Part VIII, Subpart iv, Chapter 8, Section APrestabilization Ratings Under 38 CFR 4.28

Revised 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.

2Rating 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.

Revised 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.

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.

• 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.

3Reexaminations 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).

Revised 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.