As former service men and women, we’re also battle-hardened veterans of bureaucratic warfare – – it’s just a function of life in the military.
“Back in the Day”….back when we were in the military …. we had a real interest in fulfilling the training or supply requirements of our units and our higher-ups had a requirement to provide those resources.
Of course, every once in a while, we would come across the Admin or Training Chief who acted as if the money to buy Skilcraft pens – remember those things – was coming out of his/her own pocket.
The VA is no different.
On one hand, it has a legitimate function of verifying that your VA Disability Claim meets the requirements set forth by law before granting a service-connected disability rating.
On the other hand, there are some folks at the VA that act like THEY are having to pay your benefits out of their paycheck.
Most often, I see this mentality when a Veteran has a claim for service connection of a disability or injury from military service, but is getting treatment for that condition.
There is a group of raters who believe that PTSD is cured when you get treatment, that you aren’t disabled if you are taking insulin for diabetes, or that sleep apnea is gone once you start using a CPAP.
The problem is, a lot of Veterans believe them, because it sounds pretty reasonable.
However, the law is not always written this way – and sometimes, for good reason. PTSD is not cured. Sleep Apnea rarely goes away, and its hard to reverse diabetes once your kidneys start to fail.
The VA has a responsibility to Help you Get the Highest Supportable Rating in Your VA Disability Claim.
Just like your old chain-of-command in the military had a responsibility to help you get the resources you needed to accomplish your mission as a soldier, the VA also has a responsibility to assist you in proving the highest lawful rate that you are entitled to.
Having said that, every once in a while, you run across a rating official who is looking for reasons to deny or reduce your claim rather than reasons to grant what you rate.
VA Raters May Try to Reduce Your Rating Due to the Medicines You Take.
Can the VA consider whether your medications are providing some relief when determining your degree of disability?
The issue was settled by a 2012 decision of the Court of Appeals for Veterans Claims, and in general, the answer is no.
As most of you know, the very first step for any VA disability claim is that you have to be able to show that you suffer from a “current disability.”
Of course, HOW you try to show the elements of “service-connection” can often be the difference between a grant and a denial of a claim.
Once you’ve established a service connection for your current disability, the VA Regional Office will compare the symptoms and impact of that condition (using your medical records and examinations) to the criteria listed in the VA Schedule of Disability Ratings.
By law, when determining the percentage for your rating the VA can only consider the criteria contained in the Diagnostic Code for the given disability – – to do otherwise is error.
Unless the effects of medications are specifically included in the impairment rating criteria for your condition, the VA is NOT allowed to consider whether a particular medication moderates a Veteran’s condition in determining the degree of disability.
It’s that simple.
Let’s take a look at a Sample VA Disability Claim:
As an example, say a Veteran has been able to service-connect Irritable Bowel Syndrome (DC 7319).
Undiagnosed, the symptoms of IBS might be a component of Gulf War Illness
With prescribed medication, our hypothetical Veteran’s condition moderates from a severe form of the disease to a milder form.
The severe form of IBS is rated at 30% and the moderate form of IBS is rated by the VA at 10%.
Let’s say the VA gives the Vet a rating of 10%, claiming that the Veteran’s medication limits her symptoms.
Is that 10% rating correct?
No . The Diagnostic Criteria in the VA Rating Schedule for Irritable Bowel Syndrome does not specifically list the effects of medication.
Therefore, the VA is not allowed to consider the relief it provides when determining the degree of disability.
Has this happened to you?
When have you seen the VA use “improvement due to medication” as an excuse to give a lower rating?