It is very likely that during the course of your VA disability claim or appeal process, the VA will schedule you for a medical examination either at the VA or with a contractor. These exams are used to assess whether you have a medical condition, whether it is related to service, and/or how severe your condition is. Often, the resulting examination report can make or break a claim—so it’s important to get these examinations right.
Although the VA is required to give you an “adequate” examination with a “qualified” medical provider, there are things you can do to ensure the resulting examination report and opinion are the most accurate and thorough they can be.
Who Needs an Examination?
Although all VA disability claims require some level of medical evidence to establish entitlement, not everyone who files a claim for VA disability benefits will receive a VA examination.
The VA will only schedule an exam if the following elements are present in a claim:
- There is evidence of a current disability,
- There is evidence establishing that some event, injury, or disease occurred in service,
- There is an indication that the current disability may be related to the in-service event, and
- There is insufficient evidence to decide the case without a medical examination.
This means that if you already submitted enough medical evidence to establish a claim, then you won’t need a VA examination.
If you want an exam, then you must submit enough evidence and arguments to meet these requirements.
Scheduling an Examination
After establishing that a VA exam is necessary, the VA will start the scheduling process by contacting you. Unfortunately, you cannot schedule your own VA exam.
The staff at your local VA medical center or a VA contractor will mail you a letter with the date and time of your exam. You may also get a phone call or email from the VA or the contractor. Be on the lookout for this correspondence and make sure to keep the VA updated if your address changes.
Once the VA has scheduled you for an exam, you should make every effort to attend the exam. Your claim may be delayed or denied if you do not attend the exam.
If the VA schedules you for an examination, but you cannot attend, tell the VA medical center or contractor at least 48 hours in advance and also in writing, if possible. Explain the reason you need to reschedule and request a new examination.
To reschedule, call the number on your appointment letter:
- For Loyal Source Government Services (LSGS), call 833-832-7077 (TTY: 711). Caller ID will show “Loyal Source.”
- For OptumServe Health Services (OSHS), call 866-933-8387. Caller ID will show “VA EXAM-Optum.”
- For Leidos QTC Health Services (QTC), call 800-682-9701. Caller ID will show “VA EXAM-QTC.”
- For Veterans Evaluation Services (VES), call 877-637-8387. If you’re outside the continental U.S., call +1-713-255-5656. Caller ID will show “VA EXAM-VES.”
Or call the VA hotline at 800-827-1000, the hotline is available Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.
If your exam is with a contractor, you can only reschedule once per exam. The new appointment must be within 5 days of the original appointment. If you’re not available during those 5 days, tell the contractor, then call the VA at 800-827-1000 and the VA will start the scheduling process again when you are available.
Explain Everything to the Examiner During the Examination
When a provider gives a medical opinion in a veteran’s case, the provider is required to review the veteran’s claims file. Unfortunately, however, this is often not the case in practice.
You can greatly increase your chances of obtaining an adequate medical opinion if you explain everything about your service-related condition to the examiner during the examination. During the exam, you should explain, in detail, how your condition is related to service, how your condition impacts your daily life, or both. You should assume the examiner does not know anything about your medical history or previous testimony.
You can even take your relevant records and show the examiner evidence such as when you noted a condition in service, or when you increased your medication for a service-connected condition. This helps the examiner reach a thorough and accurate conclusion, and gives you peace of mind that the examiner knows the important facts in your case.
You may also ask the provider if you can bring a friend or family member to the exam, and you can take notes during or after the exam. These steps might help ensure that the examiner gets a full picture of your condition, and that you have support, if needed.
Report an Inadequate Examination Immediately
If, after attending the VA exam, you do not think the exam was adequate—either because the examiner wasn’t listening, wasn’t qualified, forced you to do things your body could not normally do, failed to use appropriate measurement tools, failed to consider flare-ups, or for any other reason—you should let the VA know immediately in writing.
The VA assumes that all examiners and examinations are adequate unless you say otherwise. So, make sure to write down what went wrong in the examination and submit your complaints with a request for a new medical examination.
You can report your concerns to the VA in any of these ways:
- Give feedback on the contractor’s customer satisfaction survey
- Write a letter and submit it as part of your claim file
- Call the contractor who scheduled your exam
- Call the VA at 800-827-1000 (TTY: 711)
- Contact your local VA regional office
Obtain a Copy of Your Medical Examination Report
You may also want to obtain a copy of your medical exam report to assess whether the examiner’s opinion was consistent with your symptoms, testimony, and other records.
You may request a copy of the examination report, or your entire claims file, by completing and submitting a Freedom of Information Act or Privacy Act Request (VA Form 20-10206), which can be done in one of the following ways:
- Option 1: Online
- Option 2: By mail
- Mail the completed VA Form 20-10206 to this address:
- Department of Veterans Affairs
Evidence Intake Center
PO Box 4444
Janesville, WI 53547-4444
- Option 3: In person
- Submit the completed VA Form 20-10206 to your nearest VA regional office.
Contact Vets National Advocates
VA examination reports can be the deciding factor in your VA disability claim, so it is important to make sure that your report is thorough and accurate.
If you received a decision that was based on an incomplete or inaccurate VA examination report, you should consider appealing that decision and obtaining a new medical opinion. Vets National is here to help you through the VA appeal process. Contact Vets National today, at 877-777-4021.
