Overview
The discussion covers strategies for veterans to protect their VA disability rating by understanding and applying specific regulations that exempt them from future re-examinations, beyond the commonly known 10- and 20-year rules.
VA Re-Examinations: Process and Purpose
- The VA requests re-examinations to verify the continued existence or current severity of a service-connected disability.
- Re-examinations are typically scheduled if the VA suspects a disability has materially improved or the rating may be incorrect.
- Veterans are required to attend scheduled re-examinations; preparation with current medical evidence is advised.
- Initial follow-up re-examinations are usually set 2–5 years after the first VA rating decision.
Six Criteria for Exemption from Periodic Re-Examinations
- Disabilities established as static (unchanging conditions) will not require future exams.
- No material improvement shown over five years exempts the condition from future re-examinations.
- Permanent diseases with no likelihood of improvement do not require periodic re-exams.
- Veterans over 55 years old are generally exempt unless unusual circumstances exist.
- Minimum prescribed schedular ratings do not prompt future exams since the rating cannot be lowered further.
- Combined disability evaluations not affected by a reduced rating on one or more conditions eliminate the need for re-examination in those cases.
Improving Protection Against Re-Examinations
- Veterans should clearly document the static nature or lack of improvement of their condition, especially when filing initial claims.
- Physician statements confirming a static condition can help establish protection.
- Veterans attaining 100% combined disability should verify if conditions meet criteria for permanent and total status, as the VA may overlook this designation.
Recommendations
- Work with an accredited representative to review your records and determine if your disabilities are classified as static or require future exams.
- Provide thorough medical evidence and potentially a doctor's statement to support that your condition is static when submitting claims.
- Periodically review your VA ratings to ensure you're receiving all appropriate protections and designations.