Reexaminations- What, When, Why, How
You have been awarded service-connected compensation for your disability. But the VA wants to reexamine you. Why? What does this mean? What do you do? This situation often causes concern for Veterans, leaving them wondering why are they being reexamined and what does this mean for their benefits.
Why and When Are Reexaminations Required by VA?
There are certain circumstances in which the VA may require a Veteran who is already receiving service-connected compensation benefits to be reexamined by a VA physician:
- When they need to verify the continued existence of a disability
- When they need to verify the current severity of a disability
- When there is evidence to indicate a change in the disability since the last examination
- When the disability is likely to improve
- When the VA has the duty to assist the Veteran in developing the claim
After the VA awards benefits for a disability, they usually schedule a future exam if they believe that a future exam will be needed to establish that the Veteran is still entitled to that award. The reexamination is scheduled so that the VA can assign an evaluation that accurately reflects the Veteran’s level of disability. After the RO reviews the exam report, the rating could be increased, reduced, or continued at the same level. Once they determine a future examination is needed, the exam will usually be scheduled five years from the date of the rating decision.
How Do I Avoid Being Scheduled for a Future VA Exam?
The VA will generally not schedule a reexamination if:
- The disability is static
- Symptoms have persisted without material improvement for five or more years
- The disability is a disease that is permanent and not likely to improve
- The Veteran is over 55 years old
- The rating is a minimum rating, or
- The combined disability evaluation would not be affected even if a future exam resulted in a reduced evaluation
What Happens if I Don’t Show Up to My VA Reexamination?
If you fail to report for a reexamination without good cause or attempting to reschedule, they may have your benefits reduced or discontinued. If you fail to report for the reexamination, the VA is required to send you a predetermination notice. That notice will let you know that you have 60 days to notify the VA that you are willing to report for the scheduled examination or present evidence that the disability should not be discontinued or reduced. If you do not notify the VA, your benefits will be reduced or canceled. If the VA scheduled an examination for a Veteran’s claim for increase and the Veteran doesn’t attend without good cause, then the VA may deny the claim without having to consider any evidence that shows a higher evaluation.
If, however, you are not notified beforehand of the reexamination, and the VA takes adverse action against you, then the VA has committed an error and you should not be held responsible for not showing up.
What Happens if I Can’t Show up?
When the VA schedules a reexamination, you must report for the examination. But if you have good cause for not reporting for the exam, the VA will reschedule the examination. If you have a reasonable excuse for failure to report for a scheduled exam, you should notify the VA as soon as possible. They will determine if your reason is good cause on a case by case basis. If you are found to have good cause, the VA will take no action against you. If the VA finds you failed to report for the examination without good cause and you agree to report for a second examination but then don’t report, the VA can take immediate action and reduce or discontinue your benefits. If you make no effort to explain to the VA why you didn’t report for the exam, the VA will promptly reduce or terminate your benefits.
Keep in mind that a doctor-patient relationship does not exist in these examinations. While your own doctor may be sympathetic to you, these doctors will likely not be. They are not treating you; they are reviewing the extent of your disabilities.