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

Five Things To Know About the VA Disability 5 Year Rule | FAQs

Legally reviewed by Brendan Garcia , Owner and Lead Attorney

Veterans with non-stagnant service-related conditions should be aware of the ways that the VA disability 5 year rule can impact their benefits.

Summary

  • Typically, the VA checks up on service-connected conditions within the first five years if they are likely to heal or improve to see if the original disability rating is still fair.
  • After five years of having the same VA disability rating, veterans are insulated from a rating reduction in most cases.
  • Generally, the VA does not ask older veterans to undergo a follow-up C&P exam for a service-related disability, even if they are still within the five-year window.
  • The VA can decide to decrease, maintain, or increase your VA disability benefits after assessing your rating.

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.

Our team of VA-accredited veterans disability appeals lawyers at VetLaw has the skill set, proven approach, and diligent attitude you can rely on to maximize your VA disability benefits. Let VetLaw take the lead in appealing your rating reduction. Reach out to us by calling (855) 391-1579 or filling out a contact form to schedule a free consultation.

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 the VA to reduce your rating.

Typically, the VA must be able to prove that your disability shows substantial and sustained improvement. Additionally, the VA must show 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. There are possible exceptions for ratings for certain service-related 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 the VA to have the opportunity to review the progress of a disability over time. The VA can also potentially reduce benefits if the disability has improved.

Because of the 5 Year Rule, the VA generally attempts to schedule reexaminations for veterans who received their disability rating 2-5 years ago. The VA reexamination process begins with a notice that your disability claim is being reevaluated. Typically, this means you’ll need a new C&P examination. Once you complete the C&P exam, the VA uses those results to decide if it should change your rating.

Then, 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 want 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 you can appeal any finalized reduction

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

The VA also provides a 10 Year Rule. This protects a veteran from having their disability rating terminated. However, the VA can still reduce it 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 the VA sends you a reexamination notice, it does not necessarily mean that they will reduce your benefits. The VA’s goal is to accurately assess the current status of your condition, not chip away at your benefits.

In fact, in some cases, the reexamination process has revealed a worsening of a veteran’s condition. Consequently, the veteran saw 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, there are several ways a veteran can protect their rating. They should continue attending all scheduled medical appointments, taking prescribed medications, and complying with their physician’s care plan.

Also, veterans should express to their physician how the condition continues impacting their life and ability to work. That way, 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, speak with an experienced VA disability benefits lawyer. They can help you with the process of obtaining evidence to prevent the reduction. Alternatively, they can appeal the change in your rating if the VA has already finalized it.

Let the Determined Veterans Appeals Lawyers of VetLaw Defend Your VA Disability Rating

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. Our team has also seen the frustration that veterans experience when faced with the potential of losing the benefits they have been receiving for their service-connected injury.

You can reach us at (855) 391-1579 or through our online contact form to schedule a free consultation. We look forward to discussing how we can help you secure fair compensation for your service-related disability. Contact us today to talk more about your situation.  


Frequently Asked Questions

Does the VA disability five year rule apply to me if I have Permanent and Total Disability status?

Veterans with a Permanent and Total Disability status are effectively exempt from the VA disability 5 year rule allowing the VA to adjust their disability rating and corresponding benefits. The VA has already determined that their condition will not improve, so their status is protected. 

When is the effective date for the VA disability five year rule?

The clock starts on the five year rule the day of your last VA rating decision. For example, if the VA issued you a 60% disability rating and granted benefits on February 26th, 2023, the VA could reassess your rating at any point until February 26th, 2028 if your condition is likely to improve.

What happens to my TDIU benefits if the VA reduces my highest disability rating from 60% to 50% or 40%? 

If you were receiving TDIU benefits from the VA based on your Individual Unemployability status and a 60% disability rating for a service-connected condition, you may be concerned about your eligibility for TDIU if the VA reassesses your highest-rated condition and decides it should be lowered from 60% to 50% or even 40%.

However, that is only one path to eligibility for VA TDIU benefits. If you still qualify as Individually Unemployable under the VA’s definition, you may have another option after your rating reduction.

The VA’s 70/40 rule for TDIU says that you can also qualify for this benefit if your combined VA disability rating is at least 70% and you have at least one service-related condition with a 40% rating.

Do I need a VA-accredited veterans disability appeals lawyer to fight a rating reduction?

Overturning VA rating reductions is one of the many responsibilities a veterans disability claims attorney can take on for you. Their role is to advocate for you to receive the VA disability benefits you deserve, whether the VA made an error, denied your service connection, doubted your diagnosis, or otherwise hindered you from accessing the benefits you should qualify for.