When you get VA disability benefits, a permanent rating is the best. If you don’t get a permanent rating, you’ll have a periodic future examination about every 5 years to double-check your rating.
When applying for disability benefits, the VA will give you a disability rating based on how serious your condition is. The VA will determine whether they can rank your symptoms based on the VA Disability Rating Schedule and, if so, you may be eligible for benefits if your disability is service-connected.
However, this ranking is usually not permanent. If your condition improves or worsens, you may be entitled to a higher or lower disability rating.
If your disability is not deemed permanent, the VA schedules periodic future examinations or reexaminations to decide if your disability rating should increase or decrease. During these examinations, they determine whether your disability still exists or is serious enough to receive the same rating.
What We Cover In This Article about VA Re-Examinations
Have you been scheduled for reexamination?
Federal regulations provide guidelines for the VA to follow in scheduling reexaminations. However, these guidelines are not a mandatory restriction. The VA has notably ignored this guidance to schedule unwarranted exams for veterans.
We recommend that you speak to a VA disability lawyer at our firm who can advocate on your behalf to keep your disability rating and maintain your benefits if chosen for a periodic future examination.
In this video, one of our certified VA disability lawyers gives insight into reduced ratings from the VA.
What is a VA Disability Rating?
A VA Disability Rating is a figure that the VA allocates to veterans seeking disability benefits. The VA arrives at this figure by referencing their Schedule of Rating Disabilities, which places disabilities and their corresponding symptoms into various categories based on their severity.
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For example, if you suffer from sleep apnea and are seeking disability benefits, the VA will assign you a rating from 0% to 100% based on the severity of your symptoms. Then they calculate your disability compensation based on your percentage. A 0% rating would not be eligible for compensation, but a 30%, 50%, or 100% rating could entitle you to monthly tax-free payments.
If you are seeking disability benefits, the VA will assign this rating only if you can prove that your disability is service-connected. You will need to show that your disability directly connects to an incident or injury you suffered during active duty or is secondary service-connected, meaning that it is the result of a direct service-connected condition.
If you can successfully prove your service connection and the VA assigns you a disability rating, then you will receive disability compensation.
Protected Rating
Over time, your disability rating can transition into protected status. A protected VA disability rating is a rating that the VA cannot reduce or rescind. The VA is required to maintain this rating, even if the rating schedule changes or there is an overall rule change. Keep in mind: a protected rating is not static. If the VA sends you a reexamination request, they may change your rating based on your results.
Your disability rating is protected if:
- Your rating has remained the same or above a certain threshold for 20 years or more. For example, if for 20 years or more, your disability rating for PTSD is consistently at 30% or above, then the VA cannot lower your rating below 30%.
- You have a 100% total disability rating for 20 years or more.
- Your disability has remained static for over 5 years.
An expert VA disability lawyer can help you review your disability rating history to determine whether you are subject to a rate reduction. Also, if you need help calculating your prospective disability benefits, we have a free disability calculator to help you estimate your compensation.
What is a Periodic Future Examination?
A periodic future examination or reexamination is a medical observation of your VA approved disability. The VA completes these reexaminations to verify whether you are still entitled to receive disability benefits.
A reexamination can show whether your symptoms still exist and if they have changed. The VA will then use these results to assess your entitlement for continued disability compensation.
The VA will schedule a reexamination if they believe that a veteran’s disability has gotten better, there is a significant change in the veteran’s disability, or evidence suggests that the veteran’s disability rating is incorrect.
On rare occasions, a law changes which allows previously unconsidered problems to count. This is in process right now with Gulf War Syndrome and happened in just the last few years with the Blue Water Navy Agent Orange benefits.
The VA also schedules reexaminations based on the VA disability re-evaluation timeline:
- Six months following release from military duty.
- Within 2-5 years from the VA’s initial decision to grant disability benefits.
The federal guidelines have exceptions to scheduling a reexamination. However, these guidelines do not limit the VA’s ability to schedule a future exam.
The suggested guidelines for an exception are as follows:
1. The Disability is Static
A static disability is a disorder that the VA establishes as permanent during your initial disability rating approval. If you have a static disability, federal guidelines suggest that the VA should not schedule a future periodic examination of your condition. Examples of a static disability include blindness, amputation of your limbs, or complete incapacity.
2. No Significant Improvement of Symptoms
If you have completed examinations in the past, but show no significant improvement over five years or more, federal guidelines suggest that the VA should exempt you from reexamination.
3. You Have a Minimum Rating or Combined Rating Remains Unchanged
You could be exempt from a future examination if the VA gave you a minimum scheduled rating or gave you a combined rating that would not be affected by a lower rating for one condition at reexamination.
In other words, if the VA gave you a 30% rating for sleep apnea, which is the lowest compensable rating for this disorder, they could exempt you from reexamination. Alternatively, if given a combined 65% rating for urinary incontinence and direct service-connected traumatic brain injury, the VA could exempt you from reexamination if a lower incontinence rating wouldn’t affect the overall 65%.
4. You Are 55 Years Old
If you are 55 years old, then federal guidelines provide the 55-year-old rule that you should be exempt from reexamination, except in rare circumstances or by regulation. For example, a VA regulation requires that they schedule re-examination for veterans who have completed treatment for certain cancers six months after they complete treatment.
These guidelines also advise that the VA not schedule a reexamination for a veteran who may be younger than 55 but who would be 55 by the future examination date.
Unfortunately, although these federal guidelines provide a clear-cut process for reexamination exclusion, the VA continues to request reexaminations even when they are not necessary. In fact, in 2017, the Office of Inspector General (OIG) reviewed 300 reexamination cases and found that the request was unnecessary for 111 cases. OIG used this sample to estimate that, out of 53,500 cases, the VA scheduled unwarranted examinations for 19,800 veterans.
The VA’s history of overlooking federal guidelines for reexamination could put you at risk of receiving an unwarranted exam. If the VA has scheduled you for reexamination, call us or your VA disability lawyer to help you verify whether the examination request is valid.
Re-Examination Process
If the VA completes an evaluation of your case and determines that you need reexamination, then they are required to:
- Send you a letter to notify you of reexamination.
- Give you 60 days to respond to this letter.
Upon receiving this notice, you have:
- 30 days from receipt of this notice to request a hearing.
- 60 days from receipt of this notice to provide any evidence to support why not to reduce your rating.
- Attend a scheduled reexamination if unable to dispute the proposed rate reduction.
If the VA fails to send you this notice and then proceeds to rescind your benefits for failure to attend your re-examination, then you can request the reestablishment of your benefits. However, if you do receive this notice and fail to respond, request a hearing, or show up for your reexamination, then your disability will be reduced or rescinded.
You don’t have to use a Veteran’s compensation lawyer that is nearby. We can work with you over the phone and apply or appeal electronically.
What Happens to Your Disability Rating After Re-examination?
A VA Re-examination helps the VA to verify your continued eligibility for disability benefits. Following the examination, there are three possible VA disability changes.
The VA can find that:
- You are no longer experiencing symptoms of your disability that would make you eligible for compensation. If they reach this finding, then they will revoke your disability benefits.
- You are still suffering from your disability, but your symptoms have significantly improved. If so, they will give you a reduced disability rating, and as a result, the VA will reduce your compensation to correspond with your new rating.
- Your disability has worsened, causing you to experience severe symptoms and thus eligible for a higher disability rating. They will then assign you a new higher rating and increase your disability compensation to correspond with this new rating.
What steps you can take:
- Provide a doctor’s opinion to the VA that supports your continued eligibility for a disability rating. Your doctor can write a report showing that your condition still exists and that you are experiencing symptoms that would entitle you to a disability rating and, therefore, compensation.
- Provide lay statements to the VA from people in your life who are aware of your disability and its symptoms. This statement could be from a spouse, friend, or family member. For example, they could write about the persistence of a mental disorder that may not have been detectable at your reexamination.
- You could also provide a letter to the VA disputing the re-examination if you found that the exam was not thorough enough to verify your symptoms.
If you decide to challenge a re-examination result, we strongly recommend that you obtain assistance from an experienced VA disability lawyer who has experience advocating for these issues.
Here is a video review of a client who was about to have the VA take away his veteran’s disability benefits.
How Can We Help?
Have you been scheduled for reexamination, or are your benefits up for re-evaluation?
If so, here is how we help our clients through these situations:
1. Determine whether you are Eligible for Reexamination Waiver
We evaluate your case and assess if you meet the federal guidelines to be exempt from reexamination. Then we help you to challenge a reexamination request if you meet the eligibility for exemption.
2. Respond to Reexamination Notice
We can respond to your reexamination notice by helping you to provide evidence that shows why you should not be subject to a disability rate reduction.
3. Challenge a Reexamination Decision
If your reexamination results lead to a revocation of your benefits, we can challenge this decision by helping you to obtain a doctor’s report, lay evidence, or a letter disputing the validity of the exam.
Always Ready to Serve You
Woods and Woods is a family-owned law firm that has been committed to Veterans’ rights since 1985. We have a dedicated staff of expert legal professionals who want to help you keep your benefits.
Contact our office at (866)232-5777 or click here to schedule your free consultation.