VA Disability Rating?
VA Raters use the following decision tree from M21-1 to determine if/when to re-evaluate a veteran’s VA disability rating:
| If the case necessitates a(n) … | Then, at the time of the rating decision’s preparation, schedule the examination to be conducted … |
| Routine Future Examination (RFE) to monitor for anticipated improvement in a service connected disability. | In 3 years. |
| Re-examination to monitor for evidence of sustained improvement in a stabilized service connected disability that is shown to have improved. | In 18, 24, or 30 months, depending upon the facts and circumstances of the individual case. |
| Examination to facilitate the re-evaluation of a prestabilization rating prepared under the authority of 38 CFR 4.28 | No earlier than 6 months, nor later than 12 months, following discharge from service. |
| Examination to evaluate a service connected mental disorder that was: Incurred by reason of traumatic stress, and Rated in accordance with the provisions of 38 CFR 4.129 | Within the six-month period following the Veteran’s discharge. |
| Examination to evaluate post-therapeutic residuals of service connected malignancy (cancer). | Six months following cessation of surgical, x-ray, antineoplastic chemotherapy, or other therapeutic procedure. Exceptions: For SC bone malignancy evaluated under 38 CFR 4.71a, DC 5012, any needed examination must be scheduled one year following cessation of treatment. For service connected malignancy of the brain or spinal cord evaluated under 38 CFR 4.124a, DCs 8002 or 8021, respectively, any needed examination must be scheduled two years following cessation of treatment. Concede the disability evaluation’s permanence and schedule no future examinations if the considerations discussed in M21-1, Part III, Subpart iv, 5.B.3.a are applicable. |
| Mandatory examination/re-examination in connection with a specific diagnosis code. | At a time or interval consistent with the applicable regulation’s requirements. |
About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
