Sometimes VBA may return an examination report as inadequate or insufficient. These terms have different meanings when applied to VHA and contract examinations.

VHA Examinations

For VHA C&P examinations, VBA uses the term "insufficient" for rating purposes rather than "inadequate" to refer to an examination that is returned for more information.

The DMA Compensation and Pension Clinician's Guide (Chapter 1, item 2.0) explains that if information necessary for rating is missing, VBA can return an examination report to a C&P examiner as being insufficient for rating. This label does not imply the examination was inadequate. Instead, it refers to the absence of information specifically asked for in the VA Schedule for Rating Disabilities (VASRD), found in 38 CFR Part 4. An examination report is returned as insufficient most commonly due to failing to answer specific questions on a documentation protocol or asked in the Request for Examination.

VBA-Contracted Examinations

For VBA contracting purposes, inadequate and insufficient examination results are defined as follows:

"Inadequate" refers to an examination documentation protocol submitted with incomplete information, missing information, or both, from required fields. It can also refer to a documentation protocol that contains inaccurate medical information. The report is considered inadequate even if the VA Regional Office (VARO) does not require clarification to reach a disability rating decision.

"Insufficient" refers to an examination documentation protocol that requires clarification for the VARO to reach a disability rating decision, even if all fields are addressed and it contains accurate medical information.