Opinion for the court filed by Senior Judge FRIEDMAN, in which Judge RADER joins. Dissenting opinion filed by Chief Judge MAYER.
MAYER, Chief Judgedissenting.
In my view, a breach of the duty to assist the veteran by failing to provide a proper medical examination vitiates the prior decision of the Regional Office for the purpose of direct appeal. A duty to assist is an integral part of the claimant friendly, non-adversarial claims adjudication process of the Department of Veterans Affairs (VA). A breach of this critical duty compels us to create a judicial remedy tolling the finality of VA decisions for the purpose of appeal. Hayre v. West, 188 F.3d 1327 (Fed.Cir.1999). This ensures that the VA’s duty to assist claimants does not become a hollow slogan. Id.
Congress expressly stated that the VA must “fully and sympathetically develop the veteran’s claim to its optimum before deciding it on the merits.” H.R.Rep. No. 100-963 at 13, reprinted in 1988 U.S.C.C.A.N. 5782, 5795. In Hayre, we concluded that the VA breached its duty to assist when it failed to inform the veteran that it was unable to obtain pertinent service medical records the veteran had re*1317quested. 188 F.3d at 1334. But the VA’s duty to assist is not limited to obtaining medical or other government maintained records; it includes providing a thorough medical examination when necessary to develop the- veteran’s claim. Id. at 1332.
Hayre described the specific actions of the VA as a “grave procedural error” that required tolling the finality of the Regional Office’s decision. Id. at 1333. It was not, however, limited to only grave procedural errors. The results of a veteran’s medical examination are often the determinative factor in the claim adjudication process. An insufficient examination may serve to breach the VA’s duty to assist the veteran in fully developing his claim. Therefore, administering an improper medical exam has as important an effect on the proper resolution of a veteran’s claim as a failure to inform .the veteran that the VA was unable to obtain medical records. A veteran must rely upon the VA for a thorough medical examination just as he must rely upon the department to locate service medical records. Just as he must be able to assume, absent notice to the contrary, that the VA located and based its claim determination on the requested medical records, the veteran should be able to assume that the VA performed a thorough medical examination.
I would reverse the judgment of the Court of Appeals for Veterans Affairs.