When VA Requests a Reexamination of Your Disability

Navigating the VA disability claims system can be frustrating and challenging for any veteran. One of the more confusing aspects is trying to understand why the VA may reexamine your disability, especially if you believe your condition is static. 

However, there are a few reasons the VA may do this, including if they believe your medical condition has improved or if there were inaccuracies in the initial rating. Learn how to identify the reasons why you might be subjected to another C&P exam and how to handle it effectively. 

Understanding VA Reexaminations

These periodic reviews are meant to determine if there has been any change in the severity of a veteran’s service-connected condition. The evaluations can lead to an increase, decrease or continuation of the current disability rating. 

The VA may call for a veteran’s disability to be reviewed if:

• There is evidence that the veteran’s condition has improved.
• The initial examination didn’t establish a permanent degree of disability.
• The veteran’s condition is expected to improve over time.

Why Would I Need to Be Reevaluated? 

According to VA regulations, these additional C&P exams are generally required when it is likely that a veteran’s condition has improved or if it is less than five years since they were last seen. The exceptions to this rule are for:

• Static Disabilities: Conditions that are considered permanent and not expected to improve, such as the loss of a limb, may not require reexaminations.
• Age of the Veteran: Veterans over the age of 55 are less likely to be called for reexaminations unless there is evidence suggesting significant improvement in their condition.
• Long-term Stability: Disabilities that have been stable for five years or more may not require reexaminations unless there is a reason to believe the condition has improved.

But I Have a Static Disability! Why the Reexamination?

Even if you have a static disability, there are still certain circumstances where it may not be protected and the VA might still require a veteran to be seen by a medical professional again.

• Routine Future Exams (RFE): Scheduled reviews for conditions that were not initially deemed permanent may trigger reexaminations.
• Medical Evidence of Improvement: If new medical records or treatment suggests that your condition has improved, the VA may call for a reexamination.
• Inaccuracies in the Initial Disability Rating: If there was an error or insufficient evidence in the initial rating decision, a reexamination might be requested to ensure the correct rating is assigned.

How to Prepare if This Happens to You

If you receive a request for an additional C&P exam, it can be stressful and frustrating. However, it is important to respond appropriately. Here’s some helpful tips:

• Attend the Exam: Failure to attend can result in the reduction or termination of your benefits. 
• Prepare Documentation Ahead of Time: Bring all relevant medical records, treatment history and any new evidence that supports the current severity of your condition.
• Be Honest and as Detailed as Possible: During the exam, provide an accurate description of your symptoms, limitations and how the condition affects your daily life.

Veterans’ Legal Protections Against Unwarranted Reexaminations

The VA has specific regulations to protect veterans from being seen unnecessarily. According to 38 CFR § 3.327, additional C&P appointments are not required:

• When the disability is established as static.
• When the disability has been assigned a minimum rating.
• When the disability from disease is permanent in character and of such nature that there is no likelihood of improvement.
• When the veteran is over 55 years old, except under unusual circumstances.

If you believe a request for your disability to be reevaluated is unwarranted, you can appeal the decision. Consulting with a legal expert or veterans’ advocate can help you understand your rights and navigate the appeals process. Contact Hill & Ponton for a free case evaluation today.

Content Reviewed by

Cassandra Crosby

Cassandra, an Accredited Agent and claims advocate for Matthew Hill & Shelly Mark’s teams, reviewed the information provided in this post.