--- title: "Part VIII, Subpart iv, Chapter 8, Section A Prestabilization Ratings Under 38 CFR 4.28" document: "M-21-1" section: "Part VIII, Subpart iv, Chapter 8, Section A" canonical: "https://veteranai.co/va-regulations/m21-1/viii.iv.8.a-prestabilization-ratings-under-38-cfr-4-28" source: "https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000177478/M21-1-Part-VIII-Subpart-iv-Chapter-8-Section-A-Prestabilization-Ratings-Under-38-CFR-428" updated: "2026-09-06T14:37:19.860314Z" --- 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 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. 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. | **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 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). 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.