Overview
In This Section |
This section contains the following topics:
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1. A&A and Housebound Examinations
Introduction |
This topic contains information about A&A and housebound examinations, including
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Change Date |
June 21, 2018 |
III.iv.3.F.1.a. Purpose of an A&A and Housebound Examination |
The aid and attendance (A&A) and housebound examination is designed to
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III.iv.3.F.1.b. When an A&A and Housebound Examination May Be Useful |
It may be useful to request an A&A and housebound examination before a final determination is made, especially if the evidence of record demonstrates a reasonable probability of entitlement to A&A or housebound benefits but is not sufficient to allow the benefit.
Note: As provided in 38 CFR 3.326, an examination is not required and should not be pursued if the evidentiary record is otherwise sufficient to independently support entitlement to A&A or housebound benefits.
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III.iv.3.F.1.c. Requesting an A&A and Housebound Examination |
Use the table below when requesting an A&A and housebound examination.
Note: A disability benefits questionnaire (DBQ) does not exist at this time for A&A and housebound examinations.
References: For more information on
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2. Special Issue Claims and Other Types of Examination Requests
Introduction |
This topic contains information about other types of examination requests, including
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Change Date |
February 19, 2019 |
III.iv.3.F.2.a. Examinations of Non-Veteran Claimants and Beneficiaries |
As the facts of an individual case demand, the rating activity may schedule examinations of non-Veteran claimants and beneficiaries
References: For more information on
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III.iv.3.F.2.b. Hospital Observation |
To properly visualize and evaluate complex disability issues, the rating activity may request a period of hospitalization for observation and examination.
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III.iv.3.F.2.c. Field Examinations |
Request a field examination when it is not possible, through the routine examination process, to
Reference: For more information on requests for field examinations, see M21-1, Part III, Subpart vi, 8.8.
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III.iv.3.F.2.d. Examinations of Incarcerated Veterans |
An incarcerated Veteran is entitled to a Department of Veterans Affairs (VA) compensation examination as part of the duty to assist.
When examination of an incarcerated Veteran is required, the RO, Veterans Benefits Administration (VBA) contract examination provider, and/or local Veterans Health Administration (VHA) Medical Examination Coordinator must confer with prison authorities to determine whether the Veteran should be
Important:
Note: Request any examination(s) needed in support of an incarcerated Veteran’s claim for individual unemployability (IU) benefits, as discussed in M21-1, Part IV, Subpart ii, 2.F.2.c and d, even though there may be no award of such benefits while the Veteran is incarcerated.
References: For more information on
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III.iv.3.F.2.f. Reexaminations by a Different Examiner |
The rating activity may request that the claimant be reexamined by another medical examiner if compelling reasons exist.
To request a reexamination
Reference: For more information on preparing examination requests, see M21-1, Part III, Subpart iv, 3.A. |
III.iv.3.F.2.g. Homeless Veteran Examination Requests |
ROs must expedite the processing of all claims submitted by Veterans who are
Depending upon the Examination Request Routing Assistant tool’s recommendations, use the appropriate system to request these examinations, and ensure that the following comment (or its near equivalent) is included in the body of the examination request:
Claim for a homeless or at imminent risk of homelessness Veteran. Expeditious processing is requested.
Reference: For more information on priority processing of claims from homeless Veterans, see M21-1, Part III, Subpart ii, 1.D.2.
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3. FPOW Protocol Examinations
Introduction |
This topic contains information about FPOW protocol examinations, including
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Change Date |
June 21, 2018 |
III.iv.3.F.3.a. Reviewing FPOW Claims |
Review all claims from former prisoners of war (FPOWs), including original claims, supplemental claims, and claims for an increased evaluation, to determine if the
References: For more information on
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III.iv.3.F.3.b. Considerations When Requesting an FPOW Protocol Examination |
If the FPOW was not examined under the FPOW protocol, request an examination utilizing the Former Prisoner of War (POW) Protocol Disability Benefits Questionnaire, unless it
Note: Monetary benefits to an FPOW will not be denied unless the claimant has been offered a complete physical examination conducted at a VA hospital or outpatient clinic.
Reference: For more information on examination requirements, see 38 CFR 3.326.
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III.iv.3.F.3.d. How to Order Initial FPOW Protocol Examinations |
In preparing a request for an initial FPOW protocol examination,
Notes:
References: For more information on
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4. Pre-Discharge Examinations
Introduction |
This topic contains information about pre-discharge examinations, including
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Change Date |
March 12, 2018
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III.iv.3.F.4.a. Who Is Eligible for Pre-Discharge Examination |
Pre-Discharge claim submission is available to service members with no more than 180 days remaining until discharge at select military installations that contain VA intake sites.
References: For more information on
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III.iv.3.F.4.c. General Medical Examinations and the SHA |
Effective October 2013, all eligible Benefits Delivery at Discharge (BDD) claimants receive an SHA in lieu of a general medical examination. Those claimants who file pre-separation claims that are excluded from the BDD program, however, will continue to require a general medical examination and should not be examined under the SHA protocol.
The SHA DBQ is an available selection for use in connection with BDD claims at most facilities. Select the SHA DBQ if it is available at the requested examination facility and add the following comment: BDD claim.
If the SHA DBQ is not an available system selection for use in connection with a BDD claim, select the general medical DBQ and add the following statement to the comments: BDD claim: SHA DBQ is requested.
References: For more information about
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5. Examinations of Pregnant Claimants
Introduction |
This topic contains information about examinations for pregnant claimants, including |
Change Date |
February 19, 2019 |
III.iv.3.F.5.d. How Pregnancy Affects Participation in Pre-Discharge Programs |
The station of jurisdiction (SOJ) processes and rates pre-discharge claims for pregnant service members locally. Pregnant service members may file pre-discharge claims up to 180 days prior to separation/retirement; however, the claims are excluded from processing through the BDD program.
Since pregnancy prohibits certain diagnostic tests and procedures, the examiner may be unable to accurately assess the claimant’s medical condition. This would preclude completion of the examination and the rating process until conclusion of the pregnancy.
Reference: For more information on claim types or attributes that are excluded from the BDD program, see M21-1, Part III, Subpart i, 2.A.1.e.
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III.iv.3.F.5.e. Options for Processing Claims for Pregnant Claimants |
There are three options for processing claims for pregnant claimants. The receiving RO should determine, on an individual basis, which of the following actions is appropriate based on the claimed contentions:
Example: Service connection for an amputated finger can be awarded based on STRs, but the other claimed issues require specific tests that are prohibited due to pregnancy and must be deferred until the pregnancy concludes and a full examination can be conducted. Reference: For more information on partial rating decisions and deferred issues, see M21-1, Part III, Subpart iv, 6.A. |
6. IMOs
Introduction
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This topic contains information about IMOs, including
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Change Date
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February 19, 2019
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III.iv.3.F.6.a. Definition: IMO |
An independent medical opinion (IMO), as discussed in 38 CFR 3.328, is
Notes:
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III.iv.3.F.6.b. Who May Initiate a Request for an IMO |
A request for an IMO under 38 CFR 3.328, in conjunction with a pending claim, may be initiated by the
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III.iv.3.F.6.d. Processing Requests for an IMO |
The table below describes how to process a request for an IMO under 38 CFR 3.328 and identifies the responsible parties.
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