Transcript for:
VA Disability Re-Examination Strategies

hey thanks for making it to Veterans Info Tap i'm glad you made it let's talk about protecting your rating what you need to do and how you can protect your rating and and I'm going to kind of swim upstream uh on this a bit this is not the 10-year rule it's not the 20-year rule this is other ways that you can protect yourself with the VA by ensuring that you meet certain criteria in some cases in some cases veterans meet certain criteria and they don't uh articulate it appropriately with the VA and maybe you miss out on a level of protection in my opinion so before we jump into it I want to throw out a very special thank you to James MCG146 james unbelievable brother thank you so much for the super comment super chat thing i really really do appreciate your support very much um I I just it's it's a lot thank you i really do appreciate you James MCG1446 thank you all right so jumping into this and and when I'm talking about swimming upstream what I'm saying is is okay let's think about this um in in kind of the whole life cycle of a veteran with VA disability claims and so forth one of the ways that the VA will end up reducing you is by having a re-examination of one of your conditions and they may deem it to be um you know maybe better maybe you were having a good day or something that day now there's different variants of this um the most common that we see is you file a claim with whatever evidence you gave the VA not really thinking too much about the downstream effects and the VA says "Great we're going to service connect you but we're going to do a future examination somewhere between 3 to 5 years." So how can we as veterans going through the process by the way most veterans don't file their disability claims until many years later and oftent times suffering with those conditions obviously for many years prior to actually filing for the claim so what can we do to put um I guess the evidence in place to have the VA not require a future examination or a re-examination i'm going to read through uh the the uh CFR here on this specific subject of re-examinations and we're going to dive into why the VA will not have a periodic future examination and there are uh six different reasons why the VA will not have a future re-examination and if you fall into one of those categories well now you got protection right uh against that future examination now with that hit the thumbs up for me subscribe share with a friend all that good stuff i really appreciate it every thumbs up every minute watch really does help the channel i really do appreciate your support if you want to support in other ways consider being a member i really do appreciate you members very much i do my best to get back to you in the comments thank you so much all right so sometimes it's hard to talk that much without breathing all right so bear with me i'm going to get through this we'll get to the six reasons uh here in a couple minutes so bear with me i got to give you kind of the front-loaded uh information here just so we can kind of go through it so for re-examinations this is under the general um section which is a and it's in the CFR under 3.327 uh labeled re-examinations re-examinations including periods of hospitalization uh will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability generally re-examinations 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 now that part's kind of funny because they're definitely not going to reach out to you and go "Hey you know that 10% that we gave you for migraines we really think it should probably be a 50." So let's go ahead and get you back in here and have some conversations they're not going to do that but if you had a 50 and then you go the other way um that you know that's more more likely from the VA just to kind of throw that out there so um moving on individuals for whom re-examinations have been authorized and scheduled are required to report for such re-examinations now I have heard and seen different opinions on that my suggestion is if you're required if you get um we'll call it summoned uh to a re-examination prepare get all your stuff together maybe even go to the doctor prior to that and and make sure you have some current medical evidence in the event they try to um reduce you but uh definitely show up to it all right so moving on uh it says here you must report to those uh re-examinations paragraph B and C of this section provide general guidelines for requesting re-examinations but shall not be construed as limiting so that's the kind of the gray area right not limiting uh the VA's authority to request re-examinations or period of hospital observation at any time in order to ensure that a disability is properly or accurately rated so all that to say is that the whole purpose of having re-examinations is uh so the VA can ensure that you are being rated appropriately based on the evidence of your condition's severity right so the more severe um the condition is the generally the higher the rating will be so let's move on to this next section here uh and this is uh important and and this is the the first paragraph before we get into the actual uh six we'll call it protections against a re-examination so again the CFR is kind of like the rule book for the VA so that's why it kind of speaks to um the VA employee what you need to do in order to do this or what this looks like or why what you should do if this occurs that type of stuff the M21 is also uh a little more dialed in in that aspect all right so compensation cases uh we're at section B number one scheduling re-examinations uh it says assignment of pre of of a pre-stabilization rating requires re-examination within the second six-month period following separation from service so that affects some most people are going to be under this section following initial following initial your first Department of Veterans Affairs examination or any scheduled future uh or other examination re-examination if in order will be scheduled within not less than two years nor more than five years within the judgment of the rating board unless another time period is elsewhere else elsewhere specified so 2 to 5ear window from your initial um you know VA uh claim essentially so what are we talking about here when the VA approves your service connection then what's going to happen is they can set out a future examination date uh for you and they want to do it before that 5-year period why yeah because of the 5-year rule so the 5-year rule makes it more difficult for the VA to reduce your rating they need more evidence showing that your condition has improved um it's more uh more cumbersome more labor and they need more evidence uh you know showing that your improvement is is really um staying in that improvement kind of direction so um 2 to 5 years for that future examination now let's get into the when it won't happen right so no this is again think of it as the VA employee reading this on what they're supposed to do no periodic future examinations will be requested in service connected cases which would be your service connected disability compensation no periodic re-examination will be scheduled and then it has the six reasons here's your six reasons when the disability is established as static that's it that's the full line well guess what if you suffered for example with migraines that are going to be service connected when you get ready to file your claim and you've been getting let's say treatment from your doctor you're getting your prescription whatever for the past 7 years then you decided to file your VA claim for migraines uh you should absolutely prove to the VA that you have been being treated for your migraines for that period of time more than 5 years and uh at the same level let's say your severity has been the same the same the same amount of time right it didn't gradually increase severity it's just stayed the same it's it's always sucked and here it is you may also want to have your doctor write you a letter stating that your condition is considered static and that you've been on X medications over the course of the past seven years blah blah blah blah blah just a little paragraph um that you can include in with your evidence when you file that claim because you are establishing that your condition is static to the VA and if your condition is static then no future examination will be uh requested which is good because if they request a future uh examination there's a potential not always but there's a potential that they could decrease you and it just takes the pressure the stress the nobody likes to go in for a re-examination so that's number one number two when the findings and symptoms are shown by examination scheduled in paragraph B2I which is the first one that we just read static of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more they have just doubled down on the fact that uh if your condition is deemed static so there's different ways right so maybe there's a condition that's like it's just these conditions don't ever get better you're exactly where you are and it is what it is you're only going to get worse from here with that condition boom you're done static or if you have that material evidence showing that it's been static no improvements over at least 5 years if you provide that to the VA you're deemed static right so it's just another they're just highlighting another way to show uh the static nature of your condition number three where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement again a static designation u uh dependent on the type of uh condition it is in this case they're talking about a disease that just will never go away you might be able to curtail it a little bit but it's never going to go away um and so there you are all right next one is in cases of veterans over 55 years of age except under unusual circumstances all right so that's the 55 year rule is actually under the re-examinations um section so if you're over 55 years of age and you hear things like the 55year-old rule what they're saying is is that if you are over 55 years of age the VA most likely will not have you uh come in for a re-examination simply because they're deeming that your condition because of age is not going to get better as you age it's going to stay the same or get worse um now un under unusual circumstances I mean it it leaves kind of the door cracked open i mean uh an obvious one would be let's say cancer right so you get um let's use as a presumptive cancer for an example you have a presumptive cancer um that's active you get rated for that they're going to want to re-examine you uh when you are able to uh get that to go into remission and if the cancer is gone then they're going to then change your rating and rate you on your residuals all right number five when the rating is a prescribed scheduled minimum rating so if you have the minimum rating on the rating schedule you have no future examination why because you're service connected for that condition you're already at the lowest rating so if you go in for a re-examination they're not going to give you a lower rating because you're already at the lowest they're not going to take away your service connection because you are service connected for that so there's no reason for them to go through the process of uh re-examining you all right last one here number six where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for more for one or more conditions so if you have for example um 100% rating right and you have 10 conditions that took you to 100% if those 10 conditions that took you to 100% let's say eight of them were static and eight of them did not require future examinations because they were static in some way you know and you had no future examinations and those eight conditions actually took you to 100% the other two were just kind of extra conditions you don't really need the ratings they could be zeros for all you care because you're still at uh 100% the VA is not going to schedule re-examinations on those conditions because even if they took you to a 0% on those conditions you're still at 100% so um that's just a way to kind of look at it u now if if they were able to uh move one to a zero we'll say and that changes you from a 100 to a 90 then that future examination would be in place but if it doesn't change your overall rating with the VA funny math uh then you you would be able to forego uh that future examination on a side note uh sometimes what happens is people will file multiple claims over the course of their life and eventually they may get to 100% when they get to 100% the VA does not make them permanent in total they're just a 100% scheduler pays out the same but they miss a couple of the major benefits that get added as permanent and total in some cases the veteran has enough static conditions to rate permanent in total but the VA just didn't figure that out because there's not a flashing light that flashes and said there's enough static conditions it's just you know you were at 30 now you're at 50 now you're at 70 now you're at 90 now you're at 100 okay cool there you go they're not looking at you know they some it's a people business some people pay attention and they'll they'll hook you up and they'll do the right things other people are just like "Cool you're at 100 boom move on." Uh and they miss that fact you should absolutely look and see if your conditions add up to 100% with static um designation now you can get your your designations um through your C file or a quicker way would be go work with an accredited rep who has access to the VA system VBMS and then they can uh essentially desktop remote desktop into your file in the VA and look up your um nature of your conditions are they deemed static or do they have future exams all right with that thanks for watching i appreciate you very much have a great one and remember if we don't take care of each other something went wrong