VA Reexaminations Explained

Veterans who receive disability benefits are often reexamined by the United States Department of Veterans Affairs (VA), which leaves many concerned about what it can mean in terms of the benefits they receive. Military members who have served our country and suffered physical or mental injuries may be awarded compensation for these service-connected injuries. Having the VA tell you that the disability needs to be reexamined three, five, or even 10 years later can be quite troubling. Veterans often rely on these benefits for food, housing, and other needs. There are several VA reexaminations explained below to help veterans better understand what is often a stressful situation.

What Is A VA Reexamination?

Simply put, a reexamination is often requested by the VA to have a veteran’s disability or disabilities reevaluated. The VA schedules this medical reevaluation and sends notice to the veteran, who should never ignore it. Ignoring a reexamination notice from the VA may result in disability benefits being terminated automatically. Examples of reasons the VA may require a reexamination include:

• It is anticipated the veteran’s injury or condition will improve with time
• The VA must verify the veteran remains disabled
• The VA must verify the severity of the veteran’s disability
• Evidence has been received by the VA indicating the condition has changed since the veteran’s last medical examination

In most cases, those who are older than 55, have disabilities that are service-related and have failed to improve over a five-year or longer period, or whose disabilities are not expected to improve will not be subject to a reexamination. An example of a disability where improvement would not be expected is loss of limb or amputation injuries.

What Is The Reexamination Process?

When the VA evaluates a veteran’s case and determines a reexamination is necessary, it is required they:

• Send a notice of the reexamination to the veteran
• Provide 60 days for a response to the notification

When a veteran receives a letter from the VA regarding reexamination, the following is critical:

• A hearing must be requested by the veteran within 30 days of receipt of the notice
• Evidence supporting why the veteran’s rating should not be reduced must be provided within 60 days of receipt of the notice
• When it is not possible to dispute the rate reduction proposal, it is urgent that veterans attend a scheduled medical reexamination

When disability benefits are rescinded by the VA and a veteran does not receive notice, it is possible to request benefits be reestablished. When the notice is received and ignored or a veteran does not request a hearing or attend a reexamination, benefits will be rescinded or reduced. When there is any confusion at all or there have been errors or miscommunication with the VA, a veteran’s compensation attorney with Girard & Centonzio may be able to help.

When It Is Impossible To Attend A Scheduled Reexamination

There are circumstances that in some cases may make it impossible for a veteran to attend a VA scheduled reexamination. Unless there is a reasonable excuse for not reporting to an examination, it is imperative to attend. However, the VA does reschedule reexaminations when there is a good reason or cause for not attending the original examination. When circumstances make it impossible to attend a schedule examination, the VA should be notified right away. Failing to show up for a scheduled examination or failure to notify the VA immediately that you cannot attend will result in disability benefits being reduced or terminated promptly. This will make reestablishing benefits far more difficult, if not impossible.

Note: Examinations scheduled by the VA are with physicians who are not interested in the doctor-patient relationship. They are simply reviewing the extent of a veteran’s disabilities and not providing medical treatment.

The 55-Years-Old Rule

It is not unusual for the VA to request reexaminations even though federal guidelines provide clear guidance regarding veterans who are 55 years old or older, and those who would be 55 on the date of a future examination. Veterans who are 55 or older are exempt from reexamination, however it is not guaranteed the VA will not request a reexamination. The Office of Inspector General (OIG) found in a 2017 review that among 300 requests for reexamination from the VA, more than a third (111) were not necessary. The OIG further estimated that the VA scheduled examinations for nearly 20,000 of 53,500 veterans that were unwarranted. Clearly, not every VA reexamination request is warranted. The VA either overlooks federal guidelines or is severely understaffed. Perhaps they simply do not want to put forth the time and effort necessary to protecting the benefits of veterans.

Disability Ratings Following Reexamination

VA-required reexaminations assist the VA in determining a veteran’s continued eligibility for benefits. After a reexamination, the VA may determine that:

• A veteran is no longer eligible for disability benefits. This may be the result when symptoms of the disability are no longer experienced
• A reduced disability rating may be applied. When symptoms lessen substantially but remain to some extent, the VA may determine to give a veteran reduced disability benefits that correspond to the reduced rating.
• A higher disability rating may be assigned by the VA when a disability becomes worse, resulting in severe symptoms. This results in an increase in disability benefits that correspond with the higher rating

Consider Reaching Out To Girard & Centonzio 

Hopefully, the VA reexaminations explained above will be of some help to veterans who want to better understand how reexaminations work and what may impact their VA disability benefits. The VA certainly makes its share of mistakes, so it is important to keep in mind that decisions made may not always be final. Those who have had their benefits reduced or terminated may want to consider seeking legal guidance. 

Contact us today for a case evaluation.