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Reductions are something every SC veteran worries about. Its often a fear that keeps vets from seeking increases in disabilities that have worsened or appealing bad decisions.
I had my own scare a few years back when i filed for an increase, had a bad C&P on a disability and the VA sought to reduce me which freaked me out. I eventually beat them at their own game but i wanted to put out some information that are preventative measures to stop reductions from occuring or provide the evidence needed to fight them if the VA decides to push it. Unfortunately there is no silver bullet that makes a reduction ironclad, just as there is no ironclad approach to filing initial or increase claims that that VA cant argue with. Since rating is done by humans and humans are prone to fault and bias there is no guarantee with anything only higher or lower probabilities with getting claims granted and providing more armor for the appeals process.
1) Schedule regular checkups
I know alot of vets here dont have access to secondary care outside the VA whether its location or money. If you do have the money/insurance outside the VA to see a outside primary care/specialist or can access the VA’s choice program to see non VA medical professionals take advantage of that. I am lucky that I have access to this through my employer so outside of my annual checkups/specialists at the VA i go to private doctors at least annually to document the state of my current conditions. I am honest with my doctors and ask them to make detailed notes of each condition i talk to them about and its current symptoms, etc because i need to provide the VA with documentation of my disabilities. It doesnt matter if my condition hasnt worsened i still talk to them or a specialist about it so that i have the documentation. If you dont have access to this make sure that when you do your VA checkups you specifically talk to them about all your disabilities as well, how its impacts you, pain severity, how often it bothers you, etc. If your VA provider DOESNT address something in your medical record make sure you send a secure message through myhealthevet so that it is recorded that you spoke to them about it.
2) Start a Diary
I would start a diary, preferrable on a word document or even better on the “activity journal” on myhealthevet and record symptoms, sick days, etc for ALL your disabilities and even things not SC that might in the future be something that is secondary to a SC condition. I prefer to keep these journals on a word doc, you dont have the write a novel just the big things like, “ran today, bad pain in shins after 10 minutes, 4/10 then 7/10 after i walked back home. took naproxen and stayed off for the rest of the day”, “back pain after being at work for 2 hours, no relief with 800mg IBprufen and flexeril”
This diary especially when its updated on myhealthevet in a timely manner say every month or a couple times a year is great for establishing what symptoms you have been experiencing regularly day by day, week by week or month by month in between doctors visits. The VA likes to take one or two visits where you are stressed, rushed or dont want to be there and answer “fine” to “how are you doing” or “how has _____ disability been ” and use that as a justification that you are showing “material improvement” in your condition. The main takeaway is NEVER approach a C&P or ANY VA MEDICAL VISIT as routine. You dont need to stress but always describe how X disability is doing as how it feels on the WORST day not on the best or how you are felling at that moment. That being said meticulous diary entries can help bolster your case you have not experienced material improvement. Regularly updating you myhealthevet journal also timestamps it to show this has been done regularly over months, years or even decades so that a rater cant just say you made it up on the spot, and you can point to that you ahve regularly updated this journal to show over X number of months, years or decades to show what its like with your disabilities on a daily basis.
3) Dont let Medications Lapse
Never let your medications with the VA lapse. If you need 3x daily naproxen and 1x daily muscle relaxant to deal with back pain and your med refills show a 6 month gap the VA can make the claim your condition has improved. The VA CANNOT reduce you if your symptoms improve with medication, but if you are not taking your medication it can be an indicator that you are getting better. I know i sometimes get private Rx’s not throught he VA and have them lapsed so i document and keep records of those medications (the sheet they staple on the bag with the name, doseage, date, etc) so i can scan and upload as needed for C&P, claims, reductions, etc. the VA may not prescribe the Rx you want so i get why you would go elsewhere but send a message to your primary care stating that you have gotten a Rx through a private physician, ask to be prescribed it through the VA, if they refuse then keep screenshots of these discussions for reference as well so its documented.
4) IMO’s are key
I know when i got hit with a reduction attempt by the VA my IMO saved me. 100%. no doubt. I had a terrible C&P for PTSD increase, they took me to a deserted wing of this old hospital and scanned me into what i think was the psych wing with no lights, was put in a dimly lit room where a psychologists was on a telecon line. It freaked me out and i wanted to leave, so i rushed the exam to get done. This was my fault, but it resulted in him saying my symptoms had gotten better. I started looking for help and came to HADIT. the best piece of advice i got was about IMO’s so i found a psychiatrist who did a full workup and submitted a fantastic IMO. It was hard coming up with the money but $500 vs losing $600 a month was a no brainer. You dont need to get preemptive IMO’s thats a waste of money but I would make sure, if possible, that you take a little money out every month and have $1500 in savings for an IMO if this ever happens to you.
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Reductions are something every SC veteran worries about. Its often a fear that keeps vets from seeking increases in disabilities that have worsened or appealing bad decisions. I had my own scare a few years back when i filed for an increase, had a bad C&P on a disability and the VA sought to ...