Mandatory Future Reexaminations
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In only certain cases will the VA conduct reexaminations to assess the current severity of a veteran's service-connected disabilities. The purpose of these reexaminations being to ensure that disability ratings accurately reflect any changes in the condition over time. HOWEVER, MOST CONDITIONS do NOT require future evaluations!

On October 7, 2021, VA Policy Letter 21-01 updated and clarified policy surrounding when routine future examinations (RFE). In short boiling down to mandatory reexaminations being limited (in MOST cases) to when a VA regulation requires it. If a rater wants to add a reevaluation otherwise the particular evidence justifying it must be EXCEPTIONALLY COMPELLING or needed to properly evaluate the Veteran!

There are 4 primary cases in which a rater will establish an RFE:

  1. When mandated by the Rating schedule;

  2. After award of temporary 100% due to Hospitalization AND evidence suggests improvement of condition;

  3. After award of temporary 100% due to Convalescence AND evidence does not show severity afterwards or suggests improvement; or

  4. Prestabilization rating for specific conditions from a MEDBOARD separation ONLY.

    • When a rater awards an extra-scheduler 50 or 100% evaluation (rating schedule does not have a 50 or 100% rating for the condition); or

    • Service-connection is granted for a Mental condition related to trauma.

The 4th case is when there is EXTREMELY COMPELLING evidence the condition is likely to improve. This case is so rare in practice that MOST RATERS are just gonna label the condition as static and walk away.

When the Rater is Expressly PROHIBITED from Establishing a Reevaluation

  • Condition is static (disability is permanent in character and of such nature that there is no likelihood of improvement);

  • Findings and symptoms are shown to have persisted without material improvement over five years or more;

  • Veteran is over 55 years of age (except under unusual circumstances);

  • Evaluation is the lowest stated evaluation for the condition in the rating schedule;

  • Evaluation is 10% or less; or

  • Combined evaluation would not change even if the reexamination resulted in a reduced evaluation for one or more disabilities.

IMPORTANT NOTE:

  • Regulatory requirements for a reexamination DO override these prohibitions!

Penalties for Failure to Attend Scheduled Reexaminations

Attendance at these exams is REQUIRED! Failure to report without good cause may result in reduction (after appropriate Due process) to 0%, the minimum evaluation for the condition, or based upon recent evidence of record; whichever is highest.

IMPORTANT NOTES:

  • Protection via the 5 year rule does NOT apply!

  • Protection via the 20 year rule overrides and the condition CANNOT be reduced!

Conditions with Regulatory Required Future Reexaminations

The following table lists what conditions are mandated by regulation to have a reevaluation. Meaning, unless your condition is one of the following AND meets the specifics, your condition is VERY LIKELY static.

IMPORTANT NOTES:

  • In the cases of cancers, if the cancer is terminal (as noted by a doctor or the evidence of record (entered palliative care or cancer is spreading)) the condition will be made static and no further examinations will be set up for the cancer(s).

  • For situations in which (how could a rater know somethings ends/resolves), the examiner will generally note when expected treatments will end/condition will resolve. If a Veteran refuses/is not taking cancer or other treatment(s) or the examiner does not provide an expected time frame - then the rater will typically assign a reevaluation between 6 months to 3 years.

NOTE:

  • For specifics details of what is considered appropriate treatment, etc. click on the specific condition.

Condition Reevaluation
≥6 month Hospitalization for mental 6 months after release
Prestablized medboard conditions 6-12 months after separation
Acquired hemolytic anemia 6 months after release
Agranculocytosis 6 months after release
Aortic aneurysm 6 months after release
Aplastic anemia 6 months after treatment/release
Breast cancer 6 months after treatment/remission
Chronic liver disease 6 months after treatment
Chronic myelogenous leukemia 6 months after treatment
Digestive cancer 6 months after treatment/remission
Ear cancer 6 months after treatment/remission
Endocrine cancer 6 months after treatment/remission
Essential thrombocythemia 6 months after treatment/release
Eye cancer 6 months after treatment/remission
Genitourinary cancer 6 months after treatment/remission
Gynecological cancer 6 months after treatment/remission
Heart transplant 1 year after release
Heart valve replacement 6 months after release
Hodgkin's Lymphoma 6 months after treatment/remission
Hyperinfection Syndrome Immediately after going inactive
Hyperparathyroidism 6 months after release/treatment
Hypothyroidism 6 months after release
Immune thrombocytpenia 6 months after treatment
Kidney transplant 1 year after release
Large artery aneurysm 6 months after release
Leukemia 6 months after treatment
Leprosy 6 months after treatment/remission
Liver abscess 6 months after original diagnosis
Liver transplant 1 year after release
Malignant melanoma 6 months after treatment/remission
Multiple myeloma 5 years after treatment/remission
Muscle cancer 6 months after treatment/remission
Myelodysplastic syndromes 6 months after treatment/release
Non-Hodgkin's lymphoma 2 years after treatment/remission
NonTB mycobacterium infection Immediately after going inactive
Oral cancer 6 months after treatment/remission
Pancreas transplant 1 year release
Pernicious anemia 6 months after treatment/release
Peptic ulcer 3 months after surgery/release
Polycythemia vera 6 months after treatment/release
Primary myelofibrosis 6 months after treatment/release
Rectum prolaspse 2 months after repair
Respiratory cancer 6 months after treatment/remission
Skin cancer 6 months after treatment/remission
Soft tissue sarcoma (other) 6 months after treatment/remission
Soft tissue sarcoma (vascular) 6 months after treatment/remission
Solitary plasmacytoma 6 months after treatment/remission
Tuberculosis Immediately after going inactive
Ventricular arrhythmias 6 months after release
Visceral leishmaniasis 6 months after treatment/remission

At Once Examination

Unlike future reexamination; done several months to years after a decision, these examinations are typically ordered immediately after the decision is made. In practice this is a RARELY done, as most raters will simply defer for an examination or opinion and keep the current claim running.

The M21 specifically states an at-once examination should be input when:

  • Rater grants temporary 100% based on convalescence AND rating was made before end of the temporary 100% period;

  • Medboard indicates entitlement to Special Monthly Compensation (SMC) but evidence is not sufficient; or

  • Medical record shows Kidney function rates at least 10% but the record does not show a full 3 month period over a 12 month span showing that same level of kidney function.

Frequently Asked Questions

    • In those cases, the rating schedule does not mandate a future evaluation after an established period of 100%. After which the condition reduces to a set minimum evaluation. Meaning if the Veteran wants to file an increase they can do so. However, a rater CAN still schedule a reevaluation even if not mandatory.

    • Again, you were likely made static out the gate but if you want to be SURE you can Request your Codesheet, ask your VSO, or do some Wizardry.

    • When is the date of the examination?

      • If it is years in the past then the VA lost track of things at some point. If a reexamination was noted based on the prior rater’s opinion and not regulation, a new rater may simply remove it and drive on. Otherwise the VA (once told) will order the reexamination.

      • If it is in the future then you should expect that reexamination. If you are still within a year of the decision you may file a Higher level review to address the matter. Past the year there is no mechanism to fix it. Outside of that you would need to declare a CUE (which may ironically cause you to go to a new exam) or filing an increase (which WILL cause a new exam).

    • Veterans can continue to have reevaluations for cancer up to 20 YEARS (if evaluated at the 100% rate the whole time), if the condition is not made permanent sooner.