b. Requesting Examinations at a Proper Facility Request Department of Veterans Affairs (VA) examinations from the the VA Medical Center (VAMC) in whose primary service area the examinee resides another VAMC that is able to conduct the type of examination requested, or a designated contracted provider. Notes: Because not all VAMCs are able to conduct certain types of specialist examinations, it may be necessary to schedule the examination outside the primary service area in which the examinee resides. A listing of the counties and zip codes each VAMC serves must be maintained at each regional office (RO). References: For more information on specialist examinations, see jurisdiction for examinations of foreign resident beneficiaries, see , and jurisdiction for examinations of reserve component participants in the Integrated Disability Evaluation System (IDES), see . c. When an Examination or Opinion is Necessary References: For more information on when a medical examination or opinion is necessary, see , and . Continued on next page 1. General Information on Examination Requests, Continued d. DBQs Disability Benefits Questionnaires (DBQs) are documents used to elicit medical information needed to make decisions on claims, and provide a standardized report format for medical examinations and opinions. DBQs are designed for use by both the Veterans Health Administration (VHA) and contract examiners as well as private providers. References: For more information on DBQs, see VA’s , and VA’s .
a. Description of a Social Survey A social survey is an interview with the Veteran to assess the impact of disability on the capacity to interact with others and function in an industrial setting. This type of information may be used in conjunction with objective clinical findings when, for example, evaluating psychiatric disabilities, examining FPOWs, or considering individual unemployability (IU). b. When Social Surveys Can be Used to Evaluate Social and Industrial Impairment A social survey is an acceptable type of evaluation of social or industrial impairment if the rating issue pertains to the evaluation of disability, and a VA examination has established the diagnosis. Reference: For information on social surveys for FPOWs, see . Continued on next page , Continued c. When Social Surveys Should Be Used to Evaluate Physical or Mental Disability When a clinical examination alone would not provide sufficient information to assess the impact of physical and/or mental disability on the Veteran’s capacity to interact with others and function in an industrial setting, request a social survey. A social survey may be especially useful in cases concerning Veterans with psychiatric illness arrested tuberculosis loss of limbs, sight, or hearing physical disfigurement resulting in feelings of inferiority, or epilepsy. Important: Do not request a social survey in a case involving epilepsy without first obtaining the consent of the claimant. d. Who Conducts a Social Survey Social workers are responsible for conducting comprehensive social surveys for medical and rating purposes.
e. When to Order Reexaminations in FPOW Cases If the Veteran expresses dissatisfaction with either the initial examination or the rating decision based on the initial examination, order a reexamination. Reference: For more information on requesting additional information from the Veteran, see . 7. FPOW Social Surveys Introduction This topic contains information about FPOW social surveys, including participation in FPOW social surveys handling examinations that do not include an FPOW social survey automatic scheduling of FPOW social surveys, and specific scheduling of FPOW social surveys. Change Date August 3, 2011 a. Participation in FPOW Social Surveys As social surveys are a voluntary examination for FPOWs, no claim should be prejudiced by the failure of an FPOW to cooperate in accomplishing the survey. b. Handling Examinations That Do Not Include an FPOW Social Survey If a social survey was to be conducted for an FPOW but was not, then return the examination as inadequate for rating purposes unless it is indicated that the FPOW declined to participate in the social survey c. Automatic Scheduling of FPOW Social Surveys VHA automatically schedules a social survey after receiving an examination request for a special FPOW protocol examination. Continued on next page , Continued
a. Examinations Routinely Performed by Specialists Some examinations are routinely performed by specialists. These examinations include hearing vision dental, and psychiatric. b. Who May Request Other Types of Specialist Examinations In certain circumstances, specialist examinations for other conditions can be requested by the VSR or RVSR the medical examiner, or BVA. c. When to Request a Specialist Examination Request a specialist examination only if it is considered essential for rating purposes. Example: A specialist examination may be requested if an issue is unusually complex if there are conflicting opinions or diagnoses that must be reconciled, or based on a BVA remand. Continued on next page , Continued d. Who Determines the Choice of Examiner The choice of examiners is up to the VA medical facility conducting the examination, unless the BVA remand specifies that the examination must be conducted by a “Board-certified specialist in …,” or “specialist who is Board qualified.” Note: In the absence of a BVA remand, ROs may not designate qualification requirements for a specialist examination. 9. Medical Opinions
4 Social Security Number (SSN) Enter the SSN if it is different than the file number. Note: Enter the SSN of the person being examined if the person is not a Veteran. 5 Telephone Number Enter the telephone number of the person being examined. 6 Power of Attorney Enter the power of attorney of the person being examined. 7 Date Ordered Enter the date on which the examination is requested. 8 By Enter the VSR’s/RVSR’s name or initials and Correspondence Symbol. 9 Type of Examination Be sure to use the designated code to indicate the examination type. Applicable codes are “E” for Insufficient Exam “I” for Claim Increase “ON” for Original Nonservice-Connected “OS” for Original Service-Connected “OTH” for Other “P” for former POW “R” for Review Examination, and “T” for Terminal. Continued on next page , Continued (continued) Item Entry Explanation 10 Insufficient Examination If the request is for additional information because a previous examination was insufficient, enter the following in the Remarks section: the date of the inadequate examination, and a complete explanation of the necessary corrective action. 11 General Medical Examinations Indicate any known diagnoses or complaints.
Specialist Examinations Check this box to request a specialist examination. Attach a copy of any Board of Veterans’ Appeals (BVA) remand if the examination is required in connection with a remand. Note: Explain the nature of the examination and the reason for the request in the Remarks section. Remarks Restrict entries to clarifying remarks concerning the issue or issues to be resolved and/or the type of examination requested. Note: Do not use manual, regulation, or code citations. Claimant Represented By Indicate by an appropriate check or annotation, the current accredited service organization of record. Note: If the person being examined is represented by a person or organization that does not have an office located at the RO check the “Other” block in Item 19 ,and enter the complete name and address of the person or organization. Date Signature of Authorizing Official, and Correspondence Symbol Enter the date the form is signed name of the authorizing official (must be legible), and correspondence symbol and telephone number of the authorizing official. Continued on next page , Continued c. Forwarding Examination Requests to the Appropriate Forward the examination request to the clinic or medical center nearest the Veteran’s residence that is able to conduct the type of examination requested. d. Handling the File Copy of the Examination Request Reverse file a copy of the examination request in the claims folder pending receipt of the examination report.