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Q88: I submitted an application seeking an increase in my service-connected disabilities, which are getting worse as I age. I went for a C & P exam in May 2016. The so called “doctor” suggested all of my conditions were much better. Huh! Just got a letter from VA to reduce my rating from 80% to 20%. WTF! Why? What evidence do I need to send VA to at least maintain my current rating?
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A1: That depends on what conditions you have. Basically, you need to show that your conditions have not gotten better or you will lose your rating. You must be careful when seeking an increase. As you have found out, the VA can and will reevaluate all of your conditions for "improvement". If the VA finds this so-called improvement, you will be referred for reduction. Immediately, you need to request a hearing. This needs to be done within 30 days to stop them from taking your money. Then gather your evidence to bring to the hearing to show that your conditions have not improved. This is your only hope of keeping your rating. (AP) 7/30/18
A2: You'll need to provide 'new' evidence indicating that your conditions have worsen. That means you should print out any and all new documentation there is in your VA medical file stating so. For instance, go to MyHealthEVet.com and search for the most recent docs where your VA doctors have stated you are not getting better, but worse. Each time you go see a VA doctor/clinic, they are required by law to document everything you say and everything your doctor says and this information on in MyHealthEVet. And, there's a form called Nexus, which is used by your private care doctors, that treating you for your conditions, which they can fill out, hopefully stating that you're condition is getting worse and is More Than Likely, caused by service-connection situation.
Also, whenever your're talking to a VA doctor, talk about your worse day that week/month and not how you're feeling that day. (JL) 7/30/18
A3: Not a question. I'm trying to answer the man's comment about reduction of disability after a C & P exam, but hitting respond to the info on the email did not work. Anyway, he should check CFR 38, about VA disability ratings. There's lots of stuff in there but three things stand out which helped me. If you are over 55, they aren't supposed to call you back for a re-exam without there being unusual circumstances. Second, if you have had the rating for more than 5 years, there is something about not reducing it. And third, a disability rating cannot be reduced by one examination alone. If the C & P exam was done by a PA and not by a full doctor, and the rating was previously recommended by a regular doctor, then you have an argument there. If the examiner did not do a new x-ray or MRI, etc. you have some argument there. Get letters from friends and family if they can testify to your worsening over the years, if that is the case, and what restrictions you have in your daily life. Also, go to an outside doctor for an exam on the issues the used to reduce the rating. Include his or her report in your appeal. If the appeal does not work, use the Notice of Disagreement and ask for a DRO review. That process can take up to 16 months but it is a fair review by one sitting "judge" or whatever he or she would be called. And I received the back compensation from the day of the error. Good luck. (DL) 7/30/18
A4: I always caution a veteran when the reopen their claim of the risk of being reduced if they are not protected under the 20 year rule. Since you are being reduced you are going to need another Disability Benefits Questionnaire completed by a qualified doctor showing that your SC condition is still as bad as it was. Sometimes VA uses Nurse Practioners to do the C&P exams so if you have a MD do the exam that can outweigh the NP's exam especially when a medical opinion was made. (DS) 8/7/18