When a military servicemember leaves the service, they’re assessed to determine if they are eligible for disability benefits through the Department of Veterans Affairs (VA). Among those who receive a VA disability rating, some assume that once the rating is set, it isn’t subject to much change. However, the VA disability 5-year rule applies, and it’s critical to understand how it may impact a veteran’s benefits. Here’s what you need to know.
What Is the VA Disability 5-Year Rule?
The VA disability 5-year rule is a policy that outlines when a disability rating is subject to re-evaluation. Based on the rule, the VA can reassess a veteran with a disability that’s likely to improve within five years of the initial rating examination to determine if the disability has lessened or disappeared. If there’s been a change, a new disability rating is assigned, and that can alter a veteran’s benefits.
Why Are VA Disability Ratings Re-Evaluated?
Generally, disability ratings are reassessed by the VA because not all disabilities are inherently permanent. Specific service-related conditions may improve over time. As a result, the VA re-evaluates veterans with conditions that are likely to have a reduced impact as time passes, and they adjust the rating if that’s deemed to have occurred.
A variety of diagnoses can be subject to reassessment. Technically, any condition that’s listed as “less severe” or “less permanent” could fall into this category.
For example, high blood pressure and specific mental health conditions could potentially resolve, or the impairment caused by them could also reduce. As a result, veterans with disability ratings associated with those conditions are potentially subject to a re-evaluation during the 5-year window.
How the Re-Evaluations Impact Veterans
A re-evaluation based on the VA 5-year rule could lead to one of three outcomes. First, veterans who’ve experienced no change in the severity or impact of their condition may see their disability rating remain unchanged. Second, those who have improved could see their disability rating go down. Third, if the condition worsened, the disability rating may end up higher than it was initially.
Whether the rating changes, and if it does, the direction it moves may alter a veteran’s disability benefits. Rating decreases could lead to less compensation, while increases may qualify them for more compensation. If the rating remains the same, benefits don’t change.
It’s critical to note that a re-evaluation could result in the complete loss of a disability rating. This occurs if there are no remaining symptoms or impairment, making the veteran ineligible for further compensation.
Who’s Exempt from the 5-Year Rule?
Veterans with a Permanent and Total Rating from the VA are generally considered exceptions to the 5-year rule. With that rating, there’s no expectation that the veteran will improve over time. As a result, they aren’t typically subjected to re-evaluation.
For example, if a servicemember has experienced a loss of a limb associated with their service, there are no expectations of a recovery. As a result, any disability rating connected to that loss isn’t generally subject to the VA disability 5-year rule.
Additionally, veterans over the age of 55 usually aren’t subject to re-evaluations. However, whether that applies is based on the condition (or conditions) involved, and it’s determined on a case-by-case basis.
Are There Re-Evaluations After 5 Years?
While a re-evaluation during the initial five years – typically between 2 and 5 years after the first assessment – is almost guaranteed to occur if a veteran isn’t classified as having a permanent and total disability, reassessments after that usually only happen if there’s evidence of an improvement. Whether that applies is generally based on treatment notes from a doctor, which is why being open with their physician about challenges they face is critical for veterans with disability ratings.
Additionally, it’s critical to note that while the VA may re-evaluate a veteran after the 5-year rule no longer applies, what rating changes can occur after that five years are altered. For example, the VA disability 10-year rule is an official policy that formally says that the VA can’t entirely get rid of a disability rating once it’s been assigned for a minimum of 10 years (barring incidents of fraud). That essentially protects veterans from ending up with the complete removal of a disability rating for that condition after that timeframe passes. However, the disability rating can go down if there’s evidence of an improvement in the symptoms or impairment caused by the condition.
There’s also the VA disability 20-year rule. Once a disability rating at or above a specific threshold for a condition has been in place for 20 years, it’s considered continuous. At that point, the rating can’t go below the original one unless there’s evidence of fraud.
Can You Appeal a VA Disability Rating Change?
If a veteran is re-evaluated and their disability rating is reduced, they do have the option to appeal. If you intend to do so, it’s usually wise to enlist support from an attorney at that point. The process is potentially complex, so having a lawyer available can make it easier to navigate. Plus, attorneys experienced with VA disability rating appeals can offer critical guidance, and that may increase your chances of success.
Is there anything else that you think people need to know about the VA disability 5-year rule? Share your thoughts in the comments below.
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Image and article originally from www.savingadvice.com. Read the original article here.