c. When to Request a specialist examination only if it is considered essential for rating Request a purposes. Specialist Examination A specialist examination may be requested Example: if an issue is unusually complex if there are conflicting opinions or diagnoses that must be reconciled, or based on a BVA remand. d. Who The choice of examiners is up to the VA medical facility conducting the Determines the examination, unless the BVA remand specifies that the examination must be Choice of conducted by a Examiner or specialist in “Board-certified …,” who is Board “specialist qualified.” Some DBQs require a specialist to complete the examination. The DBQ will identify specialist requirements in one of the first paragraphs on the form. In the absence of a BVA remand, ROs may not designate qualification Note: requirements for a specialist examination. Effective August 4, 2014, was amended to reflect that a diagnosis of a mental e. DSM- 5 and Mental disorder must conform to the standards set in the Diagnostic and Statistical Disorders Manual of Mental Disorders, Fifth Edition (DSM-5). Before that date, the Specialty regulation required diagnoses to conform to the DSM-IV. Examinations For new examination requests on or after August 27, 2014, VHA examinations must be performed using DSM-5 criteria. No comment to that effect is required on requests for mental disorders or PTSD DBQs. Refer to the following table for guidance on whether to request a new examination under the DSM-5 in a claim for SC or Pension where Veteran’s the record contains a mental health DBQ based on historic DSM-IV criteria. If ... Then ... the DSM-IV exam on the issue of SC or do not request a new Pension examination. Veteran’s is otherwise adequate for rating purposes renders an Axis I diagnosis of a mental disorder, and supports an award of the benefit sought in view of the evidence of record the DSM-IV exam on the issue of SC or request a new examination. Pension does not satisfy all of the Veteran’s criteria above the DSM-IV exam on the issue of do not request a new
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. 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.” Some DBQs require a specialist to complete the examination. The DBQ will identify specialist requirements in one of the first paragraphs on the form. Note: In the absence of a BVA remand, ROs may not designate qualification requirements for a specialist examination. e. DSM- 5 and Mental Disorders Specialty Examinations Effective August 4, 2014, was amended to reflect that a diagnosis of a mental disorder must conform to the standards set in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Before that date, the regulation required diagnoses to conform to the DSM-IV. For new examination requests on or after August 27, 2014, VHA examinations must be performed using DSM-5 criteria. No comment to that effect is required on requests for mental disorders or PTSD DBQs. Refer to the following table for guidance on whether to request a new examination under the DSM-5 in a claim for SC or Veteran’s Pension where the record contains a mental health DBQ based on historic DSM-IV criteria. If ... Then ... the DSM-IV exam on the issue of SC or Veteran’s Pension is otherwise adequate for rating purposes renders an Axis I diagnosis of a mental disorder, and supports an award of the benefit sought in view of the evidence of record do not request a new examination. the DSM-IV exam on the issue of SC or Veteran’s Pension does not satisfy all of the criteria above request a new examination. the DSM-IV exam on the issue of do not request a new