VA Disability 5-Year Rule: What Veterans Need to Know About Re-evaluation

VA Disability Re-evaluation: When a military service member leaves the service, they are evaluated to see if they qualify for disability compensation from the Department of Veterans Affairs (VA). Some people who obtain a VA disability rating believe that once it is established, it is unlikely to change significantly. However, the VA disability 5-year rule applies, and veterans must understand how it may affect their compensation. Here’s what you should know.

What is the VA Disability 5-Year Rule?

The VA disability 5-year rule is a policy that specifies when a disability rating can be re-evaluated. The rule allows the VA to reassess a veteran with a condition projected to recover within five years of the rating evaluation to evaluate if the disability has diminished or disappeared. If there is a change, a new disability rating is awarded, which might affect a veteran’s benefits.

VA Disability Re-evaluation

The VA generally reassesses disability ratings because not all disabilities are permanent. Specific service-related conditions may improve over time. As a result, the VA re-evaluates veterans with conditions that are anticipated to have a reduced impact over time and adjusts the rating if this is determined to have occurred.

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How does the VA’s Disability Rating System work?

The VA disability rating system allows the Department of Veterans Affairs (VA) to award a percentage score to veterans with disabilities connected to their military service.

This rating system determines the amount of compensation a veteran will receive for their disability.

To assess a disability rating, the VA will first review medical data about a veteran’s condition, such as documents from healthcare providers and any other relevant medical information.

This evidence is used to assess the severity of the disability, which is then awarded a percentage score on a scale of 0 to 100, with increments of ten.

According to Hill and Ponton, a disability rating of 0% indicates that the VA has decided that the ailment is service-related but does not result in any impairment or loss of function.

Ratings over 0% represent increasing degrees of impairment, whereas 100% indicates total disability.

For example, a rating of 30% may indicate moderate impairment, but a rating of 70% may indicate severe impairment.

It’s crucial to note that the VA may give a veteran various ratings depending on the severity of each disability.

In these circumstances, the VA will combine the ratings to calculate the total disability rating.

The combined grade is then used to determine the amount of compensation the veteran will receive.

It’s also worth mentioning that the VA disability rating system is intended to be flexible, with ratings that can be altered over time as the veteran’s condition changes.

If a veteran’s condition improves, their disability rating may be decreased or erased entirely.

In contrast, if a veteran’s condition worsens, their rating may be raised to reflect the new level of impairment.

This is where the VA Disability Five Year Rule comes into play, allowing the VA to re-evaluate a veteran’s disability rating after a set amount of time has passed since the initial rating was assigned.

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Can the VA reduce my PTSD rating after five years?

The VA can re-evaluate your PTSD rating at any time within the first five years if they believe it will improve with treatment.

After 5 years, it is considerably more difficult for them to lower your rating.

They require demonstrable evidence that your PTSD has dramatically and regularly improved, not just temporarily.

If you face a reduction after five years, you have the right to dispute it.

You can gather evidence of your continued PTSD symptoms and request a hearing to submit your case.

There are various alternatives for appealing the ruling.

Here’s a breakdown of the important points about the five-year rule:

• Re-evaluations: The VA can arrange a re-examination anywhere between two and five years following your first rating.
• They often do this for illnesses that are predicted to improve with therapy, such as some mental health issues.
• The 5-Year Protection: If your disability rating has been in effect for five years or more, the VA will only modify it if there is clear evidence of significant and sustained improvement in your condition.

Temporary improvements do not count.

What to Do If Your Rating is Reduced

If the VA considers reducing your rating after five years, you can dispute it:

• Gather Evidence: Gather medical records, doctor’s opinions, and anything else that indicates that your condition has not improved.
• Request a Hearing: You have 30 days to request a hearing so that you can present evidence and argue your case.
• Appeal the Decision: If you disagree with the hearing results, you may submit an appeal with the Board of Veterans’ Appeals (BVA).

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Tips for Veterans:

• Be proactive: Maintain copies of all medical documents and documentation pertaining to your impairment.
• Stay informed: When you obtain your initial rating decision, determine whether it is subject to re-evaluation within five years.
• Do Not Ignore Notices: If you receive a notice for a re-evaluation, take it seriously and attend the appointment. If you miss it, you risk losing your benefits.
• Seek Help: If you are facing a rating decrease, consider contacting a veterans’ advocate or an attorney who specializes in VA claims.

Remember that the VA has materials to assist you understand your disability rating and the appeals process.

Please do not hesitate to contact your local VA office or veterans’ service organization for assistance.