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Your PTSD VA rating and, consequently, your monthly benefits can be reduced if your PTSD condition has improved. This must, however, be done according to certain guidelines.
Before VA reduces your PTSD VA rating, they must send you a notification letter reducing your disability rating for PTSD (or any service-connected disability) if the reduction decreases your monthly compensation benefit. Your right to request a personal hearing is outlined in the notice letter, which you should request within the specified timeframe if you wish to contest. As soon as you receive the letter, you are entitled to bring forth evidence to refute the decreased rating.
How Is PTSD VA Rating Evaluated
Veterans must satisfy the following criteria to establish a direct service connection and prove PTSD to the Department of Veterans Affairs:
- A diagnosis of PTSD
- Must have been an in-service stressor (i.e., an incident or event that caused PTSD)
- In-service stressors must be medically related to the current PTSD diagnosis
VA will assign a disability rating after establishing a service connection for PTSD. You are rated based on how difficult it is for you to carry out daily activities due to your illness. Based on the VA's review of your medical records and supporting documentation, this rating shows your level of functional impairment.
The VA uses General Rating Formula for Mental Disorders to establish a disability rating for your mental disorder following 38 CFR 4.130. Between these two ends of the scale are scores of 10%, 30%, 50%, and 70% — veterans' disability ratings can change in most cases. As PTSD progresses over time, a veteran can request an increase in rating. Veterans' disability ratings may be reduced if VA finds that their PTSD has improved. The criteria to receive each of these ratings are as follows:
100% VA PTSD Rating
A 100% PTSD rating reflects a total impairment of occupational and social functions as a result of symptoms such as:
- Inability to think or communicate clearly
- Delusions or hallucinations persisting for a prolonged period
- Behaving inappropriately
- Threat to harm oneself or others regularly
- Ability to perform minimal daily activities (including maintaining minimal personal hygiene)
- Temporal or spatial disorientation
- Inability to remember the names of family members, occupations, or own names
70% VA PTSD Rating
It can lead to functional impairment in a wide range of areas, such as work, school, family relations, judgment, thinking, or mood if it involves symptoms such as:
- Having suicidal thoughts or ideas
- Routine activities interfered by obsessional rituals
- Occasional lack of logical, obscure, or relevant speech
- Inability to function in an independent, appropriate, and effective manner due to chronic panic or depression
- Inability to control impulses (such as unprovoked irritability accompanied by violent outbursts)
- Sense of being disoriented in space
- Personal hygiene and appearance are neglected
- Inability to cope with stressful conditions (such as work or a similar setting)
- Having difficulty establishing and maintaining effective relationships
50% VA PTSD Rating
The following symptoms are associated with reduced productivity and reliability at work:
- Speaking in circumlocutory or stereotyped terms
- Frequent occurrence of panic attacks
- Complicated commands are difficult to understand
- Several problems with memory (e.g., not recalling highly learned material, not remembering to complete tasks)
- Inability to make judgments
- Inability to think abstractly; mood and motivation disturbances
- Inability to establish and maintain effective relationships at work and in social settings
30% VA PTSD Rating
A lack of occupational and social functioning with intermittent impairment in work efficiency and inability to perform occupational tasks (despite generally functioning satisfactorily, with routine behavior, self-care, and conversation being normal) due to symptoms such as:
- Feeling depressed, anxious, suspicious, and having panic attacks (less frequently)
- Chronic sleep deprivation
- Mildly impaired memory
10% VA PTSD Rating
You have disabilities in work efficiency and ability to perform occupational tasks caused by mild symptoms or transient symptoms that occur only during times of significant stress or by continuous medication that controls these symptoms.
0% VA PTSD Rating
There may be symptoms of a mental illness that have been diagnosed formally but are not severe enough to impact social or occupational functioning or necessitate continuous medication to function normally.
Circumstances Leading To Reduced PTSD VA Rating
Some service-related conditions will improve as time passes or with treatment. Because of this, VA wants to compensate each veteran as much as possible following their current level of disability. There are two scenarios under which VA generally reduces a rating:
- Scheduled re-examinations: If your disability needs to be reexamined (a C&P exam) after receiving service connection, VA will evaluate whether to schedule your benefits for a future re-examination. If VA believes your disability will improve, they usually make this decision. From the date of your first Rating Decision, your first re-examination is usually scheduled 2-5 years later.
- Evidence of change in condition: Any medical evidence that shows improvement in your disability can also trigger a VA re-examination.
Upon establishing your service connection, the VA assigns you a rating. However, there can be an improvement or deterioration of PTSD over time. Your disability rating may increase or decrease depending on either factor.
If you are returning from combat with such severe PTSD that you cannot leave the house or feed yourself — much less work — then you may be unable to leave the house. As evidence of the extent of your disability, just submit a disability claim and ample supporting documentation. When you are incapable of working or carrying out daily activities, the VA gives you a 100% rating.
After that, intensive therapy takes place. If your PTSD is moderate a year later and you can still work, a re-examination by the VA may result in you receiving a 50% rating instead.
VA Rules To Reduce PTSD Ratings
The following rules must be followed when VA reduces veterans' disability ratings for PTSD:
- Veteran's health history must be evaluated before a rating can be proposed (or a decision can be made)
- Veterans must demonstrate that they can function under the normal stresses of life and work, demonstrating an improvement in their abilities
- All conclusions drawn from examinations should be supported by adequate research and based on thorough procedures
When Your VA PTSD Rating Cannot Be Lowered
In certain circumstances, the VA cannot lower your PTSD disability rating. The following are some of them:
- PTSD rating for a disabled person that stays at a consistent level for five years or more — also considered a stabilized rating
- PTSD rating for a disabled person has been the same for more than 20 years
- VA uses the term “permanent and total disability” — this classification is usually safe for your rating once you obtain it
Get Help From VA Disability Experts
Regarding veterans' disability law, hiring a lawyer is a crucial decision. Find someone you feel comfortable with and get the benefits you're entitled to.
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