Why ratings change
Disability ratings are meant to reflect average impairment in earning capacity. When symptoms worsen, new symptoms appear, or better documentation finally captures severity, a higher rating may be appropriate. Increases are not automatic; you must usually trigger development with a claim or evidence submission that raises the issue.
This guide covers supplemental claims, new evidence, secondary conditions, and increased rating requests at a high level. Read TBI and anxiety pages if those conditions are central to your increase theory. Use the calculator to estimate combined effects. Study secondary conditions if your increase path involves new linked diagnoses.
Start with your decision letter
Identify current diagnostic codes, percentages, and effective dates. Note what evidence the rater said was missing. That list becomes your to do sheet.
Gather treatment since the last decision
New VA and private notes showing more frequent treatment, new medications, hospitalizations, or therapy intensification often support increases.
Symptom diaries
For conditions like headaches or seizures, structured diaries can help clinicians document severity. Ask your doctor whether they want a specific format.
Lay statements
Describe worsening in daily activities. Match lay statements to medical notes.
Nexus for new issues
If you add secondaries, obtain medical nexus as described in the nexus letter guide.
DBQ and exam preparation
Examiners measure range of motion, panic frequency, or hearing thresholds using structured methods. Review what is a DBQ and C&P preparation.
Filing mechanics
Use VA.gov or representative channels. Choose supplemental lanes when prior decisions exist.
Higher level review limits
HLR generally cannot add new evidence. Use it when legal error is the theory.
Board options
Evidence submission and hearings may fit complex increase stories.
TBI cognitive worsening
For TBI, neuropsych testing may help if clinically indicated.
Anxiety and occupational impact
Document panic at work, missed meetings, and reduced performance reviews carefully.
Pain flare documentation
Orthopedic increases often hinge on flare frequency and range of motion on bad days. Tell clinicians about realistic worst days without exaggerating.
Mental health rating criteria
Compare your symptoms to criteria in CFR schedules with a representative rather than guessing percentages alone.
Effective dates and increases
Earlier effective dates may apply when continuity is shown and intent rules are met. This is legal territory; verify facts.
Staged ratings
Sometimes VA assigns different ratings across time periods in one decision.
Reductions risk
If you request reevaluation, ensure your record reflects genuine severity. Do not hide improvement, but do not under report either.
SMC and special issues
Some increases intersect with Special Monthly Compensation rules beyond basic rating percentages.
Vocational impact
If unemployability is on the table, see TDIU.
Independent medical exams
Private exams can help or hurt depending on quality. Avoid boilerplate mills.
Rating decision literacy
Learn to read codes using how to read a rating decision.
Organize evidence packets
Use the claim checklist structure.
PTSD and MST sensitivity
Use appropriate evidence rules and trauma informed care when discussing history.
Sleep and mental health
Worsening sleep may support mental health increases when documented.
Medication changes
New side effects might support secondary claims rather than only increases.
Appeals clocks
Do not miss deadlines after denials.
VA Rating Assistant
Track worsening longitudinally in uploaded records.
Takeaways
- Target missing evidence identified in prior decisions.
- Use correct filing lanes.
- Support increases with credible medical and lay proof.
- Model combined ratings with tools.
Pair with buddy statements when witnesses saw decline.
Staged rating examples
You might see a decision that awards 30 percent from 2018 to 2020 and 50 percent from 2020 forward based on new evidence. Track each segment for payment questions.
Difference between reopen and review
VA may schedule routine future examinations for some conditions. Do not confuse those with your own increase requests.
Pain scales in notes
Ask clinicians to record pain levels with movement during visits, not only at rest, when accurate.
Functional questionnaires
Some clinics use standardized forms for depression or PTSD severity. Request copies for your file.
Hospital discharge summaries
Admissions show acute worsening. Upload summaries after any ER visit tied to service connected issues.
Specialist referrals
Wait times are frustrating; keep referral paperwork to show you pursued care.
Medication compliance
Non compliance can appear in notes. If side effects caused stops, tell doctors so records explain why.
Independent living versus work
High independence at home does not disprove occupational impairment if job demands differ.
Workplace accommodations letters
HR letters describing reduced hours or remote work as accommodation help TDIU and increase stories.
Labor market realities
Age discrimination in hiring may exist but is not a VA theory by itself. Keep focus on service connected limits.
Vocational testing
If neuropsych or vocational testing is suggested, follow through when affordable.
Rating protection concepts
Certain rules may protect staged ratings; legal advice needed.
Multiple claims at once
You can file increases for several issues; development may parallelize.
PTSD and work triggers
Document workplace triggers that caused leave or termination.
Orthopedic flare frequency
Two flares a month versus two a year matters. Be specific.
Audio changes
New hearing test showing decline supports hearing increases.
Skin condition photos
Date stamped photos can support dermatology increases when appropriate clinically.
Gastrointestinal symptom logs
Frequency and hospitalization for dehydration matter.
Final planning tip
Before submitting, imagine you are the rater: does this packet make severity obvious without hunting?
Hypertension and blood pressure logs
If claiming increases for hypertension, home blood pressure logs aligned with provider visits help when clinically appropriate.
Diabetes complications
Endocrinology notes documenting neuropathy progression can support increases or secondary issues.
Skin disfigurement photos
For scarring claims, consistent photo lighting helps comparisons over time.
Respiratory PFT trends
Pulmonary function tests showing decline support respiratory increases when linked to service connected bases.
Dental and TMJ
Some dental issues have specific rating paths; coordinate with treating dentists and VA dental policies.
Vision changes
Visual field tests may support increases beyond central acuity measures.
Female veteran specific care
Gynecology notes may support claims tied to service connected conditions; privacy matters, so use secure uploads.
Prosthetics and adaptive devices
Device prescriptions show functional loss even when you adapt well.
Pain management procedures
Injections, ablations, and surgical consults show severity even if they fail.
Mental health partial hospitalization
PHP and IOP attendance demonstrates acute severity periods.
Substance use treatment
Honest documentation of SUD treatment tied to service connected mental health may support severity if framed appropriately with clinicians.
Chiropractic scope
Chiropractic notes help some veterans; VA may weigh MD notes more heavily depending on issue.
Acupuncture and complementary care
Mention complementary care to treating clinicians so notes reflect full treatment picture if clinically relevant.
Functional capacity evaluations
FCE reports are sometimes used in legal cases; discuss with an attorney before ordering.
State vocational rehab
State VR files may parallel VA VR evidence.
Employer short term disability
STD claim files sometimes contain occupational analyses.
Long term disability private insurance
LTD approvals are not binding on VA but may summarize restrictions.
Return to duty failures
If you tried to return to military related work in civilian form and failed, document honestly.
Final cross links
DBQ, TDIU, decision reading, calculator.
Rating schedule language study
Spend one evening reading the actual rating schedule language for your condition in 38 CFR with a highlighter. Note trigger words like "repeated," "prostrating," or "incapacitating." Ask your clinician to document those concepts when true.
Compare past exam DBQs
If a prior DBQ showed limited motion and new imaging shows progression, line them side by side in a cover letter for your increase packet.
Personal statement refresh
Update your personal statement whenever you file for increase. Dated statements help show continuity.
Employer human resources letters
HR can confirm accommodations even if they cannot diagnose.
Workers compensation interaction
If a civilian injury claim exists, coordinate with counsel about how records can be used without creating contradictions.
Functional limitations in physical therapy notes
Therapists often record inability to complete exercises; those notes support musculoskeletal increases.
Cognitive testing batteries
For TBI or mental health, neuropsychological testing may clarify decline; insurance coverage varies.
Sleep study updates
New AHI scores on CPAP therapy may matter for sleep apnea increases when clinically interpreted.
Weight fluctuation documentation
Rapid weight change tied to service connected conditions may support mental health or endocrine arguments when clinicians agree.
Assistive devices upgrades
Moving from cane to crutch to wheelchair suggests progression; keep purchase receipts and prescriptions.
Service dog documentation
While not a rating factor alone, service dog prescriptions can illustrate safety concerns some veterans face.
Pain clinic intake forms
Intake forms sometimes quantify pain scores over time; request copies.
Pharmacy printout trends
Increasing opioid or other medication strength may indicate severity but must be interpreted carefully with prescriber notes.
Community care notes
Community care providers produce records that must be uploaded if not automatically retrieved.
Foreign provider records
Translate and submit with summaries when allowed.
Increase claim cover page template
Paragraph one: issue and current rating. Paragraph two: what changed since last decision. Paragraph three: list of enclosed evidence. Page count total.
Final reminder
Increases are about showing change or proving prior decisions missed evidence. Pick the theory that matches your facts.
Legal disclaimer
This information is for educational purposes only and is not legal or medical advice. Rating criteria are summarized from publicly available 38 CFR regulations. Consult a Veterans Service Officer (VSO) or VA-accredited attorney for advice on your specific claim.
Frequently Asked Questions
This information is for educational purposes only and is not legal or medical advice. Rating criteria are summarized from publicly available 38 CFR regulations. Consult a Veterans Service Officer (VSO) or VA-accredited attorney for advice on your specific claim.