“I’m at 100%. Should I submit additional claims?”
Great question.
Once a Veteran is classified as (P&T) permanent and total once he/she has permanent and total. It’s PROTECTED after 20 years. When the Veteran has P&T, it means no future examinations. (i.e. the every 5 year check if the Veteran is not P&T).
Short answer…To be on the cautious side, once a Veteran reaches 100% P&T, don’t go for more.
First lets talk about DIC.- Dependency and Indemnity Compensation. This is payment for a Veteran dying from a service-connected (SC) disability for permanent and total (P&T) Veterans. Basically if you meet these time hacks:
https://www.law.cornell.edu/cfr/text/38/3.5
(i) Rated by VA as totally disabling for a continuous period of at least 10 years immediately preceding death;
(ii) Rated by VA as totally disabling continuously since the veteran‘s release from active duty and for at least 5 years immediately preceding death;
Then the spouse, then the spouse get the Veteran’s payment for disability.
For re-examinations (they look at you every 5 years):
https://www.law.cornell.edu/cfr/text/38/3.327
Following initial Department of Veterans Affairs examination, or any scheduled future or other examination, reexamination, if in order, will be scheduled within not less than 2 years nor more than 5 years within the judgment of the rating board.
For service connection:
38 CFR § 3.957 – Service connection.
Service connection for any disability or death granted or continued under title 38 U.S.C., which has been in effect for 10 or more years will not be severed except upon a showing that the original grant was based on fraud or it is clearly shown from military records that the person concerned did not have the requisite service or character of discharge.
For protected ratings:
https://www.law.cornell.edu/cfr/text/38/3.951
(b) A disability which has been continuously rated at or above any evaluation of disability for 20 or more years for compensation purposes under laws administered by the Department of Veterans Affairs will not be reduced to less than such evaluation except upon a showing that such rating was based on fraud.
For Reduction:
38 CFR § 3.344 – Stabilization of disability evaluations.
The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more).
Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history.
Ratings on account of diseases subject to temporary or episodic improvement will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated.
This is the 5 year rule for reductions (Disability was in effect – stabilized for 5 years)
However, if less than 5 years VA can: Re-examinations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.
But the VA must follow this guideline if using an examination to reduce someone:
Examinations less than full and complete than those on which payments were authorized or continued will not be used as a basis of reduction.
And even if the examination was adequate the VA (rater) must determine the following:
Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life.
