The VA disability 5-year rule states that service-connected disabilities of veterans will be protected if their VA rating remains the same for five years or more. In this case, the VA can’t ask for reexamination, reduce, or remove the veteran’s compensations without the illnesses having continuous improvement.
Usually, the longer a veteran stays with a certain disability or rating, the stricter it is for the VA to change it. These rules mainly come from various Federal laws. Knowing about them will help you make the right decision upon an unwarranted reevaluation by the VA.
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Understanding a Protected and Stabilized Disability
VA must follow the 5-year, 10-year, and 20-year rules when deciding to reexamine or reduce veteran ratings. These rules are as follows-
- 10-Year-Old Rule: Unless there is any evidence of fraud, the VA cannot entirely remove any veteran’s disability rating when it remains the same for ten years or more. They can still decrease it, though.
- 20-Year-Old Rule: Unless any fraud is proven, the VA can’t remove or reduce a disability rating that has been the same for 20 years or longer. They can raise the rating, however.
In such scenarios as above, a disability rating is called protected. But, if VA is unable to remove or reduce a disability rating legally, it is protected. Similarly, a rating that remains the same for a long period gets the stabilized title.
Other VA Disability Rules
Aside from the three we discussed, there are some other disability rules that are protected by the law. You may be eligible for one or more of them too.
- VA 55-Year-Old Rule: If a 55 years old or older veteran has been with a service-connected disability before 55, the VA can’t reduce or revoke its rating or schedule reexamination unless for unusual situations.
Many service-connected disabilities show their symptoms in later parts of life. So, even if these signs start showing at 54 years old, get proven service-connected, and stay after you reach 55, they will be protected against disabilities.
- Veteran 100% Disability: Similarly, as before, when you have a total disability, which is an overall 100% rating, the VA can’t reduce, remove, or reexamine you unless any obvious improvement is there.
When your total rating reaches 100%, the VA calls it a Permanent and Total Disability Rating (P&T). They also give the same title to disabilities that are permanent, meaning there is no chance of their improvement.
When Can VA Reduce a Disability Rating After 5 Years?
According to the rule, only if there is any continuous improvement to the veteran’s condition can VA reduce its rating after five years. But it is not as easy as it sounds. VA must provide ample evidence and explanation for their action. It is not just for the 5-year-old rule but for any stabilized disability.
In this case, VA has to show medical records describing the improvement in the veteran’s body following a Compensation and Pension (C&P) examination. However, it is not that rare for VA to ignore any of this. The best course of action here is to send a letter or mail VA describing why you should be exempt. If they deny it, you can file a court appeal if you are confident about your claim.
In order to be extra safe, get an eligibility review from VA Disability Coach to know whether your disability rating should remain the same and there is no sustained improvement. It can also be ideal evidence in court. Additionally, consider hiring a VA-accredited lawyer or VSO for your case.
Does VA Really Abide by the 5-Year-Old Rule?
Here is the unfortunate fact- VA very often schedules re-exams, and reduces, and revokes disability ratings without properly following the law. In many cases, they may even call 55-year-olds or older for reevaluations without a concrete reason.
A survey in 2018 by the VA Office of Inspector General (OIG) revealed this fact. They ran the process from March 2017 to August of the same year. During it, they found that 19,800 cases of unwarranted examinations on veterans happened during this period.
So, as you can understand, you should not expect VA to schedule a reexamination for you. In fact, if you refuse to visit them at the appointed time, they can rightfully reduce or remove your rating.
If you are certain you don’t deserve to go through another exam or get your ratings lowered, consider requesting an exception. If it doesn’t work, go for the court option.
What Are Some Exceptions to the VA Disability 5-Year Rule for 55-Year-Old Veterans?
For 55-year-old veterans seeking VA disability benefits, there are certain exceptions to the 5-year rule. If an individual’s medical condition existed prior to service, became worse during service, or is connected to military service, they may be eligible for benefits regardless of the 5-year requirement. These exceptions aim to ensure that deserving veterans receive the support they need through the va disability for 55 year olds program.
Conclusion
There are various rules and regulations that both the veterans and the VA have to follow to keep fairness between both parties. One of these rules is the 5-year-old rule. But let alone that; they don’t even often follow the stricter ones, like the 20-year-old or 55-year-old rules. It is better to have the proper medical reports and evidence and submit them to the VA to certify your statement and rights during such cases.