Question:

My wife is currently rated at 30% disabled due to her shoulder joint replacement but her condition has worsened. She is under her physician’s care so medical documentation to support an increase in her rating is not an issue. If she files a claim with VA for a rating increase and it is approved, will the increase in her monthly award be retroactive to her initial claim date (12 years ago) or will the increase be effective with the new claim award?

Answer:

The general rule for a reopened claim for benefits is that the effective date is the date the VA receives the reopened claim (as opposed to the original claim), or the date that entitlement to the benefit arose, whichever is later. This means that if the VA grants a reopened claim for benefits that has previously been finally denied, the general rule prohibits the VA from assigning as the effective date the date it received the original claim for the benefits in question. To receive an effective date of the date the VA received an original claim that has already been finally denied, the claimant must file and prevail on a claim for revision of the final decision on the original claim based on clear and unmistakable error or some other mechanism.

The general rule for a claim to increase the disability rating of an already service-connected disability is that the effective date is the date of filing the claim for an increase, or the date entitlement arose (which means the date the disability increased in severity), whichever is later.

Although I have not reviewed your wife’s claims file based on what you have written her effective date would likely be the first day of the month after her request for increased rating was submitted. For example if she submitted her request for an increase on January 25, 2012 and her increase was granted in October 2012 she would be retroactively paid back to January 25, 2012 which is her effective date.

There are a number or very narrow exceptions to the rule which could provide for an earlier effective date but without reviewing her claims file I can’t make an appropriate comment.

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