My earlier video on VA Disability Re-Examinations prompted several questions on what a P&T or Permanent and Total designation really means.
Permanent, Total and Protected ratings are all separate things, though P&T often get referenced together. If one meets the requirements for a protected rating (https://www.knowva.ebenefits.va.gov/…/M21-1,-Part-III,-Subp…), those won’t be changed unless there was fraud, Permanent just means the VA would not EXPECT that item to get better and therefore will not schedule a periodic review; but if the VA becomes aware of improvements, they can re-evaluate. Total just means 100% combined Disability Rating Here is a good discussion on this. https://helpdesk.vetsfirst.org/index.php?pg=kb.page&id=1869
The issue becomes when a veteran requests an increase for something and the examiner notes improvement in an otherwise P&T item, they will re-evaluate it to see if it still meets the criteria.
In most cases, the same rating for 20 years becomes stable and therefore protected. An item rated as P&T, for let’s say just 7 years as an example, can be re-evaluated and even changed (increased or lowered) based on current symptoms and the criteria; if the VA becomes aware of any changes. How do they become aware? They notice improvement in the course of a P&C exam for a new or increase requested item. The P&T part just means the VA will not schedule a Future Recurring Exam. So if you don’t put in anything new or request an increase, they would not re-evaluate anything and eventually the item would become protected. This is the difficulty for veterans who fear they will be reduced, so they don’t request an increase for something that legitimately may have gotten worse and deserves a higher rating. My general comment on that, is to know the rating criteria and understand exactly how you meet the requirements. Then make sure you can demonstrate that through documentation and actual things like range of motion, symptoms, etc.