Increase My Rating: understand the risk before you file

Understand what this claim type is, and how it differs from filing for a new condition.

• An increase claim asks VA to reevaluate the current severity of a condition you already have a service-connected rating for.
• It uses the same VA Form 21-526EZ used for an original claim; you are requesting an increase from an existing evaluation because your condition has worsened.
• This is different from filing for a new condition. If you have a new, separately diagnosed condition, that is a new claim, not an increase.

The single most important fact to understand before filing an increase claim.

• Filing a claim to increase your rating may lead VA to schedule a review exam. A review exam can result in a higher rating, a lower rating, or no change to your current rating. VA does not schedule a review exam in order to reduce your rating — the outcome depends on the medical evidence at the time of the exam, and it is not something RatingScope or any third party can predict for your case.
• VA cannot reduce a rating simply because an exam shows some improvement. A reduction requires evidence of material improvement, and VA must find it reasonably certain that the improvement will be maintained under the ordinary conditions of life, not just under exam conditions. An exam that is less thorough than the one that established your current rating cannot be used as the basis for a reduction. Ratings that have remained at the same level for 5 years or more receive additional protection under these rules, and ratings continuously in place for 20 years or more cannot be reduced below that level except in cases of fraud.
• Before VA reduces a rating, it must send a proposed-reduction notice explaining its reasons and give you 60 days to submit additional evidence. If the reduction proceeds, it does not take effect until at least 60 days after that final notice. Review your own VA notices carefully; this is a general description of the process, not a guarantee of how any specific case will be handled.

A different risk from reexamination: missing the exam entirely can end an increase claim outright.

• Reexamination risk, above, is about what happens if you attend the exam and it shows improvement. This is a separate risk: what happens if you do not attend at all.
• Under 38 CFR 3.655, if you fail to report for a scheduled exam without good cause, the regulation states an increase claim shall be denied. This is a different, more severe consequence than an original compensation claim receives, where VA instead rates the claim on the evidence already in the file.
• If you cannot make the appointment, contact VA or the exam contractor before the scheduled date rather than not attending. The regulation's examples of good cause, the illness or hospitalization of the claimant or the death of an immediate family member, are illustrative rather than a complete list.

Understand how to file, using the same form used for original claims.

• VA Form 21-526EZ is used to request an increase from an existing evaluation, the same form used for an original disability claim.
• Filing online at VA.gov is generally the fastest method; it can also be mailed to VA's Claims Intake Center or submitted with help from a Veterans Service Officer or accredited representative.
• Identify the specific rated condition you believe has worsened so VA can associate your evidence with the correct existing rating.

Understand what kind of evidence supports an increase claim.

• Relevant evidence generally shows how your condition's current severity compares to what was documented when it was last rated.
• Updated treatment records, current diagnostic findings, and functional-impact evidence from qualified providers are commonly relevant.
• Evidence should accurately reflect your condition. Do not ask a provider to document a predetermined conclusion, and do not exaggerate or minimize symptoms.

Understand the regulatory standard VA must meet before reducing a rating (38 CFR 3.344).

• VA cannot reduce a rating simply because an exam shows some improvement. The rating agency must find it reasonably certain that the improvement will be maintained under the ordinary conditions of life, not just under exam conditions.
• An examination that is less thorough than the one that established your current rating cannot be used as the basis for a reduction.
• This standard applies specifically to reductions; it does not change the separate evidence needed to support an increase.

Understand how long a rating has been in place affects reduction protections.

• Ratings that have remained at the same level for 5 years or more receive the heightened material-improvement protection described above.
• Ratings in place for less than 5 years, or considered likely to improve, can be reduced on ordinary evidence of improvement shown at a reexamination.
• VA generally schedules a reexamination within 2 to 5 years of an initial exam, unless the disability is static, permanent, or otherwise exempted from routine future reexamination.

Understand the long-term protection that applies to ratings held for two decades or more (38 CFR 3.951(b)).

• A disability rating that has been continuously rated at or above a given evaluation for 20 or more years will not be reduced below that evaluation, except upon a showing that the rating was based on fraud.
• This protection is based on the length of time the rating has continuously been in effect, not your age or the condition itself.
• This is separate from the 5-year material-improvement standard; both protections can apply depending on your specific rating history.

Understand the notice and response period VA must provide before reducing a rating (38 CFR 3.105(e)).

• Before VA reduces a rating, it must prepare a proposed reduction setting out the material facts and reasons, and notify you at your latest address of record.
• You are given 60 days from that notice to submit additional evidence showing your compensation should continue at its present level.
• If the reduction proceeds, it takes effect no earlier than the end of that 60-day period following the final notice, not immediately after the exam.

Understand the effective-date rule specific to increase claims, distinct from original-claim effective-date rules.

• This rule is specific to increase claims. It is different from the original-claim effective-date rules and the post-separation one-year rule covered in the Already Separated pathway.
• For an increase, the effective date is generally the earliest date it is factually ascertainable that the increase in disability occurred, if VA receives your claim within one year of that date.
• If VA receives your claim more than one year after the increase became factually ascertainable, the effective date is generally the date VA received the claim instead.

Avoid filing an increase claim without first understanding that a review exam can lower a rating, not only raise it.

• The most consequential mistake is assuming an increase claim can only help. A review exam can result in a higher rating, a lower rating, or no change.
• Understanding the protections that exist (the material-improvement standard, the 5-year and 20-year rules, and the required 60-day notice before any reduction) does not eliminate the risk; it describes the process VA must follow if a reduction is proposed.
• This page does not offer strategy for maximizing an outcome. Decide whether to file based on an accurate understanding of your current evidence and these rules, not on an assumption that only one outcome is possible.