VA Rolls Out Pilot Program to Use In-House Doctors for Disability Exams, Targets Rural Wait Times

If you’ve ever dealt with the VA disability claims process, you know the medical examination—the Compensation and Pension (C&P) exam—is the biggest chokepoint. This new legislation, the Medical Disability Examination Improvement Act of 2025, is a serious attempt to fix that by addressing three major issues: exam capacity, quality control, and access for veterans living far from major cities.

The VA’s New House Call Pilot

Right now, most C&P exams are handled by third-party contractors. Section 2 sets up a pilot program that lets the VA use its own medical facilities and doctors to perform these exams. The goal is to see if using in-house staff improves cost, speed, and quality. Think of it as the VA trying to bring the work back in-house to see if they can do it better and faster than the contracted firms.

This pilot is starting small, testing the waters in just one Veterans Integrated Service Network (VISN) before Fiscal Year 2027. But it’s designed to scale up quickly, potentially expanding to 10 VISNs by 2033. For veterans, this could mean less time waiting for an appointment, especially if the VA’s own clinics prove to be more efficient than the contractors. The bill does note a slight administrative complexity: the initial funding for the pilot comes from the VA’s compensation and pension funds, though it must be reimbursed to the general operating accounts later.

Cutting the Red Tape and Improving Quality Control

Two major sections focus on ensuring the exams are done right the first time, preventing frustrating delays. Section 4 mandates rigorous new training for all VA employees who order or review these medical exams. They need to be trained on how to spot an inadequate exam and understand the legal requirements (like the VA’s “duty to assist”). If you’re a new employee ordering these exams, you’ll have your work double-checked until you hit a 90% accuracy rate—a high bar that should, in theory, translate to better initial decisions for veterans.

Section 5 introduces a mandatory quality control review. Starting one year after enactment, the VA must review a statistically significant sample of exams every three months, checking for two things: adequacy (was the exam good enough to make a decision?) and overdevelopment (did they ask for way more medical info than necessary?). If the review finds your claim was delayed by an inadequate exam, the VA must give your entire claim priority processing—a big win for anyone stuck in limbo waiting for a second or third exam.

Closing the Distance for Rural Veterans

For veterans living in highly rural areas—the kind of places where the nearest VA clinic is a two-hour drive—Section 3 is crucial. It requires the Secretary of Veterans Affairs to conduct a detailed study within one year on access to these exams. The study must compare exam completion times for rural versus non-rural veterans and figure out why any delays exist.

Crucially, the VA must develop a plan to use commercial technology and industry solutions to allow housebound or remote veterans to get their exams without extensive travel. This could mean a big push for telehealth or mobile exam units, which would significantly improve access and reduce travel costs for those who need it most.

Making the Process Smoother

Finally, the bill addresses two common administrative headaches. Section 7 mandates a review of the VA’s entire scheduling process. The resulting improvement plan must ensure that veterans have some say in when and where their exam happens within a reasonable timeframe, and that the scheduling experience is seamless regardless of which contractor is used. For the veteran, this means less frustration trying to coordinate appointments.

Section 6 fixes a common issue where veterans bring relevant medical evidence to their exam, but the examiner has no easy way to get it into the official VA file. This section requires the VA to create a mechanism allowing examiners to transmit claimant-provided medical evidence directly into the claims file, ensuring that critical documents aren't lost in the administrative shuffle. This small change could prevent countless appeals caused by missing paperwork.