Once the Department of Veterans Affairs determines that a veteran does have a disability which is connected to service, the VA considers the severity of that disability and assigns a disability rating. If the veteran is not satisfied with that rating, he or she can appeal the rating by filing a notice of disagreement within one year of the rating decision. But what happens if the veteran decides that the rating is fair and does not appeal and then the disability worsens? Is it ever too late to ask for a higher disability rating?
The answer to that question is “no.” At any time after a disability rating is assigned, a veteran may file a claim for an increased rating. Filing that claim is easy. All that is required to initiate an increased rating claim is the veteran’s good-faith belief that his or her disability has worsened. No special form is required—a veteran can simply send a letter to the VA indicating that the disability is worse and that the veteran would like the VA to consider a higher rating.
To support a claim for increased rating, the veteran needs to submit medical records which demonstrate that the condition is worse. Those records can be private medical records or VA medical records. Even though VA has access to VA electronic medical records, it is important that the veteran also submits the relevant records separately. This is the veteran’s opportunity to make sure that VA is looking at the evidence we want them to see.
It is common for the VA to send the veteran out for a new compensation and pension (C&P) examination once a claim for increased rating has been filed. The veteran must attend this examination, if scheduled, so that VA can evaluate for itself whether the veteran’s medical condition has worsened. The veteran may also, at this point, get a private medical examination to demonstrate that the disability has worsened.
Claims for increased rating can be tricky. It is important, for instance, to know what the requirements are for a higher rating under the applicable VA diagnostic codes. For example, many orthopedic disabilities, such as disabilities of the spine or knee, are rated on how much the disability limits the veteran’s range of motion. While pain is one of the symptoms which affects the veteran’s quality of life the most dramatically, VA does not consider whether the veteran’s pain is worse when determining whether the veteran is entitled to a higher disability rating for a spinal disability. Because of that, if a veteran bases his claim for increased rating solely on the fact that his pain has increased, he will probably not receive a higher rating. It is important, then, to know how to ask for an increased rating.
Considering the circumstances I have described above, where a veteran’s low back pain or knee pain has worsened dramatically but he is still able to bend just as much as he was before the pain increased, there may still be a way to ask for an increased rating. Under those facts, we might ask for an increased rating based on the fact that the veteran’s knee is now unstable and causes him to fall so that he is entitled to a separate rating for instability of the knee. Alternatively, we might ask for an increased rating for the veteran’s low back disability where the pain now causes him to miss so much work that he is now unemployable and entitled to a total rating based on his back disability. Veterans should familiarize themselves with the VA diagnostic codes governing their specific service-connected disabilities so that they know whether they are even entitled to an increased rating as well as how to ask for one. If you need help navigating the diagnostic codes, we can help.
One final note regarding claims for increased ratings–the VA regulations only allow VA to assign an effective date for the increase as far back as one year prior to filing the claim. In other words, once the veteran files the claim for increase, VA can look back at the evidence for the year prior to the claim to determine when the disability worsened and pay the veteran for that time. Don’t wait to file your claim, as you could be losing valuable benefits to which you are entitled.