Revised April 29, 2019
X.v.1.E.1.aWhen to Request a Field Examination
Claims processors may request field examinations for various reasons. These include, but are not limited to, the following:
- checking on the history of employment or social adjustment
- substantiating the existence of disease or injury prior to enlistment
- resolving the status of dependents or marital status
- checking on a Veteran’s ability to handle funds competently, and
- handling an unresolvable conflict in the evidence of record.
Reference: For more information on field examinations, see M21-1, Part IV, Subpart i, 2.E.
X.v.1.E.1.bHow to Request a Field Examination
Request field examinations on VA Form 21-3537a , Field Examination Request, and include the following information in the field labeled FACTS TO BE ESTABLISHED :
- the purpose of the field examination in language that is as specific and complete as circumstances permit
- the period of service on which the claim is based and the nature of the claim
- a summary of the material facts with names and addresses of witnesses to be contacted and other known and probable sources of evidence, and
- if entitlement depends on a marriage, the evidence of record pertaining to such marriage, and any prior marriages of the parties. (State whether or not further evidence as to the validity or termination of the marriage is needed.)
Note: If evidence of record is conflicting, clearly state the conflict.
X.v.1.E.1.cHandling Requests for Medical, Social, or Industrial History
When requesting the medical, social, or industrial history of a Veteran or incapacitated child, include the period to be covered and as much of the following information as is known in the field labeled FACTS TO BE ESTABLISHED on VA Form 21-3537a:
- names and addresses of all physicians alleged to have provided treatment
- period of treatment
- names of physicians who have submitted statements indicating whether or not to contact them (Attach copies of all statements with VA Form 21-3537a.)
- names and addresses of employers and periods of employment
- addresses of the Veteran or incapacitated person during the period.
X.v.1.E.1.dFacilitating Identification of a Person Concerned in a Claim
To facilitate identification of a particular person concerned in a claim, provide in the field labeled FACTS TO BE ESTABLISHED on VA Form 21-3537a:
- the best possible leads to obtain information, and
- all of the following information about the person:
- full name
- nickname and any other name by which the person was known
- maiden and married surnames of women, and
- date of birth.
X.v.1.E.1.eRouting Field Examination Requests
Follow the steps in the table below when routing a field examination request.
| Step | Action |
|---|---|
| 1 |
|
| 2 | When a completed field examination report is received, send the report to the activity (authorization or rating) that requested the examination. |
Reference: For more information about jurisdiction and contact information for fiduciary hubs, see M21-1, Part X, Subpart ii, 6.C.1.d.
X.v.1.E.1.fHandling a Request for a Foreign Field Examination
Send a request for a foreign field examination to the fiduciary hub having jurisdiction based on the residence of the foreign beneficiary. Note: The fiduciary hub will then forward the request directly to the appropriate embassy or consulate or to Veterans Affairs Canada. References: For more information on
- fiduciary hubs of jurisdiction, see M21-1, Part X, Subpart ii, 6.C.1.d, and
- requests for field examinations in the Philippines, see M21-1, Part X, Subpart i, 4.C.
End of Part X, Subpart v, Chapter 1, Section E