The 5 Things You Need to Know About the VA Disability 5 Year Rule

5 Things You Need to Know About the VA Disability 5 Year Rule

Legally reviewed by Brendan Garcia , Owner and Lead Attorney

After finally receiving your VA disability benefits, you may worry that the VA will ultimately attempt to reduce your compensation. Fortunately, there are protections in place that may allow you to keep your current disability rating. The VA Disability 5 Year Rule could allow you to maintain your benefits indefinitely. If you have received a reexamination notice from the VA or you are getting close to the five-year mark of when your disability rating was given, a VA disability attorney can help you understand the impact of this rule.

What Is the VA Disability 5 Year Rule?

The VA Disability 5 Year Rule is protection for a veteran against the VA reducing their disability rating after it has been in place for five years. After five years have passed, it becomes much more difficult for VA to reduce your rating – typically VA must be able to prove that your disability shows substantial and sustained improvement, and that such improvement will be maintained under the ordinary conditions of life. 

Here are five things to know about the VA Disability 5 Year Rule.

1. After Five Years of No Improvement, Your Condition Is Considered Static

Disability benefits are regularly granted for permanent conditions. However, they are also awarded for conditions that are expected to improve with medical treatment and the passage of time. The VA only requests reexaminations on conditions that they believe are likely to improve. Five years with no improvement is generally a reasonable timeframe indicating that the disability caused by the condition will be permanent.

2. If You’re Over 55, You Likely Won’t Face Reexamination Anyway

The VA rarely requests reexaminations of disabling conditions among individuals who are age 55 and over, with the exception of ratings for certain cancers. VA disability benefits continue at the same level even after a claimant is past the retirement age of 65. VA rules prohibit reductions based simply on increasing age.

3. Reexaminations Are Most Common Within 2 – 5 Years

Most initial grants are not static – reexaminations are typically scheduled for VA to have the opportunity to review the progress of a disability over time, and potentially reduce benefits if the disability has improved. . Because of the 5 Year Rule, VA generally attempts to schedule reexaminations for veterans that received their disability rating 2-5 years ago. 

The VA reexamination process begins with a notice that your disability claim is being reevaluated, typically with a new C&P examination. Once the C&P examination is complete, if VA feels that changes to your rating are necessary, they will mail you a proposed reduction.

You have 60 days to respond to the letter by providing evidence supporting the need for disability benefits to continue at their current rate. If you would like a hearing to appeal the proposed reduction,  you must request this within 30 days of the date of the letter.

Once the 60 day period has passed, if you have not submitted new evidence or requested a hearing, the proposed reduction will typically be finalized. However, it’s important to note that any finalized reduction may be appealed. 

4. The 5 Year Rule Is Only the Beginning of Disability Protections

The VA also provides a 10 Year Rule, which protects a veteran from having their disability rating terminated, though it can still be reduced if there is evidence of improvement of the condition. 

The 20 Year Rule protects a veteran’s disability rating from being reduced below the lowest rating level received for that disability in the past 20 years. And, of course, if your disability is deemed permanent with no chance of improvement, you are not subject to reexamination or a reduction of a total disability rating.

A VA disability lawyer can help you understand the 5, 10, and 20 year rules for veterans disability claims and if there are other potential benefits or benefit protections you can receive as a result of your disabling condition.

5. The Reexamination Process Can Work in Your Favor

If you receive a reexamination notice, it does not necessarily mean that your benefits are going to be reduced. In fact, in some cases, the reexamination process has revealed a worsening of a veteran’s condition and ultimately resulted in the veteran seeing an increase in their disability rating rather than a decrease. 

How Can I Protect My Disability Rating Before 5 Years Have Passed?

During the initial five-year period after obtaining a disability rating, a veteran can protect their rating by continuing to attend all scheduled medical appointments, taking prescribed medications, and otherwise complying with their physician’s care plan. They should also be sure to express to their physician how the condition continues to impact their life and ability to work so that these ongoing impacts are medically documented.

Remember: the VA generally only requests a reexamination after five years have passed if they have material evidence that the condition has improved. This evidence is generally reflected in the doctor’s treatment notes.

If you have received a notice that the VA wants a reexamination, you should speak with an experienced VA disability benefits lawyer as soon as possible, so they can help you with the process of obtaining evidence to prevent the reduction or to appeal the change in your rating if the reduction has already become final.

We Can Help

As a veteran-owned law firm with VA-accredited attorneys, we are available to answer your questions and provide assistance as you seek to obtain VA disability benefits or to appeal a decision about your VA disability. We know how complex VA disability eligibility requirements can be and the frustration that veterans experience when faced with the potential of losing the benefits they have been receiving for their service-connected injury. Contact us today to talk more about your situation.