Understanding the VA Disability 5-Year Rule

The disability benefits provided by the government through the Veterans Affairs Office are a huge help to disabled veterans who need additional financial assistance. If you are a veteran relying on your VA disability benefits for your medical expenses, you may have worries about the VA reducing your compensation.

In truth, your worries are not without cause, as the United States Federal Government can increase, reduce, or potentially even terminate the VA benefits you receive depending on your condition and disability rating.

However, there are also protections in place to safeguard your right to receive VA disability benefits for conditions you sustained or aggravated while on active duty military service. The VA disability five-year rule is one of the regulations that help protect veterans’ disability rating and the amount of compensation they are entitled to receive.

What Is the VA Disability 5-Year Rule?

The VA disability five-year rule aims to protect disabled veterans against losing their disability benefits once their condition improves. 

Any veteran who has been receiving VA disability for a service-connected condition for five years or more can’t have their VA disability rating reduced, changed, or terminated without proof of sustained improvement.

The VA needs to first be able to prove long-term or permanent improvement of a veteran’s condition — regardless of whether it is physical or mental. The illness or condition not only needs to have gotten better but must continue that way or improve even more. 

Moreover, there needs to be documentation supporting this improvement. This is commonly done through a reevaluation of the veteran’s health and disability ratings. Multiple reexaminations over a certain period are generally required to prove sustained improvement.

What Happens After Five Years?

After five years of receiving disability benefits, the VA may request or schedule a reexamination of a veteran’s condition and disability rating. 

If there are no improvements to the veteran’s condition, it will be considered static. Static conditions are those deemed unlikely to improve over time. The VA assigns a permanent rating or evaluation for static conditions. This means future reexaminations will no longer be required.

Exceptions for VA Disability Rating Reexaminations

There are certain exceptions to disability rating examinations. In general, the VA will not order a reexamination if you fall under any of the following:

  • Over the age of 55
  • Static disability or condition
  • Disability or condition is considered permanent and not expected to improve
  • Received a minimum rating for a particular disability

Additionally, the VA will not request for a reexamination in cases where any changes to the individual condition’s disability rating would ultimately not affect the person’s total combined disability rating.

Other VA Disability Protected Ratings

The VA disability five-year rule is not the only protected rating—nor is it the one with the highest level of protection. There are two more disability rating rules, each offering greater protection to veterans:

  • 10-year rule: If you have had your disability for at least 10 years and received VA disability benefits for it, the VA is not allowed to sever or cut the condition’s service connection and terminate disability benefits. However, they can still lower the rating and reduce benefits. This applies regardless of whether the rating was sustained or reduced during the 10 years. If the VA wants to terminate benefits after 10 years, they need to prove your claims were fraudulent.
  • 20-year rule: If you have had your disability for at least 20 years and received benefits for it, the VA can no longer give you a lower rating beyond the lowest one that you have received over the past two decades. Similarly, if the VA wants to terminate your benefits or give an even lower rating, they will first need to prove that you received your rating and claims through fraud.

What Is the VA’s Disability Rating System?

The VA disability rating system rates veterans’ service-connected disability based on their severity. The rating system is in percentages and ranges from 0 to 100%, going from increments of 10%. This VA disability rating represents how much the person’s disability adversely affects their ability to function day-to-day, overall health, and quality of life.

The VA uses this disability rating system to determine the monthly VA disability compensation rate. The higher the disability rating, the greater the compensation a person can receive. It’s also used to help them determine veterans’ eligibility for VA health care and other benefits.

How Can You Prove Your Disability to the VA?

In some cases, reevaluations result in lower ratings or even denial of disability claims. If you disagree with the results of the reevaluation or the VA’s denial of your disability claim, you can still appeal the decision.

Veterans who file an appeal to review their VA disability rating or claims denial will need to prove their disability and its actual severity. You can do this by filing any of the following VA forms:

  • VA Form 20-0996: This form is used to request a Higher-Level review of any decision made by the VA Office. This can be done online or on paper. Take note that this form needs to be submitted within a year of the date the VA gave you notice of its decision.
  • VA Form 21-0781: This form is used to apply for related benefits or services for post-traumatic stress disorder (PTSD). This form supports claims for service connection to PTSD by providing details about the service-connected traumatic event and other evidence.
  • VA Form 20-995: This form is used to request a Supplemental Claim, which is a new review of an issue that already received a VA decision and that you disagree with. This will require you to submit new and relevant evidence to support your claims.

Be Informed About Your VA Disability Benefits

VA disability benefits can be just as challenging to navigate as Social Security Disability benefits. Federal benefits often undergo improvement and regulation changes to adapt to the current state of healthcare, veterans’ lives, and even the economy.

Staying on top of all your veteran benefits and rights helps ensure you receive the compensation and assistance you deserve in return for all your years of active duty. Let our team at Benefits help you keep up with the ever-changing VA benefits landscape. Visit Trajector Medical today to fill out a free evaluation to receive a call back from us at 844-412-0882 and learn more about your VA disability benefits.

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