VA Deferred Issues: How They Affect Your Rating Decision
Veterans: Do You Know What a Deferred Rating Issue Is?
Veterans navigating the VA claims process often come across terms like “deferred rating” or “partial rating decision.” But what do these really mean, and how can you identify them in your VA rating decision? In this article, our contributor—a United States Army veteran and retired VA Rating Specialist—breaks down the concept of deferred and partial rating decisions based on firsthand experience from years of working inside the VA system.
What Is a Deferred Rating Issue?
In a VA rating decision, a deferred issue simply means the VA could not make a decision on that particular condition at the time. This is often due to incomplete development or missing evidence. For example, if a veteran files a claim for migraine headaches and the VA fails to schedule a necessary medical exam (C&P exam), the decision on that condition will be deferred. The rating decision should explain what development is still needed, although in many cases this is not clearly spelled out, leaving the veteran confused.
Examples of Deferred Issues:
- Pending requested medical examination or opinion – VA is awaiting additional medical input.
- Completing further development – This may refer to private medical records not yet obtained.
Our contributor notes that, ideally, deferred explanations should be detailed, such as: “Veteran stated on VA Form 21-526 received on [date] that they received private treatment. Development was not completed to obtain those records.”
VA Guidelines on When to Defer an Issue
According to the VA’s M21-1 Manual, an issue should be deferred when the proper resolution depends on the outcome of additional development, such as obtaining records or clarification of medical conditions. Raiders are expected to complete full and thorough development before deferring, but unfortunately, that’s not always the case.
What Is a Partial Rating Decision?
A partial rating decision occurs when a veteran claims multiple issues and the VA can make a decision on some—but not all—of them. For instance, if a veteran submits a claim with 10 issues and the VA has sufficient evidence to decide on nine, the tenth may be deferred while awaiting further information. This results in a partial rating: nine decided, one deferred.
When to Make a Partial Rating Decision
The VA issues partial ratings when:
- Some issues are ready for decision, while others require more development.
- There’s enough evidence to grant or deny at least one issue.
- A proposal to reduce or sever service connection is pending finalization.
“Kicking the Can” and Deferred Ratings
Our contributor refers to the practice of deferring when avoidable as “kicking the can down the road.” VA employees are instructed to complete as much development as possible before deferring an issue. A lack of clarity or initiative can result in delayed decisions for the veteran.
Real-Life Scenarios from a Former VA Rater
In cases our contributor personally handled, deferrals were often necessary due to incomplete development, unclear claims (e.g., veteran didn’t specify left or right knee), or contradictions in medical opinions. In one case, an examiner denied PTSD due to divorce, but a letter from the veteran’s ex-spouse revealed significant behavioral changes following two combat tours in Vietnam. This warranted a new exam and led to service connection for PTSD.
Why It Matters: Effective Dates and Back Pay
If a partial rating grants enough conditions to meet a higher combined percentage (e.g., 60%) based on an intent to file, veterans can start receiving back pay for that amount. When a deferred issue is later granted and increases the total rating (e.g., to 100%), the VA still owes back pay for the difference going back to the intent to file date—provided the effective date is properly assigned. Always verify your effective date carefully.
Closing Thoughts
Understanding deferred and partial rating decisions is essential to managing your VA claim effectively. Veterans should review their rating decisions carefully and ensure the VA explains deferrals clearly. When in doubt, request clarification and follow up on outstanding development items.
Disclaimer: Some parts of this article reflect the personal experiences and opinions of our contributor, who is a retired VA rating specialist. While effort has been made to ensure accuracy and relevance, readers should refer to official VA resources or consult with an accredited representative for guidance specific to their own claims.
