An Acceptable Clinical Evidence (ACE) exam is a review where a medical professional evaluates your claim based on existing medical records without conducting an in-person examination. VA uses ACE exams when the examiner determines that the existing medical evidence is sufficient to provide the requested opinion or findings without needing to see you in person. ACE exams are sometimes appropriate for conditions that are well-documented in the medical record and where the examiner can answer the medical questions based on the evidence already available. However, they can be problematic if the existing records do not capture the full picture of your condition. For example, range-of-motion measurements for joint conditions generally require an in-person exam. Mental health evaluations typically need a face-to-face clinical interview. If you receive a rating decision and discover it was based on an ACE exam rather than an in-person evaluation, review the findings carefully. If you believe an in-person exam was necessary to properly evaluate your condition, you can argue this point in an appeal or request a new exam. The key question is whether the ACE review captured all the information needed to accurately rate your condition.
Note: This article references sections of the VA's M21-1 Adjudication Procedures Manual. The VA periodically reorganizes the M21-1 and section numbers may have changed since this article was written. For the most current section references, visit the VA's public M21-1 Web Automated Reference Material System (WARMS).