What this means
m21-1:VIII.iv.8.A explains prestabilization ratings under 38 CFR 4.28. In plain terms, the official guidance says prestabilization ratings under 38 CFR 4.28 are provided to assure earliest payment to those Veterans separated from service with a significant unstabilized disability at a time when they are most likely in need and least likely to be self-sufficient. It also addresses if there is an indication of possible entitlement to special monthly compensation (SMC), but records are insufficient to make a determination
How this may help with a claim
Use m21-1:VIII.iv.8.A as an internal VA audit trail for prestabilization ratings under 38 CFR 4.28, not as a promise of a particular result. Compare the actions recorded in your claim file or decision notice with this source-specific detail: Prestabilization ratings under 38 CFR 4.28 are provided to assure earliest payment to those Veterans separated from service with a significant unstabilized disability at a time when they are most likely in need and least likely to be self-sufficient. If there is an indication of possible entitlement to special monthly compensation (SMC), but records are insufficient to make a determination If the record does not show the expected action, identify the missing step precisely when asking VA or an accredited representative to review the file.
What to review in your file
- Check the file against this official condition: when to prepare a prestabilization rating.
- Confirm that the record or notice addresses this source point: Prestabilization ratings under 38 CFR 4.28 are provided to assure earliest payment to those Veterans separated from service with a significant unstabilized disability at a time when they are most likely in need and least likely to be self-sufficient.
- Document how this stated step or exception applies: VIII.iv.8.A.1.b. When to Prepare a Prestabilization Rating
Important limits
m21-1:VIII.iv.8.A is primarily internal workflow guidance about prestabilization ratings under 38 CFR 4.28. It can help identify what VA was expected to document, but it does not by itself create a claimant deadline, a freestanding entitlement, or a guaranteed remedy. The source also states: Prestabilization ratings under 38 CFR 4.28 are provided to assure earliest payment to those Veterans separated from service with a significant unstabilized disability at a time when they are most likely in need and least likely to be self-sufficient. The provisions of 38 CFR 4.129 operate similarly to 38 CFR 4.28 prestabilization ratings. They both state that qualifying significant disabilities that exist at service discharge will be evaluated at the 50 percent level or higher.
Search terms when useful
Phrases that may help when searching your claim file or this library.
- Prestabilization Ratings Under 38 CFR 4.28
- m21-1:VIII.iv.8.A
- Prestabilization Ratings Under
- CFR 4.28
- Development Considerations Prestabilization Ratings
- purpose prestabilization ratings under
- when prepare prestabilization rating.
- VIII.iv.8.A.1.a. Purpose Prestabilization Ratings
Original VA guidance
The official VA text of this section
Overview
In This Section
This section contains the following topics:
Scroll sideways to see the full table.
| Topic | Topic Name |
|---|---|
| 1 | General Information and Development Considerations for Prestabilization Ratings |
| 2 | Rating Considerations for Prestabilization Ratings |
| 3 | Reexaminations and Reductions for Prestabilization Ratings |
1. General Information and Development Considerations for Prestabilization Ratings
Introduction
This topic contains general information and development considerations for prestabilization ratings under 38 CFR 4.28, including
- purpose of prestabilization ratings under 38 CFR 4.28
- when to prepare a prestabilization rating.
Change Date
July 29, 2021
VIII.iv.8.A.1.a. Purpose of Prestabilization Ratings Under 38 CFR 4.28
Prestabilization ratings under 38 CFR 4.28 are provided to assure earliest payment to those Veterans separated from service with a significant unstabilized disability at a time when they are most likely in need and least likely to be self-sufficient.
VIII.iv.8.A.1.b. When to Prepare a Prestabilization Rating
If a Veteran has an unstable, significantly disabling service-connected (SC) disability at the time of separation that will continue for an indefinite period
- prepare a prestabilization rating for the unstabilized disability(ies) without waiting for further development or examination on the disability(ies), and
- defer a decision on any issues that are not ready for a decision.
2. Rating Considerations for Prestabilization Ratings
Introduction
This topic contains rating considerations for prestabilization ratings, including
- criteria for assigning a prestabilization rating
- when a prestabilization rating is not appropriate
- when to assign 100- and 50- percent prestabilization ratings
- duration of the award under 38 CFR 4.28
- assigning a prestabilization rating when potential eligibility for special monthly compensation (SMC) exists, and
- handling
- prestabilization ratings when severance pay is awarded, and
- certain mental disorders that cause discharge from service.
Change Date
July 29, 2021
VIII.iv.8.A.2.a. Criteria for Assigning a Prestabilization Rating
Assign a prestabilization rating if service treatment records show the existence of an unstabilized condition stemming from any disease or injury for which service connection (SC) may be awarded.
VIII.iv.8.A.2.b. When a Prestabilization Rating Is Not Appropriate
Do not assign a
- total 100-percent prestabilization rating in any case in which a total rating is immediately assignable
- under the regular provisions of the rating schedule, or
- on the basis of individual unemployability, or
- 50-percent prestabilization rating in any case in which an evaluation of 50 percent or higher would otherwise be immediately assignable under the regular provisions of the rating schedule.
VIII.iv.8.A.2.c. When to Assign 100 and 50 Percent Prestabilization Ratings
Use the information below to determine when to assign 100 and 50 percent prestabilization ratings.
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| When … | Then assign a … |
|---|---|
| there is an unstabilized condition resulting in severe disability, and substantially gainful employment is not feasible or advisable | 100-percent prestabilization rating. |
| there are unhealed or incompletely healed wounds or injuries, and material impairment of employability is likely | 50-percent prestabilization rating. |
VIII.iv.8.A.2.d. Duration of the Award Under 38 CFR 4.28
Prepare prestabilization ratings under 38 CFR 4.28 as “open ratings.”
VIII.iv.8.A.2.e. Assigning a Prestabilization Rating When Potential Eligibility for SMC Exists
If there is an indication of possible entitlement to special monthly compensation (SMC), but records are insufficient to make a determination
- evaluate disabilities in a prestabilization rating at the level of loss that is shown, and
- request an at-once examination to determine the full extent of disability.
VIII.iv.8.A.2.f. Handling Prestabilization Ratings When Severance Pay Is Awarded
In some cases, VA assigns a 50- or 100-percent prestabilization rating for 1 or more, but not all, of the same disabilities for which the Veteran received severance pay.
In such cases, assign separate evaluations for the disabilities for which severance pay was awarded to assist authorization activity in processing an award.
VIII.iv.8.A.2.g. Handling Certain Mental Disorders That Cause Discharge From Service
The provisions of 38 CFR 4.129 operate similarly to 38 CFR 4.28 prestabilization ratings. They both state that qualifying significant disabilities that exist at service discharge will be evaluated at the 50 percent level or higher.
However, under 38 CFR 4.129
- the only covered condition is a mental disorder that
- develops in service as a result of a highly stressful event, and
- is significant enough to cause release from active service, and
- the evaluations are assigned under the regular rating schedule.
Where a qualifying mental disorder is at issue, consider whether the schedular rating available under 38 CFR 4.129 makes a pre-stabilization rating under 38 CFR 4.28 inappropriate.
Reference: For more information on evaluations in cases of service discharge from mental disorders caused by traumatic stress, see
- 38 CFR 4.129, and
- M21-1, Part V, Subpart iii, 13.1.g.
3. Reexaminations and Reductions for Prestabilization Ratings
Introduction
This topic contains guidance on reexaminations and reductions for prestabilization ratings, including
- future examination control of prestabilization ratings
- reevaluation of the service-connected (SC) disability(ies) in prestabilization ratings, and
- effective date of reductions in combined evaluations under 38 CFR 3.105(e).
Change Date
July 29, 2021
VIII.iv.8.A.3.a. Future Examination Control of Prestabilization Ratings
When assigning a prestabilization rating, set a future examination control between 6 and 12 months following separation from service for all SC disabilities that are evaluated under 38 CFR 4.28.
Reference: For more information on future examinations, see M21-1, Part IV, Subpart ii, 1.B.
VIII.iv.8.A.3.b. Expediting Reevaluation of the SC Disability(ies) in Prestabilization Ratings
After the rating activity receives the report of the examination, completed 6 to 12 months following separation, it must reevaluate the SC disability(ies) to which it assigned a prestabilization rating.
Note: A Veteran who, without good cause, fails to report for the Department of Veterans Affairs examination scheduled in connection with a prestabilization rating under 38 CFR 4.28 is subject to adjustment of benefits under 38 CFR 3.655.
References: For more information on
- a Veteran’s failure to report for a review examination, see M21-1, Part IV, Subpart ii, 2.B, and
- denials when a Veteran fails to report for an examination, see M21-1, Part VI, Subpart i, 1.A.4.b.
VIII.iv.8.A.3.c. Effective Date of Reductions in Combined Evaluations Under 38 CFR 3.105(e)
Reductions in combined evaluations under 38 CFR 3.105(e) are effective the later of the following:
- the end of the period under the provisions of 38 CFR 3.105(e), or
- the first day of the month following the twelfth month after discharge.