20% is better than 30% or higher.... prove me wrong

[MilitaryBlake]

i tend to disagree because the perk of severance pay is only a temporary kick( nice check) but not enough for a lasting impact. dod retirement is forever. with a big perk of tricare for family and a check if va runs out. 100 percent va cand be taken away or lowered at any moment whether its [email protected] or not as many of us have found out. the lure of a severance check is just that, its a lure. take the retirement

With all due respect you did not read the original post thoroughly. First, as the post mentioned, if 100% P and T on the VA side you and your family get CHAMPVA. Now, this is not really the place to debate all the different aspects between the two, but I researched Tricare for life vs. CHAMPVA and they really are equitable. I mean, sure, Tricare is more valuable for some families in some situations and CHAMPVA is more valuable for other families in other situations. There is no real solid winner, at least not as far as I can tell. So, I believe these off-set one another.

As far as VA check being taken away - I am not sure what you mean here. All the sources I consulted with, and this includes VA attorneys, etc., state that once 100% P and T this cannot be taken away. Not sure what you mean by "as many of us have found out." VA P and T, to my knowledge, cannot be taken away, not legally. Not unless the whole VA laws change. Yes, if not 100 P and T then you can be re-evaluated, and benefits can be taken away that way, but not if P&T. I do not know this from personal experience, but I created a whole thread on this topic, have consulted military lawyers, etc. and not one person has mentioned that 100% P&T can be taken away. Changes to compensatory laws can change over time (like the changes that are being proposed for Sleep Apnea), but any proposed changes to a condition (again, lets use Sleep Apnea as an example) will take place for any new claims and diagnoses. If, for example, the law changes from a max benefit for SA from 50% to say, 30%, it will have an effective date from the date of change and the future. But that does not mean that all previous SA claims found to be 50% disabling, not if the Vet. is 100% P&T, will be lowered as well.

Sure there is always the chance of some major catastrophe that demands the VA laws to be re-written and perhaps this to change. HOwever, if you are arguing that VA laws can change in terms of benefits for 100% P&T Vets, it would take a catastrophic event to cause this, and DoD laws are not impervious to this sort of change either. After 10 years of serving on the officer side of the DoD, I can tell you that DoD compensation laws can change just as easily as VA laws can be. So, again, these things off-set one another.

So, really it boils down to lump-sum of $$ versus Tricare for life and other DoD benefits, like commissary access, etc. For some, the lump sum can be several hundred thousand dollars. In such very specific cases, as mentioned in the original post, such a lump sum can be considered a greater benefit than even any reasonable expectation of the difference between Tricare for life vs. CHAMPVA...

 

[edwards7986]

With all due respect you did not read the original post thoroughly. First, as the post mentioned, if 100% P and T on the VA side you and your family get CHAMPVA. Now, this is not really the place to debate all the different aspects between the two, but I researched Tricare for life vs. CHAMPVA and they really are equitable. I mean, sure, Tricare is more valuable for some families in some situations and CHAMPVA is more valuable for other families in other situations. There is no real solid winner, at least not as far as I can tell. So, I believe these off-set one another.

As far as VA check being taken away - I am not sure what you mean here. All the sources I consulted with, and this includes VA attorneys, etc., state that once 100% P and T this cannot be taken away. Not sure what you mean by "as many of us have found out." VA P and T, to my knowledge, cannot be taken away, not legally. Not unless the whole VA laws change. Yes, if not 100 P and T then you can be re-evaluated, and benefits can be taken away that way, but not if P&T. I do not know this from personal experience, but I created a whole thread on this topic, have consulted military lawyers, etc. and not one person has mentioned that 100% P&T can be taken away. Changes to compensatory laws can change over time (like the changes that are being proposed for Sleep Apnea), but any proposed changes to a condition (again, lets use Sleep Apnea as an example) will take place for any new claims and diagnoses. If, for example, the law changes from a max benefit for SA from 50% to say, 30%, it will have an effective date from the date of change and the future. But that does not mean that all previous SA claims found to be 50% disabling, not if the Vet. is 100% P&T, will be lowered as well.

Sure there is always the chance of some major catastrophe that demands the VA laws to be re-written and perhaps this to change. HOwever, if you are arguing that VA laws can change in terms of benefits for 100% P&T Vets, it would take a catastrophic event to cause this, and DoD laws are not impervious to this sort of change either. After 10 years of serving on the officer side of the DoD, I can tell you that DoD compensation laws can change just as easily as VA laws can be. So, again, these things off-set one another.

So, really it boils down to lump-sum of $$ versus Tricare for life and other DoD benefits, like commissary access, etc. For some, the lump sum can be several hundred thousand dollars. In such very specific cases, as mentioned in the original post, such a lump sum can be considered a greater benefit than even any reasonable expectation of the difference between Tricare for life vs.

well maybe im bias to this because im currently 100 percent p&t and the va is proposing to lower my rating. my case is currently waiting for a hearing since i contested the proposal. my va rep told me that he has seen 10 other cases this year just like mine. he also told me that the va can lower these ratings any time if they feel there is material improvement or an c.u.e. in the rated condition. for me and those 10 other people or so, not taking a military retirement if given the option vs a severence check would not be sound advice.

 

[RonG]

well maybe im bias to this because im currently 100 percent p&t and the va is proposing to lower my rating. my case is currently waiting for a hearing since i contested the proposal. my va rep told me that he has seen 10 other cases this year just like mine. he also told me that the va can lower these ratings any time if they feel there is material improvement or an c.u.e. in the rated condition. for me and those 10 other people or so, not taking a military retirement if given the option vs a severence check would not be sound advice.

Hello @edwards7986 ,

Reference: M21-1, Part III, Subpart iv, Chapter 8, Section C - Protected Ratings
https://www.knowva.ebenefits.va.gov...-iv,-Chapter-8,-Section-C---Protected-Ratings <---LINK

As you imply, any rating including 100% can be reduced unless it is "protected". A rating such as 100% does not become protected immediately.

"Preservation of disability evaluations (the protection of certain long-standing evaluations from reduction) derives from 38 U.S.C. 110 and is implemented in 38 CFR 3.951(b).
The regulation provides that a disability compensation evaluation of any level that has been continuously in effect for 20 years or more will not be reduced to a lower evaluation except upon a showing that the higher evaluation was based upon fraud." [see other discussions at link]

100% Permanent and Total: A permanent and total (P&T) rating is not a protected rating. Here, “permanent” means that the condition is assumed to be chronic in nature and not likely to improve. “Total” means that the maximum rating has been assigned.

There are some non-VA sites that make the unfounded claim that a 100% T&P rating cannot be reduced, but none produce a law or regulation to support their assertion. M21-1 is a VA publication and it is the VA's Adjudication Procedures Manual. This issue comes up several times a year at another site where I spend time. Fielding questions similar to this discussion are usually done by current and former raters with the VA

Ron

 

[edwards7986]

Hello @edwards7986 ,

Reference: M21-1, Part III, Subpart iv, Chapter 8, Section C - Protected Ratings
https://www.knowva.ebenefits.va.gov...-iv,-Chapter-8,-Section-C---Protected-Ratings <---LINK

As you imply, any rating including 100% can be reduced unless it is "protected. A rating such as 100% does not become protected immediately.

"Preservation of disability evaluations (the protection of certain long-standing evaluations from reduction) derives from 38 U.S.C. 110 and is implemented in 38 CFR 3.951(b).
The regulation provides that a disability compensation evaluation of any level that has been continuously in effect for 20 years or more will not be reduced to a lower evaluation except upon a showing that the higher evaluation was based upon fraud." [see other discussions at link]

100% Permanent and Total: A permanent and total (P&T) rating is not a protected rating. Here, “permanent” means that the condition is assumed to be chronic in nature and not likely to improve. “Total” means that the maximum rating has been assigned.

There are some non-VA sites that make the unfounded claim that a 100% T&P rating cannot be reduced, but none produce a law or regulation to support their assertion. M21-1 is a VA publication and it is the VA's Adjudication Procedures Manual. This issue comes up several times a year at another site where I spend time. Fielding questions similar to this discussion are usually done by current and former raters with the VA

Ro

Hello @edwards7986 ,

Reference: M21-1, Part III, Subpart iv, Chapter 8, Section C - Protected Ratings
https://www.knowva.ebenefits.va.gov...-iv,-Chapter-8,-Section-C---Protected-Ratings <---LINK

As you imply, any rating including 100% can be reduced unless it is "protected. A rating such as 100% does not become protected immediately.

"Preservation of disability evaluations (the protection of certain long-standing evaluations from reduction) derives from 38 U.S.C. 110 and is implemented in 38 CFR 3.951(b).
The regulation provides that a disability compensation evaluation of any level that has been continuously in effect for 20 years or more will not be reduced to a lower evaluation except upon a showing that the higher evaluation was based upon fraud." [see other discussions at link]

100% Permanent and Total: A permanent and total (P&T) rating is not a protected rating. Here, “permanent” means that the condition is assumed to be chronic in nature and not likely to improve. “Total” means that the maximum rating has been assigned.

There are some non-VA sites that make the unfounded claim that a 100% T&P rating cannot be reduced, but none produce a law or regulation to support their assertion. M21-1 is a VA publication and it is the VA's Adjudication Procedures Manual. This issue comes up several times a year at another site where I spend time. Fielding questions similar to this discussion are usually done by current and former raters with the VA

Ron

i have seen alot of misunderstanding, and alot of bad advice based on that misunderstanding regarding this subject on forums like this. thanks for being crystal clear and objective.

 

[MilitaryBlake]

i have seen alot of misunderstanding, and alot of bad advice based on that misunderstanding regarding this subject on forums like this. thanks for being crystal clear and objective.

Yes, well consider me one of those who have been fooled. I have been told by many VA reps, even attorneys that 100% P&T cannot change. But, like Ron mentioned, I suppose I am wrong.

This is really disheartening. Does anyone know that statues or situations in which the VA can lower a 100% P&T rating. I mean, obviously, unfortunately, as in edwards7986 case, if the VA suspects error in a case, they have the right to open a case and re-examine it (CUE cases). Or, if a Vet asks for a case to be reopened and reexamined, the VA in their examination has the right to lower or increase a rating based on the results of that examination.

But other than those two - I am not sure a change in a 100% is common or defensible. Am I wrong on this? I have questions because my proposed ratings are 100% P&T. I have not technically retired and am still AD. When I do retire, and officially become a vet, I would like to know what situations may lead to a re-examination of my ratings or a lowering of mine.

One concern of mine is this: I plan on getting the medical care I need; but NOT EVERYTHING that is recommended. Nor take every medication prescribed. I have already done all that on the DoD side and I have learned what works for me and what does not. SOmetimes additional treatment or medication is BAD for you. In fact, the medical community calls this iatrogenic effects of treatment. If there are treatments or medications offered that I do not plan on f/u on, I do not want that to be mistaken as evidence my conditions no longer exist or affect my functioning.

Does anyone have information as to the situations or conditions that can lead to a change in a 100 P&T rating? If a Vet never requests a review of their case, and there is never any evidence of clear and unmistakable errors, is there ever any reason for the VA to examine a case to perhaps lower the rating?

 

[edwards7986]

Yes, well consider me one of those who have been fooled. I have been told by many VA reps, even attorneys that 100% P&T cannot change. But, like Ron mentioned, I suppose I am wrong.

This is really disheartening. Does anyone know that statues or situations in which the VA can lower a 100% P&T rating. I mean, obviously, unfortunately, as in edwards7986 case, if the VA suspects error in a case, they have the right to open a case and re-examine it (CUE cases). Or, if a Vet asks for a case to be reopened and reexamined, the VA in their examination has the right to lower or increase a rating based on the results of that examination.

But other than those two - I am not sure a change in a 100% is common or defensible. Am I wrong on this? I have questions because my proposed ratings are 100% P&T. I have not technically retired and am still AD. When I do retire, and officially become a vet, I would like to know what situations may lead to a re-examination of my ratings or a lowering of mine.

One concern of mine is this: I plan on getting the medical care I need; but NOT EVERYTHING that is recommended. Nor take every medication prescribed. I have already done all that on the DoD side and I have learned what works for me and what does not. SOmetimes additional treatment or medication is BAD for you. In fact, the medical community calls this iatrogenic effects of treatment. If there are treatments or medications offered that I do not plan on f/u on, I do not want that to be mistaken as evidence my conditions no longer exist or affect my functioning.

Does anyone have information as to the situations or conditions that can lead to a change in a 100 P&T rating? If a Vet never requests a review of their case, and there is never any evidence of clear and unmistakable errors, is there ever any reason for the VA to examine a case to perhaps lower the rating?

to try to answer your question about when this can happen: anytime va feels their has been material improvement in the rated condition. per my va rep this can be discovered through interactions with medical providers during regular medical care or unrelated c&p exams. my case is frustrating because its not an error but one providers opinion out of context that was triggered by a regular medical appt(an eye exam). so now i have to jump through hoops and cross my fingers.

anyway my lesson here is dont take anything for granted.

 

[RonG]

Re: “...to try to answer your question about when this can happen: anytime va feels their has been material improvement in the rated condition.“—Edwards

That is very similar to the language used by the two raters I mentioned previously.

Reportedly, the VA is not searching for cases that warrant reduction; however, when one comes to their attention, they take what they feel is the appropriate action.

Good luck to all...

Ron

 

[chaplaincharlie]

From the United States Code


"The term “total disability permanent in nature” means any disability rated total for the purposes of disability compensation which is based upon an impairment reasonably certain to continue throughout the life of the disabled person."
(Authority: 38 U.S.C. 3501(a)(8))"

 

[RonG]

From the United States Code


"The term “total disability permanent in nature” means any disability rated total for the purposes of disability compensation which is based upon an impairment reasonably certain to continue throughout the life of the disabled person."
(Authority: 38 U.S.C. 3501(a)(8))"

Excellent.

Related:

38 CFR § 3.327 - Reexaminations​

LINK <----

[selected text]

"(a) General. Reexaminations, including periods of hospital observation, will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability. Generally, reexaminations will be required if 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. "

(2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled:

(i) When the disability is established as static;

(ii) When the findings and symptoms are shown by examinations scheduled in paragraph (b)(2)(i) of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more;

(iii) Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement;

(iv) In cases of veterans over 55 years of age, except under unusual circumstances;

(v) When the rating is a prescribed scheduled minimum rating; or

(vi) Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions."

[end of quotation]
-----------------------

Comments.

One benefit of being rated 100% T&P is that the veteran does not have to report for periodic examinations. However, that does not mean they are exempt from an examination IF 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.
@edwards7986 mentioned, "per my va rep this can be discovered through interactions with medical providers during regular medical care or unrelated c&p exams."

Ron

 

[AKtrooper345]

to try to answer your question about when this can happen: anytime va feels their has been material improvement in the rated condition. per my va rep this can be discovered through interactions with medical providers during regular medical care or unrelated c&p exams. my case is frustrating because its not an error but one providers opinion out of context that was triggered by a regular medical appt(an eye exam). so now i have to jump through hoops and cross my fingers.

anyway my lesson here is dont take anything for granted.

THIS is one reason why you choose medical retirement with Tricare over severance and reliance on VA healthcare. I plan to never utilize VA healthcare and only utilize Tricare for my conditions. That will prevent a VA doctor from making a claim such as this.

 

[edwards7986]

THIS is one reason why you choose medical retirement with Tricare over severance and reliance on VA healthcare. I plan to never utilize VA healthcare and only utilize Tricare for my conditions. That will prevent a VA doctor from making a claim such as this.

agree, hard lesson learned

 

[187thINF]

Champva is decent coverage but they do have a medication copay which can sometimes be very high using a regular pharmacy. My stepmother is on champva and was paying 285 per month for meds. There is a trick to this, we switched to to champva meds by mail (similar to Tricare’s express scripts) and now she has no copays.

That said, the 20 vs 30% arguement largely depends on how much you would get DOD vs VA. In my case my high 3 was O3E over 18, and I’m rated 100% DOD and 100% VA. So I get 3400 per month VA and 1200 per month DOD due to the offset. If I were rated say 20% DOD and 100% VA, then I’d have received a large involuntary separation pay which would have been deducted from my VA compensation, so a large chuck of money followed by no money for a long time. I’ll take the 100/100 any day over 20/100.

If you were rated 100% DOD; as an O3E with over 18 years; wouldn't that translate to $3400 VA and approx. $2308 DOD offset? Base pay approx. $7,611 X 0.75 = $5708.

 

[RonG]

Hello @187thINF

You mentioned: "If you were rated 100% DOD; as an O3E with over 18 years; wouldn't that translate to $3400 VA and approx. $2308 DOD offset? Base pay approx. $7,611 X 0.75 = $5708."

Using only your figures for an example case:

If the average high three base pay (total of highest 36 months of base pay divided by 36) was 7611 and the VA comp for 100% was 3400, the following would occur:
1. 7611 x 75% = ~5708 retired pay
2. 5708 minus 3400 = 2308 residual retired pay (not DoD offset)
3. The retiree would receive:
a. 2308 residual retired pay
b. 3400 VA compensation
c. Total: 5708

The computation above does not include CRSC if any. For a CH 61 with less than 20 years AD the combination of CRSC and residual retired pay cannot exceed the longevity portion of retired pay.

Note: The offset generally refers to the amount of the VA compensation and that amount offsets or reduces the amount of DoD retired pay. Often the term, "VA offset" is used and in the context of a reduction.

Ron