18 Aug Importance of VA Exams
For some claimants, the Department of Veterans Affairs (VA) will request a VA exam. These exams help the VA make a determination regarding the disability claim. A failure to appear at the scheduled exam can have significant negative consequences on the claimant. As a result, claimants should be sure to show up for their exam or, at the very least, communicate with the VA as to why a scheduled exam will be missed.
A claimant who fails to report to a VA exam must have good cause for failing to do so. Some examples include the claimant being ill or hospitalized or the death of someone in the family. When the claimant does not have good cause, the consequences can be severe.
Before proceeding, it may be helpful to briefly discuss the various forms of claims that can be filed with the VA, which include the following:
- Original claim: the first claim a claimant files for VA compensation
- Reopened claim: a claim filed for a benefit that could not be granted and in which the decision has since become final. Meaning that it has been over one year and there has been no appeal
- Reopening can only occur if new and material evidence is received
- New Claim: a claim for a benefit that may or may not have been filed before; the decision is not related to any evidence submitted in connection with an earlier claim
- May include claims for increased disability evaluation, special monthly compensation, or individual unemployability
- Secondary Claim: a claim for disabilities that developed as a result of or were worsened by another service-connected condition. In other words, the VA recognizes that a service-connected disability can cause a second disability that may not be ordinarily covered
Pursuant to the Code of Federal Regulations, if the exam was requested as part of an original compensation claim, the claim will be rated on the evidence the VA has on file. However, if the exam relates to any other original claim, a reopened claim for a benefit that was previously disallowed, or a claim for increase, the claim will be denied.
If the exam was for a continuing entitlement, the VA will issue a pre-termination notice advising the claimant that the payment of benefits may discontinue or be reduced to a lower evaluation level. The notice must include the following:
- Expected end date or date of reduction
- Reason for discontinuance or reduction
- A statement of the claimant’s procedural and appellate rights
The claimant is given 60 days to indicate his or her willingness to report for the reexamination. Alternatively, the claimant can provide evidence that demonstrates why the payments should not be discontinued or reduced. If the claimant provides no response or insufficient evidence and 60 days pass, the payment of benefits will terminate or be reduced.
Help with VA Benefits
For more information regarding any part of the process of applying for and retaining VA disability benefits, speak with an experienced disabilities law attorney today. At the Klok Law Firm LLC, we proudly utilize our knowledge and expertise in helping our veterans and servicemembers obtain the benefits they need for service-connected conditions.