When can a VA disability rating be reviewed?

A disability rating from the Department of Veterans Affairs (VA) reflects your condition at the time VA decided your claim. Health changes over time, and so can a rating.

There are three common ways a rating gets a second look. You can file a claim for an increase. You can ask for a decision review. Or VA can schedule a re-examination.

Claiming an increase when a condition gets worse

If a service-connected condition has gotten worse, VA says you can file a claim for an increase. You use the same application as a new disability claim, VA Form 21-526EZ. You can file it online at VA.gov.

Definition

Claim for increase: A request for VA to re-evaluate a condition that is already service connected because it has become more severe. VA reviews current evidence to decide whether a higher rating fits.

Evidence is what shows a change. Recent treatment records, test results, and statements about how your symptoms affect your daily life and work can all help. VA may also schedule a Compensation & Pension (C&P) exam.

Decision reviews and their time limits

A claim for increase is for a condition that has changed. A decision review is different. It is for when you disagree with a decision VA already made. Under the Appeals Modernization Act (AMA), there are three options.

• Supplemental Claim. You submit new and relevant evidence. VA says you can file at any time, but it recommends filing within 1 year from the date on your decision letter to keep your effective date.
• Higher-Level Review. A senior reviewer looks at the same evidence. No new evidence is allowed. You generally have 1 year from the date on your decision letter.
• Board Appeal. A Veterans Law Judge reviews your case. You generally have 1 year from the date on your decision letter.

Some claim types have different deadlines. Always check your decision letter and VA's decision reviews page (opens in a new tab) for the time limit that applies to you.

Definition

Effective date: The date VA uses to start paying benefits for a claim. Filing on time, and choosing the right review option, can affect your effective date.

VA re-examinations

VA can also start a review on its own. Under its regulations, VA may request a re-examination when it needs to verify that a disability still exists or to check its current severity. This often happens when a condition is expected to improve.

VA's rules say periodic re-examinations are generally not scheduled in certain situations. These include when:

• The disability is established as static, meaning it is not expected to change.
• Symptoms have continued without material improvement for 5 years or more.
• The disability is permanent and there is no likelihood of improvement.
• The Veteran is over 55 years of age, except under unusual circumstances.
• The rating is the minimum rating the schedule allows for that condition.
• A lower rating would not change the combined rating.

If VA does ask you to attend a re-examination, take it seriously and attend. If VA later proposes to lower a rating, it generally must tell you in writing first and give you a chance to send evidence before any change takes effect.

Protected ratings

Some ratings have extra protection against reduction. The best-known example is often called the 20-year rule.

Definition

The 20-year rule: Under 38 CFR 3.951(b), if a disability has been continuously rated at or above a certain level for 20 or more years, VA will not reduce it below that level unless the rating was based on fraud. The 20 years are counted from the effective date of the rating.

This rule protects the rating level. It does not mean the condition can never be examined again, and it does not stop you from asking for an increase.

Other VA rules add safeguards before some long-standing ratings can be reduced. These rules are detailed and depend on your history. If you think one applies to you, an accredited representative can help you review it. Accredited Veterans Service Organization (VSO) representatives help at no cost.

Before you ask for a review

A few steady steps can help you choose well:

• Read your most recent decision letter and note its date.
• Gather your recent treatment records.
• Decide whether your condition has changed or whether you disagree with a past decision. That tells you which path fits.
• Check your deadlines on VA.gov.

If you are unsure which path fits your situation, you can talk with our team about your situation. You can also read What evidence supports a VA disability claim? to see what VA looks for.