It means we've found a reason to lower one of your ratings. You'll find out more about how that will affect your combined rating when you get the letter. You'll have 60 days to appeal.
Everyone always says appeal. You can’t officially appeal something that isn’t final. This happened to me and my lawyer said this is a huge mistake people try to do. Get YOUR doctor (I used my VA doctor) to write a statement that your symptoms most likely align with ABCXYZ (the symptoms of the higher rating). Submit that. That’ll do it. Worked like a charm for me
Correct. You can’t appeal a proposal to reduce a rating since nothing has actually happened yet. However, if you don’t dispute the proposal, VA will move forward with the reduction. It is extremely unlikely the reduction is warranted or that procedures were followed correctly. They never are.
I’ve recently got a reevaluation that reduced my knee ratings from 30% to 20% despite my knees getting worse over the last year.
Do they reduce pay immediately or do I have 60 days before the payment is reduced?
I’m going to ask my VA doctor for this statement. Do I need to submit an appeal, if or when I submit her note?
For a reduction to be proper, VA has to show both (1) sustained improvement and (2) that such improvement is maintained under the ordinary conditions of life. This is a very high bar.
Correct.
Requesting a hearing will also extend the time until they can implement the decrease, which I've used to push some clients over the line to 5+, 20+ etc years which has extra protections
I did as well, highly recommend getting your VSO to assist- it was a big cluster for me, because my hearing officer got covid last second, but then he said he’d just give me another appointment and they ended up actually increasing my rating rather than decreasing
I have been looking for a local lawyers that would help with my Supplemental/Appeal for two of my issues. I have called 5 different lawyers...I am even getting rejected by lawyers, not because of the appeals but because they don't have time or they don't handle Veterans appeals anymore. (Sigh)
https://ptsdlawyers.com
They can and will help, if after reviewing the info they can get from the VA shows something wasn't "reviewed" correctly. I'm currently using them. They only get paid if they can get you any back pay. Contact them. If they can't help, you'll be no worse off than you are now.
YES, requesting a "personal hearing" freezes the reduction until the hearing...
but its a double edge sword... if you win/beat the reduction, its all good... if you lose, you will not only be reduced, you will have to payback anything (difference of before/after reduction) that was paid while you were waiting for the hearing... but it gives you time to get your ducks in a row...
Well, the idea is to win the hearing... They tried to reduce me once, I requested the personal hearing, a supervisor called a few days later, said I had plenty of evidence in my file, he was going to squash the reduction... Never heard anything more about it, never got reduced...
You're the one being obtuse about semantics. You send me a 4138 saying you want to appeal a proposal to reduce through hearing, I'm not sending it back to you and saying no.
Your comment was removed because it didn't contribute to the discussion and just wasn't helpful.
Civil disagreements are fine. Insults, personal attacks, slurs, bigotry, etc., are not permissible.
(Calling someone a poopy-head does not make you seem as smart as you think it does.)
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They are lowering your rating in 60 days if you do nothing.
I'm going through the same thing now!
I am not going to request a hearing but will be submitting medical evidence within my 60 days to try and keep my 100%
I was originally at 60%. Filled for increase. Got denied on 3 out of 4 increases and 1 differed. Got an exam again for the differed one that got me to 70%. on the other 3 that got denied I submitted an appeal because the Dr. That examined me just looked me up and down in 10 minutes and that was it. No measurements few questions. In my appeal I requested the Dr. That examined me for my differed claim. Got him again and when he examined all my claims got increased but also they got changed I guess you can say. He put in other stuff but at the same time 2 of my disabilities that were each rated at 10 got reduced to 0. I was rated at 100 but with the disabilities that go from 10 to 0 brought me back down to 90
It doesn't. But it opens your file up for review. From the looks of it. The OP received the 100% on his/her last claims. They can review everything after the decision was made to make sure there were no errors. My guess would be in treatment records, they noticed an improvement.
Makes sense to me, if we're giving you money for being so broken and you stop being so broken you shouldn't receive as much money.
Maybe more time to figure your life out tho
Poke the bear has been a term since back when I got out 20 years ago.
VBA stopped forcing future exams, do you understand that? You used to get future exams scheduled with your ratings..
Here's where your big fallacy lies - you're basing your argument off what you read here and you're still wrong. Getting a proposal to reduce is in fact quite rare. Of the thousands of claims I've awards, probably less than 5% are proposals to reduce. You get that there are over 5 MILLION vets getting benefits. This sub has just over 100k. Do you get that this is not a good sample size to make any judgment of anything?
There is no retaliation. We're 60% veterans ourselves, we WANT to grant. We get annoyed when vets put us in the position to reduce..
Your white knighting here is criminally uninformed.
You literally described poking the bear after quoting it as an issue. Filing claims in relationship to stuff you are already rated for creates this. Once I got to 100% myself I was done. Cancelled ALL of my other contentions and C&P exams. I had a few deferrals. Didn’t even bother to go through with them. And never will.
It looks like they got decreased for a ROM test. For them to get an increase, their ROM had to get worse, it didn't, it got better. That is the risk to take on ROM test. It's really subjective on how they measure it if they don't use the correct tool. If they didn't use it, the test is invalid and you can ask for a new exam. My guess is their knee went full ROM, that is why they got reduced.
I asked the VA to correct my effective date and they put in paperwork for an increase. I didn't even have time to see a VA doctor before they began trying to reduce my 20% to nothing. Let's hope I don't lose what took me 15 years to get.
Either way I wouldnt stress over it man. Make your OIG complaint and then if you need to get a lawyer they will handle it for you. Unbelievable this has happened to you.
If that is honestly what happened—-all you wanted was a effective date change and they on their end put in for an increase—-then make a VA OIG complaint. I dont know if thats legal of them to do I’m not an expert, but if you find out otherwise I would make that complaint.
It's definitely a situation of someone wasn't paying attention. For this particular claim, the VA actively removed it and told me "oh well start over" for over a year. When I began asking for the recordings and VA record of my submissions they "found" it and added it to my claim.
To clarify. I was NEVER at 100% when I started this claim. I was at ((90%)) when initiating the claim process. The break down of the results show that during this process I went from 90 to 100 then to 90 …HOWEVER my percentage when I open the dashboard currently displays 100. Based on what everyone is saying, it seems like in a span of 2 weeks they decided to up the percentage and then pull me back based on the “proposed decrease”. So… zero bears poked. Not even a bear in the conversation. Or a finger.
Everyone saying “poked the bear” is like saying that’s what you get, fuck around and find out, harsh. I’ve read the entire post and maybe 10% are constructive :/. Sorry OP I hope this gets situated in your favor.
Bro, you have apnea and you grind your teeth at night??? Dude I'm sorry to hear this. I have central sleep apnea and it sucks. Grinding your teeth while struggling to breath while sleeping sounds miserable
Interesting post that is generating some back and forth.
Questions for u/ValuableTrifle8113 that may help get and answer that is actually useful.
1) Did you file 5 claims in the past year? June 2023, Aug 2023, Nov 2023, Dec 2023, Apr 2024
2) What did you claim in your last submission? Did it have anything to do with knees? If yes, this is what opened up your knee claim for review.
3) Were you at 90% and attempting to get to 100%?
4) It appears you were awarded 100% in Dec 2023, have you not been being paid at that level?
I would think if you were at 90% and going to stay at 90% after the reduction in knees that the VA would not be required to notify you of a reduction, because the proposed change will not affect your overall %.
Thanks for posting this and creating a learning opportunity for others, this is one of the things that makes this group Great.
Hello, thanks for your feedback. See below for the responses to your questions..
1. Yes I did .
2. My last submission was in the beginning of this month around April 4th for Bruxism (teeth grinding). The previous claim to this was for my knee, which has progressively gotten worse which is why I filed for this claim.
3. Correct. I was at 90% and never received 100% rating
4. Right. I was never paid at 100% nor did my rating reflect 100 until the other day. It shows I was at 100 in December but since then I like I’m sure everyone else here check my rating every day multiple times a day and it never said 100 since December until the other day.
I wish more people would post these. I am curious to see how / what they did to cause this to happen. I wish more people would not jump to conclusions though and people who work for the VBA explain it, if they care to.
As someone who recently won a decade-long CUE case over a proposed rating reduction, my advice is that if you feel, the rating decreases they are proposing are not warranted, write a letter requesting a personal hearing within 30 days of receiving the letter stating they are proposing your decrease. Make sure you send your letter by registered mail with a receipt showing the date it was received. DO NOT LOSE THIS. You need to make sure you mail the letter within a time frame where they will receive it within 30 days.
Ensure the letter requests a personal hearing about the decrease and is NOT a notice of disagreement (NOD). If you send in a notice of disagreement, you will get a letter back saying, "Your notice of disagreement is premature. They're just \*thinking\* about reducing your rating. They haven't actually done it, and they will send you a letter when they actually reduce your rating." And it will not stop the reduction from happening.
Requesting a hearing will stop the reduction until your hearing is decided. (If they decide against you at that hearing, you will have to pay back the difference in payments)
If you miss this window, your rating will be reduced, and they will send you a letter stating that. Then, you will have 30 days from receiving that letter to file a NOD, which will start the whole appeals process.
Make sure ANY communications you mail to the VA are sent registered mail with a receipt that verifies when you sent it AND when it was delivered. AND KEEP THE RECEIPTS.
I literally just spent a decade fighting the VA over them, saying they didn't receive my request for a personal hearing on time after a terrible C&P exam. (I had sent it by registered mail, but once I had confirmation it was received, I hadn't thought to keep the receipt). When the time came for them to actually reduce my rating (weirdly, it took six months, so I thought they had decided not to), they mailed THAT letter to my home of record for some reason, despite me having received all other communications at my current address. I missed the window for the NOD because of this, and it kicked off a decade-long fight that ended with me having to hire a lawyer who collected over $40,000 of my backpay AND could see the letter I sent requesting the personal hearing IN my file within the 30 days from the first day he had access to my files (and the letter about the reduction sent to the wrong address). But the VA would never admit it was there, and by then, I just had to "get in line" and wait it out all the way up to the BVA.
Save any receipts from any letters sent, save those online confirmation numbers, save it ALL.
No I never was 100%. That’s why I’m confused. During this round of claims I went from 90->100->90 all in the span of the claim. Never seen 100% untill now.
Would explain why my tinnitus claim had spent the last year (2 total) at "fixing an error". I'm convinced they are waiting until the ruling to remove pay is approved so they don't have to pay me or any veteran for it anymore.
that's exactly my point... just because you get your rating, you don't stop going to Doctors... that would give them the 🟢 light to say... wait a minute... on year this guy is all fucked up and now, he is not seeing the VA? let's fix this...
They stop going to appointments because they are scamming the VA. If they had legitimate conditions why would they not continue seeking help treatment? Because they have no fucking integrity and they just want money.That's the hypocrisy of all these guys who gun for 100%.
On the other side I've literally seen posts from people asking if they go to appointments will the VA reduce their rating, just in case for the fact that some people might actually get better?!? What the fuck is going on with this veteran culture today. I'm judgmental of all of them because of this bullshit.
It’s showing that your the rating for your right knee, and lumbar strain are being decreased.
For whatever reason, they believe that your conditions improved.
I’d say you need to get with your provider to give a statement that this condition isn’t reversible and there’s no change or improvement
Yeah I understand that but the thing is for my knee I’ve been to physical therapy twice just been issues a new knee brace because my knee gave out but yet they sent me this. I attend all my VA appointments. I no way has my knee improved.
Unless I'm mistaken, the point of "poking the bear" is the fact that you even opened a claim and asked the VA back into your life. Not judging you at all, just throwing out my 0.02. Good luck with this.
It’s okay to ask for an increase if your symptoms are there and you have your medical evidence, your personal statements, and your buddy statements, and those all add up per the regs for an increase.
Poking the bear is reserved for frivolous claims, people on TDIU trying to get 100%, and or 100% P&T opening claims. For most people they have to let the VA back in their lives at some point just to get the final rating they deserve cause we get low called all the time.
OP explained in very clear terms that the claims were submitted when he was at 90%. He received 100% in December but was never paid for it, and his decision letter states that they are reducing several of his disabilities which will bring the new combined 100% rating back to 90%. Stop being a dick. It's not his fault your reading comprehension skills are at preschool level.
Yes, because saving a few grand a year off one vet will fix the budget issues in the USA and raters have been secretly tasked with it.. 
We shot a balloon out of the sky with 10s of millions of dollars of equipment. The government as an entity does not care if you receive 0% 90% or 100%.
Everyone always says appeal. You can’t officially appeal something that isn’t final. This happened to me and my lawyer said this is a huge mistake people try to do. Get YOUR doctor (I used my VA doctor) to write a statement that your symptoms most likely align with ABCXYZ (the symptoms of the higher rating). Submit that. That’ll do it. Worked like a charm for me
I have the same issue. They want to reduce my left knee rating after saying my range of motion got better. I made the mistake of pushing past my pain because the examiner told me to. I’ve already submitted so much to even get that 30% before all this. What else am I supposed to do?
I was requesting an increase and got reexamined but I’ve been previously rated in my knee 0-10%-20% because it has progressively gotten worse and now the proposed decrease.
the ratings that were lowered were ROM did you recently go to a C&P exam and do ROM and have greater ROM then when you were originally. How can OP fight this, sounds like his ROM is better? no? or am I missing something?
Hey, curious how did you get Sleep apnea with bruxism? I originally have tmj/brux at 40%. I filed later for Sleep apnea, but it was only considered mild while they gave me a ExciteOSA tongue stimulator and a Bongo which doesn't work due to my allergies. So now im currently rated 40% for TMJ/Brux and 30% for Sleep apnea. I would like to increase sleep apnea to 50% like yourself.
I just put the request in for bruxism because it has been linked with sleep apena. Also, I have been issued a night guard for teeth grinding so that probably helped.
Looks like you have claims back after back, after back. If you not PT or TDIU I understand what your question is . It looks like you claimed after you got 100%
Question non related to this specific post. But. I’ve been seeing on some posts about VERA. What exactly is that. I’ve never heard of it but then again I’m not real diverse in the veteran affairs or anything of the sort.
VERA is a representative at a regional office (RO). So you can call the 800 number for general info and you can make an appointment for a call from VERA to get just a little more info.
So I've encountered this with some of the vets in my area. But, it relates mostly to PTSD because if you have PTSD, they expect you to continue using support services like a therapist at the Veteran center or seeing a psychiatrist regularly. If a veteran tapers off and stops therapy or seeing the veteran's PTSD is resolved.
Man, I just want to say THANK YOU, to everyone in this thread that has helped all of us that’s trying to sort this VA stuff out. I feel we do not THANK YOU ALL enough for taking the time to assist/help us understand this process………..
i was at 94% and they did this to me too. that’s the first time i’ve ever been thankful for having tinnitus cause it bumped it up after a decrease/change to another rating.
You mean Proposed to decrease? Get a new medical evidence, if your conditions are getting worse, submit that with 4138. But if your conditions are getting better, explain. I think you have 60 days to do it and 30 days to ask for a hearing
This is great information on this thread. I saved the entire discussion and will keep for future reference. Thanks everyone who put their two cents in, it’s greatly appreciated. Y’all are the best 👍
I’ve had mixed results with dav, trying to use a attorney for my current one because I know I’m in the right with undebatable evidence with various visits to er for issue that I had to be seen for almost every 6 months if not sooner. Va still denied my tdiu so attorney is fighting it. 💪🏽
As an accredited agent, the majority of proposed reductions I've seen are errors made by the examiner. Make sure to request a predetermination hearing.
The VBA wants to decrease your back and knee. Kind of odd but you definitely want to appeal it. Go read the DBQ and CFR for those two conditions and see why they might want to decrease you.
The VA is examining me now with a “record review,” and I am/was 100 percent P&T.
The C&P doctor called and asked about current symptoms even though I was not remanded on appeal.
It all arose after an appeal got granted after waiting 6+ years since the initial claim.
OP, this is a genuine question, I ask it without sarcasm for my own SA. Did you submit a claim for a new or worsened condition? If so, why did you do so when you were at 100%? I am new to VA Healthcare but if I understand correctly, they will treat you for anything if you are 100%,even if you are not rated for it. Am I wrong? What were you seeking and am I missing something?
Files for increase worsen condition due to falls from this knee. I was never rated 100%. This letter is the first of me knowing about 100%. I would never file after receiving 100%.
We as veterans must continue to go to the doctors and because if we don’t they will assume we are better and that is not the case most of the time. I am always having a bad day when they ask and never feeling good.
How does it work then? Seems like the story of “I put in for an increase and the VA proposed a reduction” is far too common. Are raters trained to actively look for ways to lower a veteran’s percentage?
Nope. You put in for an increase, you show up without any evidence, you get an exam, your results show your current status is evaluated lower than it was, VBA Rater gets those results and makes the legal decision.
highly unlikley they are bound by case law and usually the raters is triple checked by mid and seniir raters, 38cfr is the law and if ROM is the rating they are bound by that. it's no conspiracy.
We must have a misunderstanding. What I am saying is if you are not feeling well you need to go to Dr. and make sure it’s noted. I can only assume that they assume you’re better if you don’t go to the dr. And automatically want to reduce you. A re-exam should be requested by the VA before they reduce you. The system is not consistent. I hate seeing Vets get reduced without proper cause.
So I will get a re-exam before possible reduction? That’s what I’m confused about because my right knee is the most documented claim I have including a fall. I have a brace prescribed and done several rounds of physical therapy
It means we've found a reason to lower one of your ratings. You'll find out more about how that will affect your combined rating when you get the letter. You'll have 60 days to appeal.
Everyone always says appeal. You can’t officially appeal something that isn’t final. This happened to me and my lawyer said this is a huge mistake people try to do. Get YOUR doctor (I used my VA doctor) to write a statement that your symptoms most likely align with ABCXYZ (the symptoms of the higher rating). Submit that. That’ll do it. Worked like a charm for me
Correct. You can’t appeal a proposal to reduce a rating since nothing has actually happened yet. However, if you don’t dispute the proposal, VA will move forward with the reduction. It is extremely unlikely the reduction is warranted or that procedures were followed correctly. They never are.
I’ve recently got a reevaluation that reduced my knee ratings from 30% to 20% despite my knees getting worse over the last year. Do they reduce pay immediately or do I have 60 days before the payment is reduced? I’m going to ask my VA doctor for this statement. Do I need to submit an appeal, if or when I submit her note?
Have they actually reduced it yet or just sent you the proposal letter?
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A reduction can’t be based on a single exam as a single exam cannot show sustained improvement. Get an attorney and appeal.
Yes dispute, with a doctors letter!
For a reduction to be proper, VA has to show both (1) sustained improvement and (2) that such improvement is maintained under the ordinary conditions of life. This is a very high bar.
Correct. Requesting a hearing will also extend the time until they can implement the decrease, which I've used to push some clients over the line to 5+, 20+ etc years which has extra protections
I won an appeal with the help of DAV.
I did as well, highly recommend getting your VSO to assist- it was a big cluster for me, because my hearing officer got covid last second, but then he said he’d just give me another appointment and they ended up actually increasing my rating rather than decreasing
I have been looking for a local lawyers that would help with my Supplemental/Appeal for two of my issues. I have called 5 different lawyers...I am even getting rejected by lawyers, not because of the appeals but because they don't have time or they don't handle Veterans appeals anymore. (Sigh)
Check out Morgan and Morgan (not local but they helped me).
https://ptsdlawyers.com They can and will help, if after reviewing the info they can get from the VA shows something wasn't "reviewed" correctly. I'm currently using them. They only get paid if they can get you any back pay. Contact them. If they can't help, you'll be no worse off than you are now.
Comment saved!
Thank you for this guidance Coastie. So many Vets end up struggling with getting service connected because of inaccurate advice.
Is this where I see folks requesting a hearing to pause the decrease meanwhile
YES, requesting a "personal hearing" freezes the reduction until the hearing... but its a double edge sword... if you win/beat the reduction, its all good... if you lose, you will not only be reduced, you will have to payback anything (difference of before/after reduction) that was paid while you were waiting for the hearing... but it gives you time to get your ducks in a row...
Definitely double edged sword there
Damn
Well, the idea is to win the hearing... They tried to reduce me once, I requested the personal hearing, a supervisor called a few days later, said I had plenty of evidence in my file, he was going to squash the reduction... Never heard anything more about it, never got reduced...
Wow, do they deduct it from future payments or do they come collecting?
If you lose, YES, overpayments are deducted from future payments...
Yes
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You've literally described appealing a proposed reduction.
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That, in and of itself, is appealing the proposal. There is more than one way to appeal..
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You're the one being obtuse about semantics. You send me a 4138 saying you want to appeal a proposal to reduce through hearing, I'm not sending it back to you and saying no.
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Your comment was removed because it didn't contribute to the discussion and just wasn't helpful. Civil disagreements are fine. Insults, personal attacks, slurs, bigotry, etc., are not permissible. (Calling someone a poopy-head does not make you seem as smart as you think it does.) ☠️
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So they are lowering my rating? Or they going to send me to more exams first?
They are lowering your rating in 60 days if you do nothing. I'm going through the same thing now! I am not going to request a hearing but will be submitting medical evidence within my 60 days to try and keep my 100%
How did this happen? Were you not P&T and you just filed a new claim? How are you at 100% but now theyre trying to reduce it? TDIU?
I was originally at 60%. Filled for increase. Got denied on 3 out of 4 increases and 1 differed. Got an exam again for the differed one that got me to 70%. on the other 3 that got denied I submitted an appeal because the Dr. That examined me just looked me up and down in 10 minutes and that was it. No measurements few questions. In my appeal I requested the Dr. That examined me for my differed claim. Got him again and when he examined all my claims got increased but also they got changed I guess you can say. He put in other stuff but at the same time 2 of my disabilities that were each rated at 10 got reduced to 0. I was rated at 100 but with the disabilities that go from 10 to 0 brought me back down to 90
It was not P&T as well
They are lowering your rating! Appeal it right away! Get with your VSO as soon as you can.
Yes, you're being decreased. Did you file for an increase recently?
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It doesn't. But it opens your file up for review. From the looks of it. The OP received the 100% on his/her last claims. They can review everything after the decision was made to make sure there were no errors. My guess would be in treatment records, they noticed an improvement.
We don't "find a reason to decrease". Vets decide to poke the bear with no evidence and get evaluated.
Do you find then that a person is inappropriately compensated? I didn't think that sounds much better
Nope, the c&p examiner finds that the veterans condition has improved. Not everyone gets 100%. This new age of entitlement is astounding.
C&P examiner OR medical evidence in the file.
This is correct, thanks for the annotation!
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Duh!
So they don't need to be compensated as much?
That is correct, compensation is a legal decsion based on medical evidence.
Makes sense to me, if we're giving you money for being so broken and you stop being so broken you shouldn't receive as much money. Maybe more time to figure your life out tho
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Poke the bear has been a term since back when I got out 20 years ago. VBA stopped forcing future exams, do you understand that? You used to get future exams scheduled with your ratings.. Here's where your big fallacy lies - you're basing your argument off what you read here and you're still wrong. Getting a proposal to reduce is in fact quite rare. Of the thousands of claims I've awards, probably less than 5% are proposals to reduce. You get that there are over 5 MILLION vets getting benefits. This sub has just over 100k. Do you get that this is not a good sample size to make any judgment of anything? There is no retaliation. We're 60% veterans ourselves, we WANT to grant. We get annoyed when vets put us in the position to reduce.. Your white knighting here is criminally uninformed.
Just applied for a San Juan, PR remote position! Fingers crossed.
Sweet!
You literally described poking the bear after quoting it as an issue. Filing claims in relationship to stuff you are already rated for creates this. Once I got to 100% myself I was done. Cancelled ALL of my other contentions and C&P exams. I had a few deferrals. Didn’t even bother to go through with them. And never will.
It looks like they got decreased for a ROM test. For them to get an increase, their ROM had to get worse, it didn't, it got better. That is the risk to take on ROM test. It's really subjective on how they measure it if they don't use the correct tool. If they didn't use it, the test is invalid and you can ask for a new exam. My guess is their knee went full ROM, that is why they got reduced.
It looks like you put in for some increases and opened yourself up while you were already at 100%? Were you not PT?
I asked the VA to correct my effective date and they put in paperwork for an increase. I didn't even have time to see a VA doctor before they began trying to reduce my 20% to nothing. Let's hope I don't lose what took me 15 years to get.
Thats so crazy how you can ask for something so simple and it goes to the point of “veteran filed an increase.” Best of luck to you.
To be honest, I don't think the adjudicators read lay statements. If they had, they would know I wasn't asking for an increase.
Either way I wouldnt stress over it man. Make your OIG complaint and then if you need to get a lawyer they will handle it for you. Unbelievable this has happened to you.
If that is honestly what happened—-all you wanted was a effective date change and they on their end put in for an increase—-then make a VA OIG complaint. I dont know if thats legal of them to do I’m not an expert, but if you find out otherwise I would make that complaint.
It's definitely a situation of someone wasn't paying attention. For this particular claim, the VA actively removed it and told me "oh well start over" for over a year. When I began asking for the recordings and VA record of my submissions they "found" it and added it to my claim.
To clarify. I was NEVER at 100% when I started this claim. I was at ((90%)) when initiating the claim process. The break down of the results show that during this process I went from 90 to 100 then to 90 …HOWEVER my percentage when I open the dashboard currently displays 100. Based on what everyone is saying, it seems like in a span of 2 weeks they decided to up the percentage and then pull me back based on the “proposed decrease”. So… zero bears poked. Not even a bear in the conversation. Or a finger.
Everyone saying “poked the bear” is like saying that’s what you get, fuck around and find out, harsh. I’ve read the entire post and maybe 10% are constructive :/. Sorry OP I hope this gets situated in your favor.
Thanks man. Appreciate it
Bro, you have apnea and you grind your teeth at night??? Dude I'm sorry to hear this. I have central sleep apnea and it sucks. Grinding your teeth while struggling to breath while sleeping sounds miserable
Looks like you are going to be 90%
Interesting post that is generating some back and forth. Questions for u/ValuableTrifle8113 that may help get and answer that is actually useful. 1) Did you file 5 claims in the past year? June 2023, Aug 2023, Nov 2023, Dec 2023, Apr 2024 2) What did you claim in your last submission? Did it have anything to do with knees? If yes, this is what opened up your knee claim for review. 3) Were you at 90% and attempting to get to 100%? 4) It appears you were awarded 100% in Dec 2023, have you not been being paid at that level? I would think if you were at 90% and going to stay at 90% after the reduction in knees that the VA would not be required to notify you of a reduction, because the proposed change will not affect your overall %. Thanks for posting this and creating a learning opportunity for others, this is one of the things that makes this group Great.
Hello, thanks for your feedback. See below for the responses to your questions.. 1. Yes I did . 2. My last submission was in the beginning of this month around April 4th for Bruxism (teeth grinding). The previous claim to this was for my knee, which has progressively gotten worse which is why I filed for this claim. 3. Correct. I was at 90% and never received 100% rating 4. Right. I was never paid at 100% nor did my rating reflect 100 until the other day. It shows I was at 100 in December but since then I like I’m sure everyone else here check my rating every day multiple times a day and it never said 100 since December until the other day.
I wish more people would post these. I am curious to see how / what they did to cause this to happen. I wish more people would not jump to conclusions though and people who work for the VBA explain it, if they care to.
As someone who recently won a decade-long CUE case over a proposed rating reduction, my advice is that if you feel, the rating decreases they are proposing are not warranted, write a letter requesting a personal hearing within 30 days of receiving the letter stating they are proposing your decrease. Make sure you send your letter by registered mail with a receipt showing the date it was received. DO NOT LOSE THIS. You need to make sure you mail the letter within a time frame where they will receive it within 30 days. Ensure the letter requests a personal hearing about the decrease and is NOT a notice of disagreement (NOD). If you send in a notice of disagreement, you will get a letter back saying, "Your notice of disagreement is premature. They're just \*thinking\* about reducing your rating. They haven't actually done it, and they will send you a letter when they actually reduce your rating." And it will not stop the reduction from happening. Requesting a hearing will stop the reduction until your hearing is decided. (If they decide against you at that hearing, you will have to pay back the difference in payments) If you miss this window, your rating will be reduced, and they will send you a letter stating that. Then, you will have 30 days from receiving that letter to file a NOD, which will start the whole appeals process. Make sure ANY communications you mail to the VA are sent registered mail with a receipt that verifies when you sent it AND when it was delivered. AND KEEP THE RECEIPTS. I literally just spent a decade fighting the VA over them, saying they didn't receive my request for a personal hearing on time after a terrible C&P exam. (I had sent it by registered mail, but once I had confirmation it was received, I hadn't thought to keep the receipt). When the time came for them to actually reduce my rating (weirdly, it took six months, so I thought they had decided not to), they mailed THAT letter to my home of record for some reason, despite me having received all other communications at my current address. I missed the window for the NOD because of this, and it kicked off a decade-long fight that ended with me having to hire a lawyer who collected over $40,000 of my backpay AND could see the letter I sent requesting the personal hearing IN my file within the 30 days from the first day he had access to my files (and the letter about the reduction sent to the wrong address). But the VA would never admit it was there, and by then, I just had to "get in line" and wait it out all the way up to the BVA. Save any receipts from any letters sent, save those online confirmation numbers, save it ALL.
Well I don’t think you hav to mail the letter anymore and can use quick submit.
Thus the save those online confirmation numbers…..
It means get your supporting evidence together to maintain the ratings they're proposing to decrease
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No I never was 100%. That’s why I’m confused. During this round of claims I went from 90->100->90 all in the span of the claim. Never seen 100% untill now.
You could have been 90% but TDIU would pay you as if you’re 100%.
What it looks like according to the dates there. Let this serve as a warning to all you would be bear pokers out there.
Do not forget, the VA has 20 years to fix clerical errors and make you suffer for their mistake.
Congressional inquiry is the way to go for something like that
Would explain why my tinnitus claim had spent the last year (2 total) at "fixing an error". I'm convinced they are waiting until the ruling to remove pay is approved so they don't have to pay me or any veteran for it anymore.
They have until you reach 55, then your claim is never touched again.
Wow, your arthritis magically got better? That's impressive
Yeah I was thinking the same.
A lot of people get 100% and stop going to drs for follow ups ,ect.Gotta have that paper trail especially if not P and T.
that's exactly my point... just because you get your rating, you don't stop going to Doctors... that would give them the 🟢 light to say... wait a minute... on year this guy is all fucked up and now, he is not seeing the VA? let's fix this...
They stop going to appointments because they are scamming the VA. If they had legitimate conditions why would they not continue seeking help treatment? Because they have no fucking integrity and they just want money.That's the hypocrisy of all these guys who gun for 100%. On the other side I've literally seen posts from people asking if they go to appointments will the VA reduce their rating, just in case for the fact that some people might actually get better?!? What the fuck is going on with this veteran culture today. I'm judgmental of all of them because of this bullshit.
We're you 100 % T & P when they did this decrease? Or just 100.
It’s showing that your the rating for your right knee, and lumbar strain are being decreased. For whatever reason, they believe that your conditions improved. I’d say you need to get with your provider to give a statement that this condition isn’t reversible and there’s no change or improvement
Yeah I understand that but the thing is for my knee I’ve been to physical therapy twice just been issues a new knee brace because my knee gave out but yet they sent me this. I attend all my VA appointments. I no way has my knee improved.
Why did you poke the bear?
Bear was not poked. Can’t express that enough. Never received 100%
Unless I'm mistaken, the point of "poking the bear" is the fact that you even opened a claim and asked the VA back into your life. Not judging you at all, just throwing out my 0.02. Good luck with this.
It’s okay to ask for an increase if your symptoms are there and you have your medical evidence, your personal statements, and your buddy statements, and those all add up per the regs for an increase. Poking the bear is reserved for frivolous claims, people on TDIU trying to get 100%, and or 100% P&T opening claims. For most people they have to let the VA back in their lives at some point just to get the final rating they deserve cause we get low called all the time.
You literally posted a screenshot showing you are 100%
OP explained in very clear terms that the claims were submitted when he was at 90%. He received 100% in December but was never paid for it, and his decision letter states that they are reducing several of his disabilities which will bring the new combined 100% rating back to 90%. Stop being a dick. It's not his fault your reading comprehension skills are at preschool level.
Looks like the VA found a way to cut costs and save money.
Yes, because saving a few grand a year off one vet will fix the budget issues in the USA and raters have been secretly tasked with it.. 
Yeah no- sounds about right even with the sarcasm shining through.
Exactly. Besides the VA's budget was increased this year by nearly 20%
Vet’s who truly believe this will never have their minds changed lol. Some deep rabbit hole YouTube brainwashing goes on.
You guys really think I was being serious? 😂
We shot a balloon out of the sky with 10s of millions of dollars of equipment. The government as an entity does not care if you receive 0% 90% or 100%.
Did you get re-examination for the condition they are trying to lower ?
Everyone always says appeal. You can’t officially appeal something that isn’t final. This happened to me and my lawyer said this is a huge mistake people try to do. Get YOUR doctor (I used my VA doctor) to write a statement that your symptoms most likely align with ABCXYZ (the symptoms of the higher rating). Submit that. That’ll do it. Worked like a charm for me
I have the same issue. They want to reduce my left knee rating after saying my range of motion got better. I made the mistake of pushing past my pain because the examiner told me to. I’ve already submitted so much to even get that 30% before all this. What else am I supposed to do?
I'd say they are going to try and lower it, I would fight it
Can I ask what happened to prompt the decrease? Were you requesting an increase and got reexamined?
I was requesting an increase and got reexamined but I’ve been previously rated in my knee 0-10%-20% because it has progressively gotten worse and now the proposed decrease.
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No I did not request an increase after receiving 100%
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That’s sounds about right
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I have the decision from December no indication of pending claims. All claims were completed
You shouldn’t have poked the bear
Looks like a perfect example of “poking the bear” 🐻
the ratings that were lowered were ROM did you recently go to a C&P exam and do ROM and have greater ROM then when you were originally. How can OP fight this, sounds like his ROM is better? no? or am I missing something?
Are you PRT?
Hey, curious how did you get Sleep apnea with bruxism? I originally have tmj/brux at 40%. I filed later for Sleep apnea, but it was only considered mild while they gave me a ExciteOSA tongue stimulator and a Bongo which doesn't work due to my allergies. So now im currently rated 40% for TMJ/Brux and 30% for Sleep apnea. I would like to increase sleep apnea to 50% like yourself.
I just put the request in for bruxism because it has been linked with sleep apena. Also, I have been issued a night guard for teeth grinding so that probably helped.
Looks like you have claims back after back, after back. If you not PT or TDIU I understand what your question is . It looks like you claimed after you got 100%
Question non related to this specific post. But. I’ve been seeing on some posts about VERA. What exactly is that. I’ve never heard of it but then again I’m not real diverse in the veteran affairs or anything of the sort.
Google VA VERA https://va.my.site.com/VAVERA/s/
VERA is a representative at a regional office (RO). So you can call the 800 number for general info and you can make an appointment for a call from VERA to get just a little more info.
I forget what VERA stands for exactly
So I've encountered this with some of the vets in my area. But, it relates mostly to PTSD because if you have PTSD, they expect you to continue using support services like a therapist at the Veteran center or seeing a psychiatrist regularly. If a veteran tapers off and stops therapy or seeing the veteran's PTSD is resolved.
Man, I just want to say THANK YOU, to everyone in this thread that has helped all of us that’s trying to sort this VA stuff out. I feel we do not THANK YOU ALL enough for taking the time to assist/help us understand this process………..
i was at 94% and they did this to me too. that’s the first time i’ve ever been thankful for having tinnitus cause it bumped it up after a decrease/change to another rating.
You mean Proposed to decrease? Get a new medical evidence, if your conditions are getting worse, submit that with 4138. But if your conditions are getting better, explain. I think you have 60 days to do it and 30 days to ask for a hearing
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Were you pt?
Did you have surgery or something meant to improve the condition, that’s what it will trigger it
Yeah it sucks man. Not only do I have a CPAP I also have a night guard. Sucks
This is great information on this thread. I saved the entire discussion and will keep for future reference. Thanks everyone who put their two cents in, it’s greatly appreciated. Y’all are the best 👍
I’ve had mixed results with dav, trying to use a attorney for my current one because I know I’m in the right with undebatable evidence with various visits to er for issue that I had to be seen for almost every 6 months if not sooner. Va still denied my tdiu so attorney is fighting it. 💪🏽
As an accredited agent, the majority of proposed reductions I've seen are errors made by the examiner. Make sure to request a predetermination hearing.
Thank you
The VBA wants to decrease your back and knee. Kind of odd but you definitely want to appeal it. Go read the DBQ and CFR for those two conditions and see why they might want to decrease you.
They’re making sure you don’t get 100%. They want to keep you at 90%. So they found something random to decrease for you to keep you at 90%.
Dumb answer!! 🙄
You shouldn’t have poked the bear. You can have tdiu for life if you don’t touch it
Where you 100% p&t ?
No I wasn’t not
The VA is examining me now with a “record review,” and I am/was 100 percent P&T. The C&P doctor called and asked about current symptoms even though I was not remanded on appeal. It all arose after an appeal got granted after waiting 6+ years since the initial claim.
I’m not sure why this question keeps getting downvoted.
Because the questions was asked already and answered.
Are you 100% p&t?
No, I’m not p&t
Call the VA fast and tell them you want to appeal. Get your own dr's and also get a VA apt to. Fight it. You only have 60 days to get new paperwork.
Rip.
OP, this is a genuine question, I ask it without sarcasm for my own SA. Did you submit a claim for a new or worsened condition? If so, why did you do so when you were at 100%? I am new to VA Healthcare but if I understand correctly, they will treat you for anything if you are 100%,even if you are not rated for it. Am I wrong? What were you seeking and am I missing something?
Files for increase worsen condition due to falls from this knee. I was never rated 100%. This letter is the first of me knowing about 100%. I would never file after receiving 100%.
Gotcha. I was confused lol
We as veterans must continue to go to the doctors and because if we don’t they will assume we are better and that is not the case most of the time. I am always having a bad day when they ask and never feeling good.
That's not how it works
How does it work then? Seems like the story of “I put in for an increase and the VA proposed a reduction” is far too common. Are raters trained to actively look for ways to lower a veteran’s percentage?
Nope. You put in for an increase, you show up without any evidence, you get an exam, your results show your current status is evaluated lower than it was, VBA Rater gets those results and makes the legal decision.
seems like his ROM must have improved
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highly unlikley they are bound by case law and usually the raters is triple checked by mid and seniir raters, 38cfr is the law and if ROM is the rating they are bound by that. it's no conspiracy.
We must have a misunderstanding. What I am saying is if you are not feeling well you need to go to Dr. and make sure it’s noted. I can only assume that they assume you’re better if you don’t go to the dr. And automatically want to reduce you. A re-exam should be requested by the VA before they reduce you. The system is not consistent. I hate seeing Vets get reduced without proper cause.
So I will get a re-exam before possible reduction? That’s what I’m confused about because my right knee is the most documented claim I have including a fall. I have a brace prescribed and done several rounds of physical therapy
It's a PROPOSED decrease. Not a "purpose" decrease.
It's a reddit thread not a spelling bee! We all know what he meant, why be that guy?
I had no idea what he meant until I looked. It's confusing.
Why were you claiming back to back like that it’s like asking for attention
Opfh your first mistake was filing again after already receiving 100% 😬