; (B) the relevance of causation compared to other evidentiary standards in covered medical disability examinations; (C) the required elements of a covered medical disability examination, with an emphasis on the requirement for reasoned analysis to support medical opinions; and (D) the relevance of a lack of a statutory or regulatory presumption of service-connection in covered medical disability examinations. (c) Frequency The Secretary shall ensure that each employee of the Department who orders or uses a covered medical disability examination to evaluate a claim for a benefit under chapter 11 or 15 of title 38, United States Code, completes training that incorporates the requirements of subsection (b) not less frequently than once each year. (d) Modification of reports (1) Board of Veterans' Appeals Section 7101(d)(2) of title 38, United States Code, is amended— (A) in subparagraph (F), by striking ; and and inserting a semicolon; (B) in subparagraph (G), by striking the period at the end and inserting ; and