Learn how the VA really decides claims, in plain English, before you file anything.

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The VA DisabilityADVOCATE

What The VA Won’t Put In Writing

Declassified

Description

We decode the evidence rules, exam traps, and rating tricks the VA won’t spell out, then fight to win what you earned.

Notes

Information here is free. Optional accredited representation, no fees unless you win.

VA-ACCREDITED CLAIMS AGENT #45147DENIALS REOPENEDLOW RATINGS CHALLENGEDC&P EXAMS AUDITEDEFFECTIVE-DATE & CUE HUNTSTDIU · SMC · PACT ACTNO WIN, NO FEE ON 20% OR 30% REPRESENTATION · $750 FLAT MISSION 5 BRIEFGOVERNED BY 38 CFR §14.636SECONDARY CONDITIONS LINKEDTERA & TOXIC-EXPOSURE CLAIMSBOARD & HIGHER-LEVEL APPEALSFREE CASE REVIEW, ASK A QUESTIONVA-ACCREDITED CLAIMS AGENT #45147DENIALS REOPENEDLOW RATINGS CHALLENGEDC&P EXAMS AUDITEDEFFECTIVE-DATE & CUE HUNTSTDIU · SMC · PACT ACTNO WIN, NO FEE ON 20% OR 30% REPRESENTATION · $750 FLAT MISSION 5 BRIEFGOVERNED BY 38 CFR §14.636SECONDARY CONDITIONS LINKEDTERA & TOXIC-EXPOSURE CLAIMSBOARD & HIGHER-LEVEL APPEALSFREE CASE REVIEW, ASK A QUESTION
The 5, 10, 20 & 55 Year Rules
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VA-Accredited Claims Agent #45147

Advice from the Advocate

The 5, 10, 20 & 55 Year Rules

When your rating becomes protected from reduction

The VA can reduce ratings, but a set of protection rules limits that power based on how long you have held a rating and your age. Know your milestones. The VA will not remind you when a protection kicks in, and it will not mention one when it proposes a cut. Your part is to know the date each rating took effect, track how long you have held it, and respond in writing right away if a proposed reduction letter arrives.

The Law That Governs This
38 CFR §3.344 (stabilized ratings, standards for reduction)38 CFR §3.951 (continuous rating held 5 or more years)38 CFR §3.957 (service connection held 10 or more years)38 CFR §3.952 (rating held 20 or more years)38 CFR §3.105(e) (procedural due process for reductions)
In Plain English

Ratings Are Not Always Forever, Except When They Are

The VA retains the authority to reduce ratings when a condition improves. But Congress and the VA's own regulations have created a series of protection milestones that progressively limit the VA's power to take back what it has granted. Understanding these milestones affects how you respond to proposed reductions, and whether you have to respond at all.

Ratings Are Not Always Forever, Except When They Are
Broken Down

The Protection Milestones

5-Year Rule, §3.344 / §3.951

5-Year Rule, §3.344 / §3.951

A rating that has been continuously in effect for five or more years is considered "stabilized" and cannot be reduced unless the VA can demonstrate sustained improvement under the ordinary conditions of daily life, not just a single exam showing better numbers. The improvement must be shown through multiple examinations over time, and the VA must consider the entire record, not just the latest snapshot.

10-Year Rule, §3.957

10-Year Rule, §3.957

Service connection that has been in effect for 10 or more years cannot be severed except upon a showing of fraud. The VA can still reduce the rating percentage, but it cannot take away the underlying service connection itself. This means the condition remains recognized, even at 0%, and can be re-evaluated for an increase.

20-Year Rule, §3.952

20-Year Rule, §3.952

A rating held continuously for 20 or more years cannot be reduced below the lowest rating it has held during that period, except upon a showing of fraud. If your knee has been rated at 10% for 22 years, it cannot be reduced below 10% regardless of what an examination shows.

55-Year Rule (Age Protection)

55-Year Rule (Age Protection)

Veterans over the age of 55 are generally not scheduled for routine reexaminations. While the VA retains the theoretical authority to order one, the practical effect is that ratings held past age 55 are rarely disturbed. This is not a statutory guarantee, but it is the VA's consistent practice.

The Checklist

When the VA Proposes a Reduction, Your Rights

Before reducing any rating, the VA must comply with the due-process requirements of §3.105(e):

Photo for point 1: The VA must issue a proposed reduction letter explaining the basis for the reduction
01

The VA must issue a proposed reduction letter explaining the basis for the reduction

Photo for point 2: You have 60 days to submit additional evidence opposing the reduction
02

You have 60 days to submit additional evidence opposing the reduction

Photo for point 3: You have the right to request a predetermination hearing within 30 days
03

You have the right to request a predetermination hearing within 30 days

Photo for point 4: The reduction cannot take effect for at least 60 days from the date of the final decision
04

The reduction cannot take effect for at least 60 days from the date of the final decision

Photo for point 5: If the VA fails to follow these procedures, the reduction is void and can be reversed on appeal
05

If the VA fails to follow these procedures, the reduction is void and can be reversed on appeal

In Plain English

Strategic Implications

If you are approaching a protection milestone, think twice before triggering a new C&P exam by filing for an increase on that condition. Sometimes the strategic move is to let the clock run and secure the protection before seeking a higher rating. This is a case-specific decision that depends on your overall rating picture and financial situation.

Strategic Implications

The Advocate's Take

The VA counts on you not knowing your rating is protected. Know the milestones, and a reduction notice becomes a fight you can win. We have defeated proposed reductions by holding the VA to its own rules, and those rules strongly favor the veteran who knows them.

Where the VA Gets This Wrong

The most common error is proposing a reduction of a stabilized rating (5+ years) based on a single improved exam, without demonstrating sustained improvement under the ordinary conditions of daily life. If the VA cites one exam to take away a rating you have held for years, that is a fightable error.

Where the VA Gets This Wrong, a veteran and his advocate going over the claim
How claims are won

Building a The 5, 10, 20 & 55 Year Rules Claim That Wins

Every claim stands on three legs. Knock one out and the claim falls over, no matter how bad your symptoms are. Before you file, look at your file and find all three. If one is missing, that is the piece to build first. The VA will not build it for you, and filing without it usually just buys you a denial letter and lost time.

A current diagnosis
01

A current diagnosis

A doctor has to say you have it, now, in writing. Not "reports symptoms of", a diagnosis. Without this leg, nothing else in the file matters.

A link to your service
02

A link to your service

An event, an injury, an exposure, or an already service-connected condition. Service records, unit records, buddy statements, and your own account all count as evidence.

A nexus that ties the two together
03

A nexus that ties the two together

A medical opinion stating it is at least as likely as not that your service caused or aggravated the condition. That phrase is a legal standard: 50 percent or better. It is the leg most denials break.

Document the problem before you file

• Keep a dated symptom log for at least 30 days. Frequency, severity, and what it stopped you from doing.

• Get statements from people who see it, a spouse, a coworker, a battle buddy. Lay evidence is legal evidence.

• Pull your private treatment records. The VA only has to help; it does not have to go find everything.

• Write down what you have stopped doing. Lost work, lost sleep, lost activities. That is what impairment looks like on paper.

Know them before you file

Your Rights in This Process

Most veterans walk into this system without knowing the rules the VA itself has to follow. That is how claims get denied for missing evidence the VA was supposed to help you find, and how exams get done by the wrong clinician. These six rights are written into federal regulation. Know them before you file, and make the VA honor every one of them when it decides your claim.

It costs nothing to file

It costs nothing to file

Filing a VA claim is free. Accredited representatives may only charge for work on an appeal after an initial decision, and those fees are capped by 38 CFR §14.636.

The VA has a Duty to Assist you

The VA has a Duty to Assist you

Under 38 CFR §3.159 the VA must help you get the evidence it needs, and it must tell you what is missing before it denies you for missing it.

You can ask for a different examiner

You can ask for a different examiner

You may request a trauma-informed clinician, or a clinician of a specific gender, for a C&P examination. Ask before the exam is scheduled.

You can claim every condition you have

You can claim every condition you have

There is no limit and no penalty. Primary conditions, secondary conditions, and conditions made worse by service all get filed.

You can appeal and be re-evaluated

You can appeal and be re-evaluated

A denial is not the end. You may submit new evidence, request a higher-level review, appeal to the Board, and ask for re-evaluation when your condition worsens.

You must be considered for TDIU

You must be considered for TDIU

If your service-connected conditions keep you from holding substantially gainful employment, you may be paid at the 100 percent rate without a 100 percent rating.

Free · no obligation

When You Are Ready to File

Talk to an accredited representative before you file. It costs nothing to ask, and the order you file in changes what the VA is allowed to award you. Albert L. Thombs Jr. is VA-Accredited Claims Agent #45147. A short conversation now can save you a year spent waiting in the wrong review lane.

Your part starts at the kitchen table. Pull your DD-214, your rating decision if you have one, and the names of every doctor who treats you today. Under 38 CFR 3.159 the VA has to help you gather records, but it can only chase the records you tell it about. Leave a doctor off the 21-4142 and that treatment may never reach your file.

Veteran filling out a VA disability claim application at her home desk with her records folder open
VA Form 21-526EZ

The application itself

This is the form that opens a disability compensation claim. List every condition you are claiming, and name the secondary conditions explicitly.

VA Form 21-4142

Release for private records

Authorises the VA to request records from your private doctors. Without it, treatment outside the VA may never reach your file.

VA Form 21-10210

Lay or buddy statement

The official form for your own statement and for statements from people who witnessed the event or the change in you.

A veteran checking his claim status on a laptop with his papers beside him
Your responsibility as a veteran

Your Part in This Is Not Optional

I will be straight with you. No advocate on earth can win a claim for a veteran who will not do his or her part. The VA decides on the record, and you are the only person who can build the medical side of that record. We do the legal and forensic work. You do yours. Here is what that means, every single time:

  • See a doctor and get every symptom written into your medical record. If it is not on paper, the VA treats it as if it never happened.
  • Keep a symptom journal. Dates, flare-ups, missed work, the nights you did not sleep. That is the evidence of how this condition actually runs your life.
  • Answer every VA letter and every request for evidence before the deadline. Silence gets claims denied.
  • Show up to your C&P exam and describe your worst days honestly. Do not tough it out in that room. Do not exaggerate either.

You do your job and we will do ours. That is how claims get won.

Choose Your Service

The Three Services

We offer three completely separate services, kept distinct on purpose so you know exactly what you are buying, what it costs, and how it is paid. These are not tiers of one agreement, you choose the single option that fits your situation.

Two are contingency representation with no cost up front; they differ by how hard the case is and how the fee gets paid. The third is a flat-fee forensic report for the veteran who wants to fight the claim himself.

An accredited claims agent and a veteran reviewing a clean, single-issue appeal together
Option 1

Standard Direct-Pay Representation

20% of back pay

No cost up front, nothing out of pocket. The VA withholds our fee and pays us directly under §14.636(h). Best for cleaner, more recent, single-issue denials, routine higher-level reviews, supplemental claims, and rating increases, carried all the way to the Board of Veterans’ Appeals.

See full details
An advocate reviewing a veteran's decade-deep claims file
Option 2

High-Complexity Representation

30% of back pay

For high-complexity cases, long claim histories, prior Board denials, CUE, complex effective-date and TDIU fights, multi-issue toxic exposure. Still no cost up front. Because the VA pays a rep only up to 20% directly, the VA sends your full retro to you and we invoice you directly for the 30%. Lawful, but never entered into lightly.

See full details
A forensic file audit in progress
Option 3

Mission 5 Intelligence Brief

$750 flat

A standalone forensic file review and written road map, not representation. For the veteran with a tough, older case who wants to fight it himself and keep 100% of his back pay. We audit your file, show you every error, and hand you the plan. Available only to veterans who already have a VA decision.

See full details

The exact contingency percentage on your case is set in a written agreement by the complexity of the work, always within the maximum the law allows. Federal-court litigation, if it is ever needed, is a separate, pre-agreed arrangement.

A veteran shaking hands with his VA-accredited claims agent after reviewing his claim
Denied or under-rated?

Talk to a VA-accredited claims agent about your claim

Albert L. Thombs Jr. is a US Army veteran, VA-Accredited Claims Agent #45147, and 100% service-connected himself. He personally reviews every request. Fees are capped by 38 CFR §14.636, and there are no fees on representation unless you win.

702-992-4883

Mon–Fri, 11AM–6PM Pacific

Questions are always free. The Mission 5 Brief is $750 flat.