If you are a veteran who has been receiving disability benefit payments from the U.S. Department of Veterans Affairs (VA) for over 10 years, you will be happy to know that the VA cannot terminate your benefits absent a showing of fraud.
The 10-Year Rule Explained
The VA awards monthly compensation to veterans with persistent medical conditions and debilitating injuries caused by their service. These payments are based on a rating assigned by the VA. The VA calculates this percentage after assessing the nature and severity of the veteran’s condition.
In some cases, injuries or medical conditions improve over time. The VA initially monitors for changes in a veteran’s condition with periodic reexaminations. But once it becomes apparent that the medical issue has become static or permanent, the VA ceases scheduling routine examinations.
As veterans well know, it is difficult to adapt to living with a persistent disability. Some veterans find alternate work they are able to do despite their limitations. But even then, most rely on disability payments to get by. As a result, it helps to have some reassurance that the VA will not suddenly change its rating and take away benefits.
Fortunately, the 10-year rule provides such peace of mind. Once the VA has paid disability benefits for this length of time, the VA cannot take away its finding of a service connection. And while the VA can reduce the benefit, it may only do so after providing notice, a sufficient reason, and the opportunity to present new evidence at a hearing.
If you are not sure if you qualify under the 10-year rule or you received a notice of proposed rating reduction, Gerling Law is here to help. Just as you served your country, Gerling Law focuses on service to the communities where we live and work. And part of our mission is to ensure that our veterans receive the benefits they earned.
What Is the 5-Year Rule?
Before delving into the 10-year rule, it is helpful to know what protections veterans have after five years. The 5-year rule offers veterans some reassurance that their rating will not change. When the VA questions whether a disability still exists or has become less severe, it will order a reexamination. But if a service-connected disability has not materially improved after five years, the VA will stop requesting periodic reexaminations. It considers the condition static.
How Does the 10-Year Rule Build on the 5-Year Rule?
After 10 years without any material changes to your condition, the VA goes a step further. If you have a service connection that has been in effect for 10 years or more, the VA will not sever it. This means that the VA cannot terminate your service-connected disability rating.
The 10-year period is calculated from the day the VA found you had a service-connected disability (not the date it assigned a rating). And there are a few exceptions to the 10-year rule. The VA could sever your service connection if you committed fraud in obtaining the original grant. It also may terminate your rating if you never had the required service or discharge record in the first place.
How Does the VA 10-Year Rule Help Veterans?
The 10-year rule gives veterans a protected status. It offers them the peace of mind of knowing they will receive some amount of disability benefits for the remainder of their lives.
Can the VA Reduce a Rating After 10 Years?
We have already established that the VA cannot terminate your rating after 10 years unless the rating was not legal in the first place. But can VA disability be reduced after 10 years? Unfortunately, the answer is yes. That being said, the VA can do so only if medical evidence establishes that your disability has actually improved. Temporary or minor improvements do not count. To change your status, the VA must demonstrate that your condition has improved materially. And of course, because the VA does not typically schedule reexaminations after a disability remains static for five years, the VA must establish a sufficient medical record of this improvement.
How Can I Challenge a Proposed Rating Reduction?
Before the VA can reduce your rating, it has to provide you with notice and an opportunity to object to the reduction. It begins by sending you a notice of proposed reduction at your last known address. This notice must provide detailed reasons for the recommended action.
The veteran then has:
- 30 days to request a hearing, and
- 60 days to present new evidence showing why the VA should not reduce benefits.
Once the veteran takes either of these actions, the VA cannot make a final determination until it has held a hearing, if requested, and considered any new evidence. The VA then issues a notice of decision. If it decides to reduce the payment, the reduction will not take effect until the last day of the month, 60 days after the veteran was notified of the final rating decision.
Can I Appeal a Rating Reduction Made After 10 Years?
Yes, but only a final decision. You cannot appeal a notice of proposed reduction.
The new appeal process gives veterans a choice of how to challenge an unfavorable decision. They may file a supplemental claim, seek higher-level review, or file a board appeal. If you are not satisfied with the outcome of the appeal option you chose, you can try another option if you are eligible.
How Can an Attorney Help Me Protect My Disability Benefits?
There is no question that the VA disability benefits system is convoluted and involves some procedural hurdles. Because of this, many veterans understandably seek help filing their claims, responding to notices of proposed reductions, and appealing rating changes and denials.
The attorneys at Gerling Law know how to navigate the VA disability web and can help protect the benefits you rely upon to pay the bills. Our attorneys have over 125 years of combined experience and have received numerous awards. That’s why we say: Go with Experience. Go with Gerling.®
When you are ready to ensure that you and your loved ones are provided for by pursuing VA disability compensation, contact Gerling Law.
Gayle Gerling Pettinga
Born and raised in Evansville, Gayle is a respected, experienced lawyer and a valued community leader. She graduated near the top of her class at Indiana University’s prestigious Maurer School of Law. She’s practiced law with one of the largest firms in Indianapolis as well as one of the largest pharmaceutical companies in the world. And that means she knows how big law firms and big companies think and how they operate – and she will put that knowledge to work for you.
Gayle has received numerous awards and honors including Martindale-Hubbell — Peer Review Rated: AV®, American Institute of Personal Injury Attorneys 10 Best Attorneys in Indiana for Exceptional and Outstanding Client Service, and YWCA Evansville 100 Years, 100 Women Honoree, 2011.
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