For veterans receiving VA disability benefits, concerns about a potential rating reduction can be stressful. Fortunately, the VA Disability 5-Year Rule offers protection, making it more difficult for the Department of Veterans Affairs (VA) to lower a disability rating after five years. But when does this rule actually take effect, and what does it mean for you? Let’s break it down.
5-Year Rule
The five-year period begins on the date of your last VA rating decision—not when you initially filed your claim.
For example:
- If your disability rating was finalized on February 26, 2023, the VA can reassess your condition up until February 26, 2028, if there is reason to believe your disability may improve.
Once the five-year mark passes, the VA can still review your case. However, at this point, they can only reduce your rating if clear medical evidence proves your condition has shown sustained improvement under normal life conditions.
VA Uses Reexaminations
During the first five years, the VA may require a Compensation & Pension (C&P) exam to determine if your condition has improved. These exams are usually scheduled within two to five years after your rating decision.
Review
- You receive a notice stating that your disability rating is under review.
- A new C&P exam is scheduled to reassess your condition.
- The VA reviews the exam results and decides whether to reduce, maintain, or even increase your disability benefits.
- If a reduction is proposed, you have:
- 60 days to submit medical evidence proving your condition has not improved.
- 30 days to request a hearing before the VA makes a final decision.
Exempt from Reexaminations
Certain veterans are protected from reexaminations, even within the first five years. You may not be required to undergo a review if:
- You are 55 or older, except in rare cases (such as some cancers).
- Your disability has remained unchanged (static) for five years or more.
- You have a Permanent and Total (P&T) disability rating.
If you fall into any of these categories, the VA is unlikely to schedule a reexamination.
How to Protect
To prevent a rating reduction, it’s essential to:
- Attend all medical appointments and follow prescribed treatments.
- Ensure your doctor documents how your condition affects your daily life and work.
- Keep copies of medical records that support your disability claim.
- Consult a VA disability lawyer if you receive a reexamination notice to protect your rating.
The VA Disability 5-Year Rule provides crucial safeguards for veterans, but staying proactive is key. Knowing your rights and keeping thorough medical documentation can help ensure your VA benefits remain secure.
FAQs
When does the VA 5-year rule start?
The five-year period starts from the date of your last VA rating decision.
Can the VA lower my rating after five years?
Yes, but only if medical evidence shows sustained improvement.
Who is exempt from VA reexaminations?
Veterans 55+, those with static conditions, and P&T disability holders.
How can I prevent a VA rating reduction?
Attend medical appointments, follow treatments, and keep records.
What should I do if I get a reexamination notice?
Consult a VA disability lawyer and submit medical evidence if needed.
