Scheduling Examinations | M21-1 IV.i.2.B

What this means

m21-1:IV.i.2.B explains scheduling examinations. In plain terms, the official guidance says “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. It also addresses 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.

How this may help with a claim

Use m21-1:IV.i.2.B as an internal VA audit trail for scheduling examinations, not as a promise of a particular result. Compare the actions recorded in your claim file or decision notice with this source-specific detail: “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. Make every attempt to avoid a conflict of interest when scheduling the examinations of VA employees. If the record does not show the expected action, identify the missing step precisely when asking VA or an accredited representative to review the file.

What to review in your file

Check the file against this official condition: 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.
Confirm that the record or notice addresses this source point: 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...;
Document how this stated step or exception applies: 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.

Important limits

m21-1:IV.i.2.B is primarily internal workflow guidance about scheduling examinations. It can help identify what VA was expected to document, but it does not by itself create a claimant deadline, a freestanding entitlement, or a guaranteed remedy. The source also states: “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. 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.

Search terms when useful

Phrases that may help when searching your claim file or this library.

Scheduling Examinations
m21-1:IV.i.2.B
examinations Department -employee claimants
exceptions employees work examining
scheduling examinations conditions subject
scheduling specialist examinations.
IV.i.2.B.1.a. Scheduling Examinations
Scheduling examinations refers process

Original VA guidance

The official VA text of this section

Overview

In This Section

This section contains the topic “ General Information on Scheduling Examinations.”

1. General Information on Scheduling Examinations

Introduction

This topic contains general information about scheduling examinations, including

general information on scheduling examinations
examinations for Department of Veterans Affairs (VA)-employee claimants
exceptions for employees who work at an examining facility
scheduling examinations for conditions subject to temporary or episodic improvement, and
scheduling specialist examinations.

Change Date

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.

Scroll sideways to see the full table.

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...
available	contract facility that does not employ the Veteran.
not available	Department of Veterans Affairs (VA) facility that does not employ the Veteran.

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.