VA reduced final rating from proposed rating

S

shadow4

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On 31 DEC 2012 I was medically retired from the Army after 14 years of service with a 100% proposed rating:

Menieres 100%
PTSD 50%

On 20 June 2013 The VA made a final decision with a combined rating of 70%

Menieres 30%
PTSD 50%
Hearing loss 0%

I feel I should have the 100% for Menieres as I meet the rating criteria. I have recently failed college courses do to being in bed or problems with Menieres and not being able to complete the course work on time. I also have not found employment or feel stable enough to work full time. Social Security also agreed that my condition is severe and awarded SSDI. Has anybody had this situation where the final award was reduced from the proposed this much? Should I request an increase for Menieres or instantly appeal the decision?
 
If you request an increase you would have to send them new evidence that your condition is worse
 
shadow4 said:
On 31 DEC 2012 I was medically retired from the Army after 14 years of service with a 100% proposed rating:

Menieres 100%
PTSD 50%

On 20 June 2013 The VA made a final decision with a combined rating of 70%

Menieres 30%
PTSD 50%
Hearing loss 0%

I feel I should have the 100% for Menieres as I meet the rating criteria. I have recently failed college courses do to being in bed or problems with Menieres and not being able to complete the course work on time. I also have not found employment or feel stable enough to work full time. Social Security also agreed that my condition is severe and awarded SSDI. Has anybody had this situation where the final award was reduced from the proposed this much? Should I request an increase for Menieres or instantly appeal the decision?
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Based upon the information provided, I would suggest that you request a DoVA rate increase initially since the turn-around time is potentially much less than submittal of an official appeal via the DoVA Notice of Disagreement (NOD) process.

If the objective medical evidence within your service/VA treatment record showed improvement prior to the adjudication of the final DoVA rating, then an individual shall receive a decreased final rating.

If I may ask, when were you officially awarded SSA SSDI compensation? Was your award of SSA SSDI compensation prior to the official award of your DoVA final rating? Moreover, what was the SSA SSDI award based on as the primary diagnosis and secondary diagnosis? What did SSA DDS state were the medically determinable impairments and its severity?

With that all said, you will need to overwhelmingly prove via objective medical evidence and/or documentation that your “Menieres” disease medical condition meets the VASRD criteria which you seek whether by DoVA rate increase request or official DoVA appeal process.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
shadow4 said:
On 31 DEC 2012 I was medically retired from the Army after 14 years of service with a 100% proposed rating:

Menieres 100%
PTSD 50%

On 20 June 2013 The VA made a final decision with a combined rating of 70%

Menieres 30%
PTSD 50%
Hearing loss 0%

I feel I should have the 100% for Menieres as I meet the rating criteria. I have recently failed college courses do to being in bed or problems with Menieres and not being able to complete the course work on time. I also have not found employment or feel stable enough to work full time. Social Security also agreed that my condition is severe and awarded SSDI. Has anybody had this situation where the final award was reduced from the proposed this much? Should I request an increase for Menieres or instantly appeal the decision?
Click to expand...

Did the VA explain why the Meniere's rating was reduced. I have also been awarded 100% for Meniere's but I am waiting for my official ratings. Did the VA request anymore medical documents before the final rating was issued.
 
If they reduced it they had to feel as if his condition could progress, idk if everyone's conditions had notes added to them but I know with my conditions it was noted that pretty much I've exahausted rehabilitation without progression(injuries are permanent)
 
Also when they finalize ratings they go into more depth when they review them again after proposed
 
Warrior644 said:
Based upon the information provided, I would suggest that you request a DoVA rate increase initially since the turn-around time is potentially much less than submittal of an official appeal via the DoVA Notice of Disagreement (NOD) process.

If the objective medical evidence within your service/VA treatment record showed improvement prior to the adjudication of the final DoVA rating, then an individual shall receive a decreased final rating.

If I may ask, when were you officially awarded SSA SSDI compensation? Was your award of SSA SSDI compensation prior to the official award of your DoVA final rating? Moreover, what was the SSA SSDI award based on as the primary diagnosis and secondary diagnosis? What did SSA DDS state were the medically determinable impairments and its severity?

With that all said, you will need to overwhelmingly prove via objective medical evidence and/or documentation that your “Menieres” disease medical condition meets the VASRD criteria which you seek whether by DoVA rate increase request or official DoVA appeal process.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
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I have not had any appointments or more treatment prior to or since the final adjudication of the final DoVA rating. I was officially awarded SSDI prior to the final DoVA rating which was based on Meniere's.
 
jdjohnson said:
Did the VA explain why the Meniere's rating was reduced. I have also been awarded 100% for Meniere's but I am waiting for my official ratings. Did the VA request anymore medical documents before the final rating was issued.
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No they did not request any more documents or appointments but case when from pending decision to review 4 times.
 
From your proposed ratings to your official, what's the difference in the VA description/evaluation of your condition? What's the wording?

First thing I would do is call the VA to inquire about this just to make sure it's not some type of clerical error or something like that--anything is possible, a decrease of 70% is pretty extreme.
 
ceilingfan said:
From your proposed ratings to your official, what's the difference in the VA description/evaluation of your condition? What's the wording?

First thing I would do is call the VA to inquire about this just to make sure it's not some type of clerical error or something like that--anything is possible, a decrease of 70% is pretty extreme.
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Better off calling DAV, calling the 1800 # is a waste of time, all they can do is read him what he already see
 
Warrior644 said:
Based upon the information provided, I would suggest that you request a DoVA rate increase initially since the turn-around time is potentially much less than submittal of an official appeal via the DoVA Notice of Disagreement (NOD) process.

If the objective medical evidence within your service/VA treatment record showed improvement prior to the adjudication of the final DoVA rating, then an individual shall receive a decreased final rating.

If I may ask, when were you officially awarded SSA SSDI compensation? Was your award of SSA SSDI compensation prior to the official award of your DoVA final rating? Moreover, what was the SSA SSDI award based on as the primary diagnosis and secondary diagnosis? What did SSA DDS state were the medically determinable impairments and its severity?

With that all said, you will need to overwhelmingly prove via objective medical evidence and/or documentation that your “Menieres” disease medical condition meets the VASRD criteria which you seek whether by DoVA rate increase request or official DoVA appeal process.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
Click to expand...
shadow4 said:
I have not had any appointments or more treatment prior to or since the final adjudication of the final DoVA rating. I was officially awarded SSDI prior to the final DoVA rating which was based on Meniere's.
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In my opinion, one possible senario is as follows...

Unfortunately, it seems that the DoVA potentially viewed your non-continuation of appointments and/or treatments as an improvement in the severity of your meniere's disease/syndrome since the adjudication of your final DoVA rating.

Moreover, there seems to not exist any continuation of objective medical evidence and/or documentation within your VA/service treatment record prior to the adjudication of the final DoVA rating to support the "hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus" VASRD criteria for a 100% rating.

Therefore, the DoVA potentially lowered their evaluation in support of the "hearing impairment with vertigo less than once a month, with or without tinnitus" VASRD criteria for a 30% rating due to the lack of supportive objective medical evidence and/or documentation.

But, the encouraging news is that your Meniere's based award of SSA SSDI compensation occurred during the finalization period of your DoVA rating and can potentially be viewed as new evidence for either a VARR request submittal (while still on Active Duty) or a DoVA NOD appeal (as a military veteran).

To that extent, it’s in your best interest to also submit any new objective medical evidence and/or documentation procured (after receipt of your DoVA proposed rating) supporting the VASRD criteria’s 100% rating.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
Warrior644 said:
With that all said, you will need to overwhelmingly prove via objective medical evidence and/or documentation that your “Menieres” disease medical condition meets the VASRD criteria which you seek whether by DoVA rate increase request or official DoVA appeal process.
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NOOOO!!!!

The evidentiary standard is "as likely as not." It does not even have to be "likely." That is, the evidence must be against the requested benefit to deny it.

Also, "subjective" evidence (which would be "lay" evidence) is valid- it is only when the rating criteria asks for objective evidence that you need it.
 
I am not clear at all about the procedural history of this case. Something seems wrong. I can't tell if this was a review based on pre-stabilization ratings, a final decision, or something else. However, generally, the difference between an appeal and an original claim will be when the benefits are backdated or paid from. I would be very careful about how you approach all of this.
 
Jason Perry said:
NOOOO!!!!

The evidentiary standard is "as likely as not." It does not even have to be "likely." That is, the evidence must be against the requested benefit to deny it.

Also, "subjective" evidence (which would be "lay" evidence) is valid- it is only when the rating criteria asks for objective evidence that you need it.
Click to expand...

As always, appreciate the sound insight with potential correction of member's comments, when warranted. ;)

Best Wishes!
 
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