How to Punch Back Against a Proposed VA Rating Reduction (Step-By-Step)

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Facing a proposed VA rating reduction can be incredibly frustrating and stressful.

It’s a daunting situation that threatens your earned and deserved VA disability benefits and adds uncertainty to your daily life, causing feelings of anxiety and concern about the impact on your finances and well-being.

If the VA has notified you of its intent to reduce or discontinue your benefits, there are crucial steps you can take to challenge the decision and protect your benefits.

Understanding the VA’s rules and regulations on rating reductions is mission critical to effectively fight back legally and ethically.

This article from VA disability claim expert Brian Reese will walk you through everything you need to know about the VA rating reduction process, your rights, timelines, and tips and strategies to contest a proposed reduction step-by-step.

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Summary of Key Points

• The Stress of Facing a Proposed VA Rating Reduction: Receiving a notice about a proposed VA rating reduction can be a daunting experience that triggers significant anxiety and stress. This situation brings uncertainty regarding your earned benefits and financial future, potentially affecting your quality of life and mental well-being.

• Action Steps to Protect Your VA Disability Benefits: When notified of a potential reduction, it is essential to act quickly to protect your benefits. You have a 60-day window to submit new and relevant medical evidence to contest the reduction, and you can also request a hearing within 30 days to delay the reduction until after the hearing. Taking these steps can be crucial in fighting the VA’s decision.

• Understanding When and How the VA Can Reduce Ratings: The VA may propose a reduction in your disability rating under certain conditions, such as during a Routine Future Examination (RFE) or when there is evidence of sustained improvement. If your disability rating has been in place for over five years, the VA must meet a higher standard of proof to demonstrate lasting improvement under “ordinary conditions of life.” Ratings in effect for 20 years or more are protected against reduction unless there is evidence of fraud.

• Know Your Rights and Legal Standards: Familiarity with VA regulations, such as 38 CFR 3.105(e) and 38 CFR 3.344, is critical in legally challenging a proposed reduction. The VA must provide adequate notice and demonstrate sustained improvement in the veteran’s condition over time. Temporary improvement doesn’t count. Being educated on the process can significantly improve your ability to contest a rating reduction and retain the VA disability benefits you deserve.

When Can the VA Reduce a Disability Rating?

The VA can propose a reduction in your disability rating under various circumstances, including:

• Routine Future Examination (RFE): The VA may schedule an RFE if your condition is expected to improve over time. This typically occurs between two and five years after the initial rating. The results of the C&P exam could lead to a proposed reduction in your VA disability rating.

• Evidence of Sustained Improvement: If your disability rating has been in place for five years or longer, the VA is required under 38 CFR 3.344 to show that any improvement in your condition is sustained and occurs under “ordinary conditions of life.” This standard is higher than for conditions rated for less than five years.

• Conditions Rated for 20 Years or More: According to 38 CFR 3.951(b), the VA cannot reduce a rating that has been in effect for 20 years or more unless there is evidence of fraud.

• Significant Change in Circumstances: If there is new medical evidence suggesting that your disability has improved, the VA may propose a reduction. However, the medical evidence must show sustained improvement over time.

How Often Does the VA Reduce Compensation?

There is no set schedule or frequency for when the VA reduces a veteran’s disability rating or compensation.

Instead, reductions occur under specific conditions, driven primarily by the veteran’s individual circumstances and medical evidence.

It’s important to remember that if the VA proposes a reduction, veterans have the opportunity to challenge it by submitting additional evidence.

The VA Rating Reduction Process

The regulation 38 CFR 3.105(e) outlines the procedure the VA must follow when reducing a veteran’s disability rating:

• Notification: The VA will send a “Notice of Proposed Reduction” letter in the mail detailing the reasons for the proposed action and providing you with 60 days to respond.

• 60-Day Response Period: Within 60 days, you can submit additional evidence to support your case and show that your condition has not improved. It’s critical to submit new and relevant medical evidence not previously considered during this contested period. You also have 30 days to request a hearing, which will delay the reduction until after the hearing is held.

• Final Decision: If you do not respond or provide sufficient evidence, the VA will issue a final decision, and the reduction will take effect on the first day of the month following a 60-day period after the final decision.

Can the VA Reduce Your Rating Without a New C&P Examination?

The VA is not required to conduct a new C&P exam before a proposed rating reduction; however, it’s common for you to get one.

However, in order for the VA to proceed with the proposed reduction, the veteran’s condition must show sustained improvement in his/her ability to function under “ordinary conditions of life,” which includes maintaining employment.

It’s not enough to show that symptoms have lessened temporarily or under special circumstances (like rest or specific treatments); the improvement must be demonstrated to be sustainable in the veteran’s usual daily environment.

This standard was further clarified in the case of Brown v. Brown (5 Vet.App. 413, 1993), which emphasized that any reduction must be based on evidence showing improvement in the disability under the conditions of ordinary life.

This ensures that veterans receive fair evaluations and that reductions are only made when there is clear evidence of a lasting change in their condition.

How to Fight Back Against a Proposed VA Rating Reduction

If you receive a Notice of Proposed Rating Reduction, you have several options to contest it:

• Request a Hearing: If you request a hearing within 30 days, the reduction will be delayed until after the hearing. This gives you more time to gather supporting evidence.

• Submit New Evidence Within 60 Days: Provide additional medical evidence, such as statements from your healthcare providers or an independent medical opinion, demonstrating that your condition has not improved or has worsened.

• Request a New C&P Exam: If the proposed reduction is based on a recent C&P exam, consider requesting a new C&P exam to challenge the findings. You can also argue that the initial exam was inadequate. Call 1-800-827-1000 immediately!

• Challenge the VA’s Burden of Proof: Under 38 CFR 3.344, the VA must show that the improvement is sustained over time and occurs under ordinary life conditions, especially for ratings that have been in place for five years or more. If the evidence does not meet this standard, you can argue against the reduction.

Additional Protections for Long-Term VA Ratings

For veterans whose VA ratings have been in place for five years or more there are additional protections to be aware of:

• The VA Must Show Sustained Improvement: The VA must demonstrate that the condition has improved consistently under ordinary conditions of life and work. Temporary improvements or conditions subject to episodic changes do not meet this standard.

• Reexaminations Must Be Thorough: Any new C&P examination used as a basis for reduction must be as comprehensive as the exam that established the current rating.

• Higher Standard of Evidence: If a rating has been in place for more than five years, the VA must use a higher standard of evidence to justify a reduction. This standard is based on court decisions like Brown v. Brown, which established that the VA must show clear evidence of sustained improvement over time.

What Happens When a Reevaluation C&P Exam Shows Improvement of My Disability?

If a review examination indicates that your stabilized disability has improved, the VA must evaluate whether the improvement is sustained under “ordinary conditions of life,” such as maintaining employment or performing daily activities.

This requirement is crucial for conditions rated for over five years, where the VA needs proof of ongoing improvement before reducing the rating.

If there is any doubt, the VA may schedule another review 18 to 30 months later to confirm that the condition remains stable.

Steps to Take if You Disagree with the VA’s Rating Reduction

If the VA decides to reduce your rating despite your objections, you can take the following steps:

• File a Higher-Level Review (HLR): A more senior VA official will review your case and determine whether the rating reduction was justified.

• File a Supplemental Claim: If you have new and relevant evidence not previously considered, submit it through a Supplemental Claim to contest the rating reduction.

• Appeal to the Board of Veterans’ Appeals (BVA): If other review options are unsuccessful, you can appeal the decision to the BVA. I recommend a records-only Board Appeal at first, and only after an HLR, Supplemental Claim, and HLR of the Supplemental Claim are unsuccessful.

Common Pitfalls to Avoid

• Ignoring the Notice: If you fail to respond to the VA’s notice of a proposed reduction, your rating will be automatically reduced. You must take action!

• Not Submitting New and Relevant Evidence: Always provide as much supporting evidence as possible to show that your condition has not improved. Medical evidence is critical. You should provide the VA with new and relevant medical evidence not previously considered.

• Not Requesting a Hearing: A hearing can delay the reduction and give you more time to gather evidence. This is optional and not required.

Conclusion & Wrap-Up

Navigating a VA disability rating reduction can be scary and frustrating, but understanding the rules and regulations can help you effectively contest the decision.

Remember, the VA must show that your condition has shown sustained improvement under ordinary life conditions in order to reduce it.

By gathering comprehensive evidence, requesting a hearing, and utilizing the appeals process, you can protect your disability rating and ensure that your benefits reflect the true impact of your service-connected condition.

VA Disability Rating Reduction: Frequently Asked Questions (FAQs)

What Is a VA Disability Rating Reduction?

A VA disability rating reduction occurs when the VA decreases a veteran’s disability percentage, which can reduce the monthly compensation amount. This typically happens if the VA determines that the service-connected condition has improved based on medical evidence or if the veteran no longer meets the criteria for the current rating.

When Can the VA Propose to Reduce a Disability Rating?

The VA can propose a rating reduction if there is evidence that the veteran’s condition has shown sustained improvement. This must be supported by a thorough medical examination and documentation showing that the veteran’s ability to function in daily life, including employment, has improved under ordinary conditions.

What Are the Steps in the VA Rating Reduction Process?

The VA follows specific steps when proposing a reduction. First, a notice of the proposed reduction is sent, detailing the reasons for the reduction and providing the veteran 60 days to submit evidence or request a hearing. If no additional evidence is submitted or the reduction is deemed warranted after considering new evidence, a final decision is made.

Can the VA Reduce My Rating Without a New Examination?

The VA must have recent medical evidence, often from a thorough reexamination, to justify a VA disabiltiy rating reduction. However, a new C&P exam is not a required element before a VA rating reduction.

What Is the Evidentiary Standard for Rating Reductions?

The VA must show that there has been a sustained improvement in the veteran’s condition under ordinary conditions of life, including work. For stabilized ratings (in place for five years or more), the evidence must be clear and convincing to justify a reduction.

What Is a Stabilized Rating, and How Does It Affect Reductions?

A stabilized rating is a disability evaluation that has been in effect for at least five years. For these ratings, the VA must meet a higher evidentiary standard to reduce the rating, demonstrating that the improvement is sustained and not due to temporary factors.

Can a Rating Be Reduced After a Routine Future Examination?

Yes, if a routine future examination indicates that the veteran’s condition has improved, the VA may propose a reduction. However, the veteran will be notified and given a chance to submit additional evidence to contest the reduction before a final decision is made.

How Does the VA Handle Reductions in Staged Ratings?

Staged ratings are assigned for conditions that have changed in severity over time. The protections provided under 38 CFR 3.344, which apply to stabilized ratings, do not apply to retroactively assigned staged ratings. However, the VA must still notify the veteran of the proposed reduction.

What Happens if I Request a Hearing After a Proposed Reduction?

If a veteran requests a hearing within 30 days of receiving the reduction notice, the VA will delay the final decision until the hearing is held and any new evidence is considered. The final rating action can only occur after the hearing process is complete.

Can the VA Reduce a Rating for a Permanent and Total Disability?

In most cases, a 100% Permanent and Total (P&T) disability rating is protected from reduction unless there is clear evidence of fraud. Ratings considered “permanent” are not subject to routine future examinations, providing an extra layer of security for veterans.

How Are Reductions Handled for Veterans Receiving Individual Unemployability (IU)?

When a veteran is receiving compensation based on IU, the VA must show evidence of “material improvement” in the veteran’s ability to work before reducing the IU rating. The VA also considers whether the improvement occurred under ordinary life conditions.

How Does the VA Determine the Effective Date of a Rating Reduction?

The effective date of a rating reduction is typically the first day of the month following a 60-day period that starts on the date the veteran was notified of the final reduction decision. This gives the veteran time to appeal or submit new evidence.

What Is the Impact of a Reduction on Special Monthly Compensation (SMC)?

If a reduction in a disability rating affects a veteran’s eligibility for SMC, the VA will also notify the veteran of changes to SMC payments. However, reductions in individual ratings that do not change the combined rating or SMC entitlement may not require notice under 38 CFR 3.105(e).

Are There Special Rules for Reductions in Ratings for Mental Health Conditions?

Yes, when reducing a rating for mental health conditions, the VA must provide evidence of significant improvement in occupational and social functioning. A thorough review of the veteran’s entire medical history is required to ensure the reduction is justified.

What Protections Exist for Ratings in Effect for 20 Years or More?

Under 38 CFR 3.951(b), disability ratings in place for 20 years or more cannot be reduced below the original level unless there is evidence of fraud. This protection ensures that long-standing ratings remain secure.

What Should I Do if I Disagree with a Rating Reduction?

If you disagree with a rating reduction, you can submit additional evidence, request a hearing, or file an appeal. Responding within the 60-day window after the reduction notice is critical to ensure your case is reviewed before the reduction takes effect.

Can a Rating Be Reduced Due to Substantially Gainful Employment?

If a veteran receiving IU begins substantially gainful employment, the VA may propose to reduce or terminate the IU rating. However, the VA will conduct a thorough review to ensure that the veteran can maintain employment under ordinary life conditions.

What Is the Role of the Rating Activity in a Proposed Rating Reduction?

The rating activity is responsible for determining whether a reduction in the evaluation of a service-connected disability is warranted under 38 CFR 3.105(e). If the decision is made to propose a reduction, the rating activity will prepare a rating decision that specifies the reasons for the proposed action and outlines the evidence supporting the change. This rating decision dictates what adjustments, if any, should be made to the veteran’s compensation award.

What Is the Initial Notification Process for a Proposed Rating Reduction?

When a proposed rating reduction is made, the VA sends a notice of the proposed adverse action to the veteran’s last known address. The notification includes details of the proposed reduction, the reasons for the decision, and informs the veteran of the opportunity to submit evidence or request a hearing within 60 days. This initial notification is an important part of the due process protections for veterans.

What Happens If New Evidence Is Submitted After a Final Rating Decision but Before the Effective Date of a Reduction?

If the VA receives new evidence after the final rating decision but before the effective date of a proposed reduction, the rating activity must review the evidence to determine whether it justifies maintaining the current rating or requires further examination. If the evidence supports restoring the previous evaluation, an amended award will be prepared to cancel the scheduled reduction. If the evidence warrants a partial restoration, the rating will be adjusted accordingly.

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