What Is the VA 5-Year Rule for Disability? How It Protects Veterans’ Benefits

The VA disability 5-year rule is designed to protect veterans from having their disability ratings reduced without sufficient evidence of sustained improvement. According to this rule, once a veteran’s disability rating has been in place for five years, the U.S. Department of Veterans Affairs (VA) cannot reduce the rating unless there is clear evidence of significant and lasting improvement in the veteran’s condition. This ensures that veterans do not face unjust reductions to their disability benefits.

“The VA 5-year rule is a critical safeguard for veterans. It helps ensure stability in their benefits and provides peace of mind, especially when a disability rating has been in place for several years,” says Dr. Eric Miller, a veterans’ benefits expert.

Overview: VA Disability Rating Protections

Rule	Description	Key Points
VA 5-Year Rule	Protects ratings that have been in place for five years or more from reductions unless there is sustained improvement.	Prevents arbitrary reductions without evidence of sustained improvement.
VA 10-Year Rule	VA can reduce ratings after 10 years, but only if there is evidence of fraud or improvement.	VA cannot terminate benefits after 10 years without fraud.
VA 20-Year Rule (Continuous Ratings)	Service-connected conditions rated for 20 years or more are considered continuous, and cannot be reduced unless based on fraud.	Provides lifetime protection for long-term ratings.
Permanent and Total (P&T) Disability	Veterans rated 100% total and permanent are protected from reductions.	No future rating reductions for permanent conditions.
Veterans Over Age 55	Veterans over 55 are often protected from re-evaluations.	Case-by-case determination to prevent unnecessary changes in ratings.

How Does the VA Disability 5-Year Rule Help Veterans?

The 5-year rule aims to prevent arbitrary reductions of veterans’ disability ratings. Once a veteran has had a rating for five years or more, that rating is considered “stabilized” and cannot be reduced unless there is solid medical evidence of a sustained improvement in the veteran’s condition.

This rule eliminates the potential issue of veterans being reexamined unnecessarily, as long as their condition has remained stable. In cases where a veteran’s disability has not improved significantly, the VA cannot reduce their rating or discontinue their benefits.

Can VA Reduce a Rating After 5 Years?

The VA can only reduce a disability rating after five years if there is strong medical evidence showing that the veteran’s condition is steadily improving over time. This improvement must be confirmed through a Compensation and Pension (C&P) reexamination and must be deemed “sustained.”

Two conditions must be met for a reduction to occur after five years:

1. Evidence of Sustained Improvement: The VA must demonstrate that the improvement in the veteran’s condition is not temporary and that it is likely to continue.
2. Detailed Medical Records: The VA must provide supporting evidence from the veteran’s claims file, including medical records and C&P exam results, showing that the improvement is permanent.

“The key here is ‘sustained improvement.’ Temporary flare-ups or episodic improvements don’t qualify under this rule. The VA must show that the veteran’s improvement is likely to last,” explains Timothy Richards, a VA claims specialist.

Other Protected VA Disability Ratings

In addition to the 5-year rule, there are other protections that veterans should be aware of:

100% VA Ratings

If a veteran has a 100% disability rating, the VA cannot reduce this rating unless there is clear and convincing evidence that the veteran’s ability to function has significantly improved.

VA’s Disability 10-Year Rule

While the VA can reduce a veteran’s rating after 10 years, it can only fully terminate benefits in the case of fraud. This gives veterans some additional protection after a decade of receiving benefits.

VA’s Disability 20-Year Rule: Continuous Ratings

Service-connected conditions that are rated at or above a certain percentage for 20 years or more are considered continuous. Under the 20-year rule, the VA cannot reduce a veteran’s rating below its original level unless it was based on fraud. For instance, if a veteran was rated 50% for a disability, the rating must remain at least 50% for the rest of their life, even if the condition fluctuates over time.

Permanent and Total (P&T) Disability Ratings

Veterans who receive a Permanent and Total disability rating (100%) are protected from any future reductions. This status is granted when a veteran’s condition is unlikely to improve and is considered permanent.

Veterans Over Age 55

Veterans over the age of 55 are often exempt from rating re-evaluations, though this is determined on a case-by-case basis.

When Can VA Reduce a Disability Rating?

The VA can reduce a disability rating before the five-year mark if the condition is not considered “stabilized.” In these cases, veterans may be scheduled for a C&P exam to reassess their condition. This exam will evaluate the severity of the veteran’s symptoms and their impact on daily life. If there is evidence of improvement, the VA may propose a reduction.

The reduction process is governed by 38 CFR § 3.105(e), which stipulates that:

1. The veteran’s full medical history must be reviewed.
2. A thorough C&P examination must be conducted.
3. The VA must find sustained improvement in the veteran’s condition and ability to function in daily life.

It is important to note that improvements cannot be based on temporary factors such as rest or an episodic period of lessening symptoms.

Challenging a VA Rating Reduction

If the VA proposes a rating reduction, veterans are not without recourse. They will receive a notice of the proposed reduction and have 30 days to request a hearing and 60 days to submit new evidence.

If a veteran chooses to request a hearing, the VA cannot issue a final decision until the hearing takes place, which allows more time for the veteran to provide additional evidence. However, a hearing is not required to challenge a proposed reduction; new evidence can be submitted within the 60-day window.

If a reduction is finalized, veterans can appeal the decision by:

• Requesting a Higher-Level Review
• Submitting a Supplemental Claim
• Filing a Notice of Disagreement

“It’s important for veterans to know their rights in challenging a VA rating reduction. The appeal process can be complex, but having the right legal or claims support can help veterans navigate this challenge effectively,” says Rachel Greene, a veteran’s legal advocate.

Final Thought

The VA 5-year rule is an important safeguard for veterans who have a stable disability rating. It prevents unnecessary reductions and ensures that veterans receive the benefits they are entitled to, especially if their condition has remained consistent over time. Understanding this rule, along with the 10-year and 20-year protections, can help veterans confidently manage their disability benefits.

For Veterans:
Veterans should keep detailed medical records, attend scheduled C&P exams, and be aware of their rights to challenge any proposed rating reductions.

For the VA:
This rule is designed to ensure fairness in rating decisions and to prevent veterans from experiencing undue financial hardship due to reductions based on inaccurate assessments.

FAQs