How to Increase An Existing Rating

This is not legal advice. You should always seek the advice of an attorney who is qualified in Veterans' law before you make any decisions about your own benefits. Visit Stateside Legal (below) for assistance with legal issues.

NOTE:  Letters in my Q&A columns are reprinted just as they come to me. Spelling and grammar are left as is and only small corrections are made to improve readability, ensure anonymity or delete expletives that may offend some readers. This is not legal advice. You should always seek the advice of an attorney who is qualified in Veterans' law before you make any decisions about your own benefits.

Determine exactly what your current ratings are before you proceed.

Did out those original award letters so that you know exactly what sort of benefits and ratings you have. Don't just guess at it, get the facts. You may need to check your records at the  eBenefits site.

This will be a good time to initiate the VA Form 21-0966.

Using the VA Form 21-0966 will establish the effective date of your claim to increase the ratings of your existing benefits. Form is  Here

Look at the ratings table for your existing benefit.
The Schedule For Rating Disabilities is your guide to what you may be eligible for.You may learn that your current rating is already at the maximum or that you're current rating is seriously deficient. You have to research it to know.

Gather your evidence and records to support the increase.
If there are civilian medical records, you have to gather those for yourself.Do not rely on VA to obtain your civilian records.

Consider having an IMO completed.
The IMO is the most efficient way to provide evidence in support of your claim.

It's time to file the claim.
Use VA Form 21-526EZ  
Be as precise as you can to describe just what it is that you want.
Provide supporting evidence.

Congratulations! You're done.

Proceed With Caution


Any time we ask VA to open our file to make any adjustment, we open ourselves up to a complete review of all ratings.  Many veterans get an unpleasant surprise when they discover that their request for an increase leads to a proposal to decrease a rating.

You have an absolute right to be rated appropriately for each disabling condition you may have incurred during your honorable military service. 

If you feel that your rating is not correct for your condition, by all means seek an increase.

Before you do...be sure that you can't lose. 
Check your current condition's symptoms against the standards you find in  The Schedule For Rating Disabilities . Match your physical or mental health status to the ones you find there. 

If you are confident that you can prove your entitlement to a higher rating, go for it. If not, sometimes sleeping dogs are best left to just lie there.


Do you have a temporary 100%  TDIU  rating? 

Do you need it raised to 100% Permanent and Total so that you may collect the  CHAMPVA  and  Chapter 35 DEA benefits ?

I asked a senior RVSR (Ratings Veterans Service Representative-a rater) to comment on this topic.  Many VAWatchdog visitors are writing in to ask why they aren'tP & T and why they don't have the 100% P & T benefits? Most of those disabled veterans have a mental health problem as their highest rating. Most are under the age of 55 years old.

I asked the rater why he doesn't offer a 100% rating...TDIU or Schedular...rather than a rating where future exams are scheduled.

His reply is here...

Hi Jim, 
TDIU  P&T is a problematic issue, particularly with mental health issues. It  places RVSR’s between a rock and a hard place at times. It is much easier to determine the long term outcome for someone with physical disabilities. 
It is not that we do not want to give a Veteran what he is entitled to but there is always the underlying concern that we are encouraging dependence on the VA and not providing the Veteran any motivation to become a productive member of the workforce.  A major problem with Veterans from the most recent conflict is that many went in so young that they had no work skills in the first place. Now they are out of the military and the question becomes whether or not the Veteran truly cannot work nor has the potential if he or she learned some skills. Also, we both know the job market is not that great. The general rule of thought (nothing on paper) is that the 20-40 year old group has the potential for re-entry into the workforce. 

There are  occasions where it is clear that the Veteran’s mental health issues will never get better and P&T can be granted at the time of the initial  rating decision but that it rare.  Under 38 CFR 3.327, we cannot conduct a review examination for anyone over 55 unless the circumstances areextraordinary or mandated,as with the regulation that requires review of a Veteran’s status 6 months after the completion of cancer treatment.  

It is the age 40-55 group that is toughest to address. A couple of years ago VBA mandated that no review examination could be conducted before 5 years unless there is special circumstance or a regulation. 

If, after 5 years, the Veteran has improved, we still have to wait another 18, 24 or 36 months to get a second review before determining that improvement is sustained. That means that if a Veteran shows even a little improvement, he has to wait for a total of about 7 years before a final P&T decision is made.Another reason for delaying a P&T evaluation is that there is a time limit to chapter 35 benefits and so you want to grant that benefit at the time it will be of the most use to the Veteran. 

Under Chapter 35, dependents are allowed 45 months of full-time benefits.  Spouses have 10 years from the date of the veteran's effective date of  permanent and total disability rating or the veteran's death.  Dependents' benefits end on their 26th birthday or eight years from the veteran's effective date of permanent or total disability rating or the veteran's death, but not after the dependent's 31st birthday. If the kids are 2 & 3, those Chapter 35 benefits won’t be of much use  until many years later. Unfortunately that delays the ChampVA benefit  also. If the  Veteran with small children has a physician who will clearly state that  his/her potential for seeking and maintaining gainful employment is slim to none and the ChampVA benefits are what is most important to him/her, a claim for P&T can be made before the 5 year period is up. 

If the Chapter 35 benefits are most important, it is in the Veteran’s best interest to wait it out until his/her children are of age to use the benefit and then file the P&T claim with the medical evidence. 

If the Veteran does not have a strong statement from his physician or  psychologist that gainful employment is not possible, it is best for the Veteran to leave the issue alone as there is the risk of a reduction. 

I hope this explanation helps.

Chapter 35 Dependents Educational Assistance
  

CHAMPVA Policy Manual  


Would VA give me a higher rating and if so, how do I begin?

Dear Jim,
  My two disability ratings are for my knees. I was Airborne and my knees got the worst of it. I've managed to get along for all these years with physical therapy, a limited amount of walking and pain medicine as needed.
  But now, as the years have gone by, my knees are much worse than they were when they were originally rated. My civilian doctor tells me that he can replace both knees during the same operation so that I only have to spend time recovering once.
  It seems to me that I should have a higher rating now that my knees are completely failing me. Would VA give me a higher rating and if so, how do I begin?

Reply
  A disability rating should, to the extent that it can be done, reflect your condition accurately in time. If your condition improves and you are less disabled, your rating should fall. If your condition becomes worse, your rating should rise.
  The system allows for all that but it isn't very efficient. Your condition may change for better or worse and by time VA gets around to setting a new rating, the condition may have changed again.
  In your case, it's apparent that your service connected condition is much worse. Your rating should climb correspondingly.
  You must tell VA that it's time to raise your ratings. This is best done in writing. A brief (one page) certified letter that tells VA that you deserve an increase is all that it takes to begin the process.
  You'll also be eligible for temporary 100% ratings as you recuperate from surgery. Since you're being cared for in the civilian sector, it's up to you to notify VA of the surgery and to provide them with your medical records.


If I appeal the rating decision and I am denied a rating increase back to 100% will I lose the 70% UI rating that they are proposing?


I recently had a reexamination not 2 years after I was granted 100% which was a reexam after my initial C&P which rated me 70% IU. My rating is being proposed to be reduced to 70% IU which isnt a problem. My concern is my reexam was only 20 minutes and nothing actually changed except I started seeing a VA psychiatrist again about 7 months prior to my exam. My question is if I don’t agree with my rating at all. I’m housebound and can’t drive and other major issues. If I appeal the rating decision and I am denied a rating increase back to 100% will I lose the 70% UI rating that they are proposing. I know it sounds greedy but with the 100% rating I also got SMC-S and now I will loose that extra money if I am at the 70% IU. Any advice would be helpful.

Reply:
  I believe you have had a temporary rating of 100% TDIU. The underlying rating was at 70%. In the award letter you originally received it should have said, "Future exams are scheduled" or similar wording.
  You've come to the time when VA has reexamined you and they believe that they see an improvement in your condition. They have proposed to reduce you from the 100% TDIU and rate you at the 70% you had before.
  That's a significant loss. You should appeal if you believe that VA has made a mistake and that you should be rated at the 100% TDIU as before.
  To appeal isn't difficult. You can probably do a DRO appeal for yourself.
If you believe that you need a hand with the appeal, you can speak with a veterans law attorney at no cost.
  Don't wait too long to begin the appeal. Timeliness in filing is important.


Should I apply for an increase?

Dear Jim,
  I was awarded a 30% service connected compensation, in Oct. 2006.  In December 2013 I talked with an American Legion VSO about appealing my claim and requesting an increase to 50%.
  He told me I should see the psychiatrist who is handling my treatment.
  I talked with the doctor and he said he couldn't make a statement on whether I was eligible for an increase because he had to remain neutral because  of VA policy.
  He did give me a letter of "support" saying he believed my current condition supported an increase. I was told by the American Legion VSO and by my doctor that I should really think about the possible loss of my original award, as it could be taken away.
  I read your statement about filing my own claim  I am asking advice on how to proceed. Thank you in advance for any help you can offer.

Reply:
  It's my opinion that the VSO advising you was wrong. There's no reason for you to ask a VA doctor about filing for an increase to your benefit. VA medical staff have nothing to do with the disability compensation award process. They rarely have any clue of how that works.
  If you haven't had any adjustment to your rating since 2006, you aren't asking for an appeal, you're seeking an increase. It's simple and easy to do your self. Since your rating is comparatively low at 30%, I don't think you have any risk of losing that benefit.
  Any time any veteran who has an existing rating believes it should be increased, a VSO has no reason to tell him it shouldn't be with determining the nature of your request. The VSO should have directed you to The Schedule For Rating Disabilities so that you could determine if you are eligible for an increase because of your rated condition.
If you meet the criteria for an increase to 50%, by all means...go for it
Jim Strickland
Jim's Archives Here

E-mail Jim at:
jim912a@gmail.com

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