Medical Disability Examination Improvement Act of 2025
The Medical Disability Examination Improvement Act of 2025 proposes a comprehensive package to change how the Department of Veterans Affairs (VA) conducts medical disability examinations used to adjudicate disability compensation claims. Key components include a pilot program to conduct exams at VA medical facilities, a study and plan to improve access for rural veterans (including potential remote solutions), enhanced training and quality controls for VA staff and contractors, mandatory reviews of examination quality with priority processing for inadequate exams, a mechanism to capture evidence veterans introduce during examinations, and a thorough review and reform plan of VA scheduling and customer experience. The overarching goals are to improve the timeliness, quality, consistency, and accessibility of medical examinations and to reduce remands and delays in benefit determinations. The bill would phased expansion of the pilot program across VA facilities, require regular reporting on costs and outcomes, and establish new oversight and accountability measures (including second-level reviews for new examiners and expanded reporting on issues that lead to remands). It also creates a process to reexamine claims when an examination is found inadequate, and requires better coordination between claims processors, exam vendors, and veterans throughout scheduling and exam processes. The bill emphasizes rural access, contractor and employee performance, and improved transparency for veterans navigating the disability claims system.
Key Points
- 1Pilot program to conduct medical examinations at VA medical facilities under 5103A(d), with phased expansion by Veterans Integrated Service Networks (VISNs): up to 1 VISN before 2027; up to 3 VISNs in 2029; up to 6 VISNs in 2031; up to 10 VISNs in 2033; and expansion as appropriate thereafter (2035+).
- 2Study and plan for rural access: within one year, VA must study access for rural/highly rural veterans to covered medical disability examinations, compare time to complete exams, analyze root causes, and develop a plan (including pursuing remote technology or industry solutions to reach housebound or rural veterans).
- 3Training and quality controls for processing CMD examinations: by 180 days after enactment, require enhanced training for new/probationary staff who order or review exams; cover adequacy, necessity, duty to assist, causation, examination elements, and inputs from employees. New hires must pass a second-level review and reach 90% accuracy before ordering exams.
- 4Improvements to reporting on exam quality: amend Board of Veterans' Appeals and Court of Appeals for Veterans Claims procedures to require summaries of recurring issues that cause remands, improving traceability of problems and potential fixes.
- 5Review and priority processing for inadequate or unnecessary exams: within a year and then quarterly for three years, VA must review samples of all CMD exams (both VA employees and contractors), determine adequacy and overdevelopment, and, if an exam is inadequate, re-examine on a priority basis and provide priority processing for the affected claim (unless deemed unnecessary).
- 6Evidence transmission during examinations: create a mechanism for examiners to transmit evidence introduced by veterans during exams into the veteran’s claims file, ensuring such information is preserved and used in adjudication.
- 7Scheduling reform and plan: require a formal review of scheduling tools/contracts/systems within one year, and a plan to improve communication between claims processors and exam vendors, ensure examiners review necessary records, give claimants some agency over when/where exams occur within a reasonable timeframe, create a seamless scheduling experience across vendors, and implement claimant satisfaction surveys.