FROM THE BRIDGE-
How are Veterans Disability Benefits Originally Determined?
Upon first application for veterans benefits, the veteran must meet certain criteria: the veteran must currently have a medically diagnosed disease or disability, and the current injury or disease be “service-connected”, meaning that it was incurred or aggravated in the line of active duty in the military, naval or air service. The veteran must provide an application and supporting documentation. At that time the Department of Veterans Affairs (VA) will make a determination as to whether or not the veteran qualifies for disability compensation, and, if so, determine the degree of disability the veteran has suffered in ten percent increments, ranging from 10% to 100% disabled.
How Long Do Disability Benefits Continue?
After the VA has made its original determination, the monetary benefits continue to be paid to the veteran as long as the disability continues. In certain circumstances, a veteran’s disability may be re-evaluated or re-examined, after which the disability rating may be increased, decreased or remain the same.
If a veteran receiving disability benefits develops a new disability or disease that is connected to their service, or finds their condition worsening, they may file VA Form 21-4138, requesting a new evaluation. At that time, the VA may increase the veteran’s disability rating and therefore increase the compensation.
When Does The VA Re-Evaluate Disability Cases?
The VA may require medical re-examination of the veteran six months after leaving service, and then again between two and five years later, in order that the VA can verify either the continued existence or the concurrent severity of a disability. The VA will require re-examinations in cases where it is likely that a disability has improved or if evidence indicates there has been a material change in a disability or that the current rating may be incorrect. If there is significant improvement to the veteran’s health, the VA may choose to re-evaluate the disability and then assign a lower disability percentage rating and lower the amount of benefits. The VA may also determine that the disease or disability no longer exists, and the benefits may be discontinued.
Permanent or Long-Term Disabilities:
In cases where the disability was determined at the outset to be static, or permanent, or if the disability has not improved in five years and is not likely to improve, the VA is not likely to require a re-examination. Likewise, if the veteran is over the age of 55 or if a re-examination would not change the veteran’s current rating, then a re-examination would not be scheduled.
If a veteran has had the same disability for five years or more, their rating should not be lowered unless a wide and comprehensive examination of all medical records and history concludes that “sustained improvement has been demonstrated”.
If a veteran has a 100% disabled rating-also known as “totally disabled”-this rating cannot be reduced unless there is a medical examination that shows “material improvement” in the veteran’s physical or mental condition. The VA may also look at whether or not the veteran is able to work or maintain employment for 12 consecutive months or more, or their employability is otherwise proven on clear and convincing evidence. In such cases, a rating of “totally disabled” may be reduced. (However, if the veteran’s work is for vocational rehabilitation, education or training, or if the job uses mental demands rather than physical, when the disability is physical, than a reduced rating may not occur.)
If a veteran has been deemed to have permanent and total disability and has been receiving disability benefits for twenty years or more, their benefits cannot be reduced. If the veteran’s disability is less than permanent and total, and the veteran has been receiving disability benefits for twenty years or more, and upon re-examination by the VA the veteran’s disability rating is lowered, the amount of compensation will not drop below the original level. For example, if the veteran has been deemed to be 40% disabled for a period of twenty continuous years or more and is then re-evaluated to be only 30% disabled, the amount of their benefits will not drop below 40% compensation rate.
Is It Possible for a Veteran To Lose Disability Benefits?
In certain circumstances (in addition to no longer being disabled), a veteran can lose their disability benefits. First, if a veteran makes a fraudulent statement, affidavit, or claim in order to obtain disability benefits, they forfeit all rights to receive such benefits. (Benefits may still be paid to the veteran’s spouse, children, and parents, however.)
If a veteran receives or accepts disability payments that they are not entitled to, with the intent to defraud the government, they will likely lose their disability benefits, and may also be subject to imprisonment or fine.
If a veteran commits treason, mutiny, or sabotage, or assists an enemy of the United States, they forfeits their right to veteran’s benefits, including disability benefits.
Any veteran who is incarcerated for more than 60 days in a federal or state prison or other correctional facility due to a felony or conviction will not receive disability benefits after the sixtieth day of incarceration until release from incarceration, or will receive a lower amount of compensation.
If the veteran is a fugitive felon (meaning that they are fleeing to avoid prosecution or incarceration), they will not receive disability benefits for the period during which they are a fugitive felon.
Can a Veteran Voluntarily Choose to Stop Receiving Disability Benefits?
A veteran entitled to disability benefits may voluntarily renounce their right to benefits by doing so in a written, signed application.
Lehigh Valley Health Network-Veteran Health