VA Disability Review ► Frequently Requested to Check Severity of Disabilities

VA Disability Review ► Frequently Requested to Check Severity of Disabilities

A thorough review of disability examinations is often requested by the Department of Veterans Affairs (VA) to check on the severity of a previously rated service-connected disability. VA staff use review exams, and any other relevant evidence, to assess the current severity of a disability and, If possible, reduce the initial rating assigned. VA regulations point out specific timelines for “examination checks,” but, it is not a hard and fast rule, and, oftentimes, ignored by VA personnel. But, rest assured, it will happen at some point. By law, VA should and will request a review exam under the following circumstances:

  • VA needs to assess the severity of a disability; · Additional or more relevant evidence indicates there has been an important and significant (or material) change in a disability; or
  • Because of law, VA personnel are required to conduct a periodic review.

The Examination Process
Oftentimes, a contracted medical professional or VA medical professional will conduct the disability review exam. The medical examiners and staff will not answer specific questions about benefits, pension program or compensation. Nor, will they consult with a veteran about the disability compensation process. Acting as a stoic conduit within strict bureaucratic protocol, the medical examiners methodically go through a set of procedures to assess disability conditions. Typically, the examination is conducted in a medically approved facility, with the veteran and medical staff member. In very rare cases, VA personnel may decide that an examination by telephone would be the most appropriate route.

The medical examiner will often conduct the following procedures:

  • Ask a veteran questions related to the disability in question; · Perform a physical exam related to the disability; · If multiple disability conditions are to be examined the medical examiner will conduct one examine at-a-time; · Send the veteran for lab work, which may include: blood work, X-rays, MRI, etc.; · While conducting exam, the medical examiner will pay very close attention to how the veteran reacts to certain procedures; · At the conclusion of the exam, sometimes the medical examiner is required to go over the veterans medical file with him/her;
  • In some instances, if the veteran is accompanied by someone familiar with the disability the veteran is having examined, the medical examiner may ask that person questions related to the disability being examined. It is important to understand that the medical examiner is not involved in making a rating decision about the disability. The medical examiners’ job is simply to conduct the examination based upon certain set of criteria established by VA. However, the words the examiner uses in describing the examination review, may ultimately affect the thinking of the VA rater and how a disability is to be perceived. The medical examiner may select words and sentence structures that may be perceived in a way that a reduction in compensation benefits is necessary, or that an increase is appropriate or no change at all is necessary.

Based on a thorough review of the disability examined, VA raters may issue a new or updated medical decision and contact the veteran by mail. After the decision has been made, VA will do 1 of 3 possible outcomes:

  • The veteran’s disability rating will remain unchanged;
  • It was concluded that the disability has worsened and an increase in compensation benefits may be approved. If not approved for an increase it will be annotated in a veteran’s disability file that an increase was not warranted, but the worsening of the disability condition has been recorded and recognized;
  • The disability has improved significantly enough that a reduction in compensation benefits may be appropriate at this time.

If a veteran misses a review exam, it may negatively affect the outcome of any potential increase in compensation benefits. The veteran should always call their VA Regional Office (VARO) to reschedule their appointment as soon as reasonably possible once they realize they won’t make it to the scheduled review exam. Harsh, but true, if a veteran misses an exam without details as to why, VA may be required by law to propose an immediate reduction in the disability that was to be examined or an immediate termination of compensation benefits for that specific disability.

It’s very important that a veteran review exam results as soon as possible. All too often, what is written by the medical examiner differs quite a bit from what the veteran witnessed. For instance, some veterans have reported that the medical examiner indicated that a certain instrument was used during the exam, and the veteran was sure no such instrument was ever used. Checking the accuracy of the medical exam is crucial. Some veterans use the Post Examination Assessment Form immediately after medical examinations conducted by VA medical staff. In doing so, the veteran has an opportunity to record exam results as he/she remembers them, and the form provides a structured format the way VA personnel like to work with.

Lastly, it is vital to the outcome of any medical examination conducted by VA personnel that the veteran comb over all details of correspondence sent to them related to the medical examination. Addressing any and all issues related to the medical examination is a must. If VA is asking for information, it is very important that a veteran respond to the question as soon as humanly possible. Some veterans may require the help of a certified VSO in interpreting information sent to them be VA personnel. Understanding what a veteran receives from VA is of utmost importance. [Source: USVCP | June 2018 ++]