The VA does not always consider disability ratings permanent. If you don’t have a permanent or protected disability rating, the VA can reevaluate your disability rating and does so at two to five-year intervals in some cases.
However, the 55-Year-Old Rule for VA disability ratings states that Veterans receiving VA disability benefits for service-connected conditions are exempt from periodic future examinations after they turn 55. This is a form of a protected rating and shields Veterans from having an existing rating reduced in the future.
Understanding the Purpose & Eligibility Criteria of the VA Disability 55-Year Rule
If you are not 55 or older and do not have a permanent or protected disability, the VA can reevaluate your disability at its discretion. You have to attend a reevaluation exam in person or over the phone if the VA contacts you.
Following a reexamination, your VA rating may be reduced, stay the same, or will increase.
In cases of a reduced rating, Veteran Ratings can only help you with a reevaluation if you are a client who originally received guidance from us. In all cases, Veterans can request a personal hearing within 30 days of the notice of the proposed reduction.
It’s essential to understand the difference between a permanent and a protected rating. A permanent rating is assigned to a Veteran with a service-connected condition that is not expected to improve and applies in situations of a lost limb, deafness or blindness, or if a Veteran is paralyzed, etc.
A protected VA rating goes into effect if a Veteran has had a disability for more than five years and falls into one of three categories.
- 10-Year Rule: if a service connection for a disability has been in place for ten years or more, it cannot be severed unless there is proof of fraud, but the VA can reduce the rating if the condition has improved.
- 20-Year Rule: An evaluation that has been in place for 20 years or more at a certain level cannot be reduced or eliminated unless there is evidence of fraud.
- The 55-Year-Old Rule: Veterans who receive VA disability benefits for service-connected conditions are exempt from periodic future examinations once they turn 55.
Exceptions to the VA Disability 55-Year-Old Rule
If you are 55, federal guidelines dictate that you should be exempt from reexamination, except in rare circumstances or by regulation. For example, a VA regulation requires a re-examination for Veterans who have completed treatment for certain cancers six months after treatment. The guidelines also indicate that the VA should not schedule a reexamination for a Veteran younger than 55 who would be 55 by a future examination date.
Here are some other exceptions to the 55-Year Rule.
100% Disability VA Rating Protection.
This is also known as TDIU Rating Protection. Veterans who obtain a 100% disability rating are protected from the VA lowering that rating automatically at any age. A 100% disability rating may be due to paralysis, amputation, or other similar instances where no improvement will occur. Total ratings will usually not be assigned for temporary exacerbations or acute infectious diseases except where specifically prescribed by the schedule.
However, the VA can still reduce a disability rating from the maximum allowable 100% if they obtain extensive evidence of medical, physical, or cognitive improvement to a level that enables the Veteran to work and care for themselves. TDIU status can only be terminated when the VA can show clear and convincing evidence of actual employability. Specifically, that means you have held some form of employment for at least one full consecutive year and earned more than the federal poverty threshold for that year.
10-Year Disability Rating Protection.
Veterans who maintain a disability rating for at least 10 years are protected from termination of their benefits at any time. But the VA can reduce their disability rating if they can prove that the Veteran’s health condition has improved substantially.
20-Year Disability Rating Protection.
In most cases, the VA cannot reduce disability ratings for Veterans who have maintained a constant disability rating for at least 20 years. That applies even if a Veteran’s Compensation & Pension (C&P) exam shows that the Veteran’s condition has improved drastically with some new treatment regimen and suggests a lower rating.
However, only the 20-year rating percentage is protected. If a Veteran had a 40% rating for 20 years, but it was increased to 50% for five years, the VA can always reduce the 50% rating back down to 40% if warranted.
Applying for an Exception to the VA Disability 55-Year-Old Rule
The quality of your request for an exception is always determined by the quality of the documentation and evidence you submit.
Before you reach a point where exceptions may be warranted, the best way to understand your potential outcomes is to schedule a risk-free consultation with Veteran Ratings. After determining your needs through an extensive screening process, you may be directed to our Veteran consulting partners who will assist you in determining if you can get an increase or not, or guiding you in securing the proof you need so that you can protect and maintain your rating before you turn 55.
