"Poking the Bear": When Is It Worth the Risk for VA Claims?

Quick Answer

"Poking the bear" filing a new VA claim or request for increase when you already have a stable rating is worth the risk when you have strong medical evidence of genuine worsening or when filing for a brand-new condition you never claimed before. The risk is highest for veterans with 100% Permanent and Total (P&T) status, where additional claims cannot increase compensation but can expose your file to scrutiny. The risk is lowest when you use an Intent to File (ITF) first, know your 5-year, 10-year, and 20-year protections, and have clear medical documentation. Simply filing a claim does not automatically trigger a reduction the VA must prove sustained improvement under the ordinary conditions of life to reduce a rating, and a single exam is not sufficient for ratings held 5 years or more .

Understanding the "Poking the Bear" Risk

The phrase "don't poke the bear" warns veterans against filing new claims when they already have a high rating. The "bear" is the VA rating system, and "poking" it means giving the VA a reason to review your file.

The Core Concern: When you file for an increase or a new secondary condition, VA reviews your entire claims file including conditions you didn't claim . If they find evidence that any condition has improved, they may propose a reduction.

The Reality Check: The VA is not actively hunting for reasons to reduce ratings. As one experienced VA decision maker noted, the VA system is designed to encourage granting claims: "Grant if you can, deny if you must" . Raters are evaluated on how many claims they can accurately complete, and grants require less documentation than denials. When mistakes happen, they are far more likely to be errors that favor the veteran .

However, there is a real risk. Every time you file, you open your file for review, and a new rater becomes responsible for it. If they find an error that favors you, they are obligated to correct it even if it results in a reduction .

When Poking the Bear Is Worth the Risk

1. You Have Clear Evidence of Worsening

The most legitimate reason to file for an increase is when your service-connected condition has clearly worsened . Signs include:

• More frequent or severe symptoms
• New functional limitations or assistive device use (CPAP, cane, hearing aids)
• Inability to work or reduced work hours
• Hospitalizations or emergency visits
• Development of secondary conditions

Key Principle: "Most of the time, this process results in an increase or no change" . The majority of service-connected conditions worsen over time rather than improve .

2. You're Filing for a Brand-New Condition

If you have a condition you never claimed before, a new claim is appropriate. The effective date will be the day you submit your Intent to File, not the date of diagnosis .

3. You Were Underrated from the Start

If you believe the VA made a legal error in the original rating decision and you have evidence that existed at the time, a CUE motion may be appropriate. However, this is extremely difficult to win and carries significant risk .

4. You're Pursuing TDIU

If your conditions prevent you from working, filing for TDIU can be worth the risk. TDIU pays at the 100% rate even if your schedular rating is lower .

5. New Presumptive Conditions

If a new law like the PACT Act creates presumptive service connection for a condition you have, filing is appropriate.

When Poking the Bear Is Risky

100% Permanent and Total (P&T) Status

Once you have reached 100% P&T, filing additional claims exposes your file to further scrutiny. Since you cannot receive more than 100% compensation unless you qualify for SMC, the risk often outweighs the reward .

The Rule: Filing a new claim for SMC or a Specially Adapted Housing grant will automatically trigger a C&P exam . If the examiner determines your condition has improved or might improve, VA may reduce your rating .

Exception: P&T veterans are not subject to routine re-examinations. "Filing any new claim or requesting an increase could expose your full rating to review" .

Filing a CUE Motion Incorrectly

A CUE motion asks VA to revise an old decision because they made a serious, undeniable error. However:

• No new evidence may be submitted
• If you include new evidence, VA may treat it as a new claim
• This can reset your effective date and trigger a review that could lead to a reduction

Filing After Surgery

While surgery often signals severity, it can also improve the condition. Requesting a review can lead to a reduced rating once recovery is documented .

The Protections That Reduce Your Risk

5-Year Stabilization Rule (38 C.F.R. § 3.344)

Once a rating has been in effect for at least five years, VA considers it "stabilized." To reduce it, VA must show sustained improvement under ordinary conditions of life .

• VA cannot reduce based on a single exam
• VA must consider your entire medical history
• The burden of proof is on VA

10-Year Service Connection Protection (38 C.F.R. § 3.957)

Once service connection has been in effect for 10 years or more, VA cannot sever that service connection entirely. The percentage can still be reduced, but the underlying service connection is protected .

20-Year Continuous Rating Rule (38 C.F.R. § 3.951(b))

If a rating has been continuously in effect for 20 years or more, VA cannot reduce it below its lowest level during that period unless the original rating was based on fraud .

The Bear Has No Teeth Argument

Some veterans argue that "don't poke the bear" is a myth that keeps veterans scared to file legitimate claims .

Key Counter-Arguments:

• Simply filing a new claim does not automatically open up unrelated P&T conditions for review
• The regulations (38 C.F.R. § 3.344) make it difficult for VA to reduce ratings
• VA can review your file even if you don't file a claim they just generally don't
• Each time you file and VA continues your other ratings, they cannot later use evidence from before that decision to reduce you

The Balanced View: The risk is real, even if small. As one experienced VSO put it: "It came down to measuring the potential for gain against the potential for loss" .

The Intent to File: Your Safest Strategy

File an Intent to File (ITF) before deciding whether to file a claim . An ITF:

• Is just a placeholder it doesn't trigger a rating review
• Gives you a one-year window to gather evidence
• Preserves your effective date if you decide to file
• Simply expires if you don't file

This is the safest way to "poke" without triggering the full review process.

Realistic Scenario: When to File vs. When to Wait

Scenario A (Worth Filing): Veteran with 70% PTSD (held 8 years) whose symptoms have clearly worsened. Treatment records document ongoing symptoms, medications have increased, and the veteran has missed work. This is worth filing most increase claims result in an increase or no change .

Scenario B (High Risk, Avoid): Veteran with 100% P&T for 12 years considering filing for a new condition that wouldn't increase compensation. Filing exposes the file to scrutiny. SMC claims automatically trigger C&P exams . The veteran should wait until the 20-year protection if possible.

Scenario C (Use ITF First): Veteran with 90% rating unsure whether to file for a new condition. File an ITF first. Gather evidence, consult a VSO, and decide within the one-year window. If you decide not to file, the ITF simply expires .

Actionable Steps to Minimize Risk

1. File an Intent to File (ITF) first It doesn't trigger a review and gives you one year to gather evidence .

2. Know your protections If your rating is close to 5, 10, or 20 years, you may have more protection than you think.

3. If you are 100% P&T, think twice before filing Additional claims can put your protected status at risk .

4. Gather strong medical evidence Document ongoing treatment and symptom severity. Personal and lay statements can also be powerful .

5. Attend your C&P exam and be honest and thorough Do not downplay symptoms. Describe your worst days, not just how you feel during the exam .

6. Respond to reduction proposals You have 60 days to submit evidence and 30 days to request a hearing .

7. Consult a VSO or VA-accredited attorney An accredited representative can evaluate the risk vs. reward .

Disclaimer: This content is for educational purposes only and does not constitute legal, medical, or financial advice. We are not affiliated with the U.S. Department of Veterans Affairs. VA policies, forms, and rates change. Always verify current information on the official VA.gov website before filing any claim. For personalized assistance with your claim, consult an accredited VSO (DAV, VFW, American Legion, etc.), a VA-accredited claims agent, or an attorney.