Introduction

We’re here today to try and inform as many veterans as we can. We’re here with Dr. Bash. Welcome, Radio Land, TV Land, and YouTube viewers and listeners. This is Dr. Craig Bash. I’ve been doing Veterans Medical Opinions for 30 years, and I have dozens and dozens of these radio shows, which we’re going to publish on this YouTube channel. So thank you for listening, and here we go.

Discussion on Reductions

Dr. Bash: Dr. Bass, how are you doing today? It sounds like you had a lot of trouble out there. I hate to hear that. You’re in California right now, right? I hope you can work through that mess.

Bill: Yes, we had that big firestorm and lost a bunch of records in part of our office. One of the things we’re working on these days has to do with the reduction of benefits. Are you guys seeing a lot of that reduction stuff going on? Patients are talking about it.

Dr. Bash: It seems as though I’ve heard a lot of veterans talking about it. Every time they reach a 100% disability rating from the VA, the VA seems to automatically go into reduction mode. Anything they can find to reduce your rating, especially if it’s 100%, they latch onto aggressively. It’s something that shouldn’t be going on, but yes, we’ve heard of veterans in that situation, and it’s not nice.

Bill: About 20% of my work now involves reductions. A patient will get 100%, and then the VA must have some kind of internal audit system. Suddenly, two or three weeks later, they say, “No, that’s a mistake,” and they reduce them back down.

Dr. Bash: They have a quality assurance step, I think. The claim goes to the quality assurance team, and they will see if there’s a mistake or if they can reduce it. It’s just a bureaucratic quality assurance thing. I’ve seen it increase tremendously in the past six months.

Bill: Yes, maybe every fifth case I do now is a reduction case. I see people who had 100% for a while and suddenly face a reduction. I also see a lot of cases where veterans are on the fringe for TDIU. They might have 40%, 50%, or 60%, and the VA comes at them.

Call-in Information

Dr. Bash: I think Bill is trying to call in. Another number.

Bill: He should have an email with the information. I sent a copy of it, so he needs the call-in number.

Dr. Bash: The call-in number is 347-237-4819. Once again, the call-in number is 347-237-4819. A lady will talk, and you hit number one, which will put you in the queue with us, and we can pick you up there if you have a question or comment.

Bill: So they’re coming at all these patients who are on the fringe of TDIU, undermining the foundation for the 100% rating later on.

Dr. Bash: I don’t know why they do that. I guess there are some veterans they feel they’ve overrated instead of underrated. Some veterans don’t put up a fight, and that’s the trouble. They take it instead of fighting. If you’re entitled to benefits, you ought to get them.

Legal Points on Reductions

Bill: Dr. Bash, you mentioned seeing about 20% of your workload involving reductions. The manual doesn’t say to reduce everybody, does it?

Dr. Bash: No, it doesn’t. But I see a lot of cases where, for example, they increase the ankle rating and decrease the knee rating at the same time, not changing the overall rating.

Bill: Right, that’s what I’m talking about. Some of that is going on. The regulations and the manual accurately instruct that you do not arbitrarily change a diagnostic code based on a simple finding on an examination. You must review all the evidence. There are protection rules if a veteran has been service-connected for a condition for ten years or more. Even if it’s wrong, the VA cannot sever service connection for that condition.

Dr. Bash: We often see reductions where the examination must be as thorough as the one that granted the higher rating. The new examination must be as detailed as the original. If it’s not, the reduction cannot take place.

Bill: Right, and even if improvement has occurred, it must result in the ability to function under the ordinary conditions of life, including employment. If a veteran has been out of the workplace and not working, how can a Raider say the improvement is under employment conditions? That doesn’t make any sense.

The Court’s Stance on Reductions

Bill: The court addressed this in Brown v. Brown in 1993. The court said you must show that there has been material improvement under ordinary conditions of daily life, including employment. If you can’t show that, even if the immediate examination shows improvement, it doesn’t justify reduction.

Dr. Bash: I see a lot of cases where veterans are being reduced without proper procedures being followed. They’re supposed to wait 60 days for the next level of rules for the reduction. They send letters out at 55 days or 59 days and do reductions without reviewing the record or doing the necessary exams.

Bill: Yes, I see that too. If a reduction is made and it fails to point to the evidence to justify the reduction, it is what the court calls void ab initio, meaning from the beginning. You must reverse and reinstate the evaluation if the reduction was made in error.

Dr. Bash: Bill, can you give us some of the legal points about how the different steps are supposed to go through for reduction?

Bill: Yes, I checked for any updates in the manual today. The manual now reasonably represents the intent of the law that protects veterans from premature reductions. It establishes the standards that must be satisfied before a reduction can be implemented and provides a 60-day period prior to the reduction.

Conclusion

Thank you all for listening. That ends this show, and now I’m going to zoom off.