Part IV, Subpart i, Chapter 2, Section BScheduling Examinations

Revised April 10, 2020

IV.i.2.B.1.a#General Information on Scheduling Examinations

“Scheduling examinations” refers to the process by which the Veterans Benefits Administration (VBA) and either a Veterans Health Administration examining facility or a contract examiner work together to set up a particular examination. VBA will request the examination, which may involve notation of information pertinent to the time and place of the examination. However, the examining facility will actually

• set up the examination, and
• advise the claimant of the time and place of the scheduled appointment.

References: For more information on

• examination requests, see M21-1, Part IV, Subpart i, 2.A
• scheduling problems and rescheduling examinations, see M21-1, Part IV, Subpart i, 2.F.

IV.i.2.B.1.b#Examinations for VA-Employee Claimants

In any case where an examination is needed and the claims folder contains VA Form 20-0344 ,Annual Certification of Veteran Status and Veteran Relatives, or there is a VA Employee flash associated with the record, refer to the table below for appropriate action. — If examination by a contract facility is … — Then clearly note on the examination request that the Veteran is an employee, and schedule the examination at the nearest ...

Important: Make every attempt to avoid a conflict of interest when scheduling the examinations of VA employees. If the need for an exception arises, follow the guidance in M21-1, Part IV, Subpart i, 2.B.1.c.

Reference: For more information on handling claims from employees and their relatives, see M21-1, Part II, Subpart i, 2.D.5.

IV.i.2.B.1.c#Exceptions for Employees Who Work at an Examining Facility

If an employee works at an examining facility and requires an examination in connection with a pending claim, request the examination from a different facility, as described in M21-1, Part IV, Subpart i, 2.B.1.b, unless the Veterans Service Center Manager (VSCM) determines an examination at the employing facility will not affect its integrity.When a VSCM chooses to allow an examination of an employee at the employing facility, the VSCM must

• prepare a signed memorandum explaining the reason(s) for allowing the examination, and
• file the memorandum in the claims folder.

Important: An examining facility will reject an examination request if, while processing the request,

• it recognizes the Veteran as an employee of the facility, and
• there is no indication in the claims folder (if provided) or the request that the VSCM has
  • acknowledged the employee-employer relationship, and
  • approved examination of the employee at the facility.

IV.i.2.B.1.d#Scheduling Examinations for Conditions Subject to Temporary or Episodic Improvement

Schedule the examination of disabilities subject to temporary or episodic improvement, such as skin conditions and other disabilities listed in 38 CFR 3.344, when the conditions are most likely to show representative or claimed symptoms.If there is specific competent information that a disability is worse at predictable times, schedule the examination based on that information.Examples:

• If a Veteran’s symptoms become worse after work, the examining facility should be asked to examine the Veteran at the end of the day.
• If a disability is subject to periodic flare-ups, and the record does not contain specific competent information on when a flare-up can be observed, the Veteran can provide the information about the peak periods of the disability and contact the regional office when the condition worsens. (Note: If the Veteran received treatment for the worsened condition, ask the Veteran to submit evidence of the treatment.)

Important: Under the Acceptable Clinical Evidence (ACE) Process, examiners may be able to complete a fully adequate disability benefits questionnaire capturing representative or claimed symptoms, to include periods of exacerbation and improvement, based on review of existing evidence and/or an interview in lieu of an in-person clinical examination or testing. References: For more information on

• submitting evidence of a worsened condition, see
  • Bowers v. Derwinski, 2 Vet. App. 675 (1992), and
  • Ardison v. Brown, 6 Vet. App. 405 (1994), and
• ACE examinations, see M21-1, Part IV, Subpart i, 2.A.4.

IV.i.2.B.1.e#Scheduling Specialist Examinations

VA examination providers schedule specialist examinations only when requested to do so.Reference: For more information on specialist examinations, see M21-1, Part IV, Subpart i, 2.A.6.