What Is the VA Disability 5-Year Rule?
The VA disability rating 5-year rule states that the U.S. Department of Veterans Affairs (VA) cannot reduce a veteran’s disability rating if it has been in place for five years or more unless the condition shows sustained improvement over time. In this situation, the veteran’s rating is considered a stabilized rating.
§ 3.327 Reexaminations.
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(a) General. Reexaminations, including periods of hospital observation, will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability. Generally, reexaminations will be required if it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability or that the current rating may be incorrect. Individuals for whom reexaminations have been authorized and scheduled are required to report for such reexaminations. Paragraphs (b) and (c) of this section provide general guidelines for requesting reexaminations, but shall not be construed as limiting VA's authority to request reexaminations, or periods of hospital observation, at any time in order to ensure that a disability is accurately rated.
How Does the VA Disability 5-Year Rule Help Veterans?
VA’s 5-year rule is intended to protect veterans from unfair reductions in disability benefits. According to VA, a stabilized rating is considered a protected disability rating. Generally, protected disability ratings are VA disability ratings that cannot be reduced or revoked by VA in the future.
Sometimes VA will wrongly assume a veteran’s condition is improving and thus reduce or discontinue their benefits. The VA disability 5-year rule eliminates this issue by not requiring reexaminations if a veteran has had the same rating for five years or more.
Can VA Reduce a Rating After 5 Years?
After five years, a disability rating can only be reduced if VA obtains medical evidence indicating the veteran’s condition is substantially improving over time on a sustained basis. Essentially, VA must provide an explanation for why it is reasonably certain that the veteran’s condition will continue to show sustained improvement.
If a rating is considered stabilized, two things must be evidence before VA can propose a reduction:
VA must show that the improvement is not just temporary through a Compensation and Pension (C&P) re-examination and medical records; and
VA must provide evidence that the veteran’s claims file demonstrates sustained improvement.
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(Authority: 38 U.S.C. 501)
(b) Compensation cases -
(1) Scheduling reexaminations. Assignment of a prestabilization rating requires reexamination within the second 6 months period following separation from service. Following initial Department of Veterans Affairs examination, or any scheduled future or other examination, reexamination, if in order, will be scheduled within not less than 2 years nor more than 5 years within the judgment of the rating board, unless another time period is elsewhere specified.
(2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled:
(i) When the disability is established as static;
(ii) When the findings and symptoms are shown by examinations scheduled in paragraph (b)(2)(i) of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more;
(iii) Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement;
(iv) In cases of veterans over 55 years of age, except under unusual circumstances;
(v) When the rating is a prescribed scheduled minimum rating; or
(vi) Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions.
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