You have been scheduled for a C&P exam as part of your appeal/application and the Regional Office has determined that you have met a minimal standard qualifying you for an evaluation by a physician to determine the etiology and/or severity of your condition.
WHO ARE THE EXAMINERS? The Compensation and Pension examination may take place at a VA Medical Center, outpatient clinic or with a contract examiner. The VA has contract sources to assist with getting these examinations done in a timely fashion, such as Veteran Evaluation Services. The exam will be scheduled within 90 miles of your home, if possible. Once you receive notice, plan on going or request it be rescheduled immediately.
HOW ARE THE EXAMS COMPLETED? In general, the examiner is provided with some basic information about your claim from the VA Regional Office. The examiner by law must review your claims file to include medical and service records. The VA has developed a series of Disability Benefits Questionnaires, DBQs, that are generally provided to the examiners. It is a good idea to review these prior to reporting to the exam to be prepared and informed about what the examiner will be reporting.
For example, if the claim is for a knee, the examiner may complete the DBQ for the knee, VA Form 21-0960M-9, Knee and Lower Leg Conditions. This exam should focus on the Range of Motion for the knee to include extension and flexion, stability of the knee, possible x-ray or MRI, as well as a series of questions about how the knee affects your ability to work and complete daily activities such as bathing, walking, and common household chores.
Please be aware that not all examiners complete the forms and not all examinations require the DBQ to be completed.
TYPES OF EXAMINATIONS
- Original service connection determination
- Increased evaluation for a veteran’s service connected condition
- Evaluations multiple claims or disabilities
- Evaluations for an opinion or nexus to an event in service
The examiner may simply ask you a couple of questions and base his findings off of the record or he may complete a thorough examination of your condition with possible x-ray, MRI, stress test or other testing.
The scheduling of an exam does not necessarily mean that your claim will be granted. Often the examination can result in a negative outcome for the claim. Below is some general advice for preparing for an examination, what to do during the examination and what to do after the exam is completed.
- SHOW UP TO THE EXAM. If you do not go to the exam, for any reason, it may be very difficult to get the exam rescheduled. If you don’t show up, the VA will most likely deny the claim based on failure to show up for the examination and the veteran must request for the exam to be rescheduled via appeal or reconsideration.
- COME AS YOU ARE. Be yourself, dress how you dress daily, and act how you act daily. If you have a significant other who can report the symptoms and assist with giving information, then bring him/her along and request he/she be allowed in the exam with you. If you generally wear a suit, wear a suit; if you wear sandals, shorts and a t-shirt, wear that. Do your best to be comfortable and open with the examiner.
- TELL THE TRUTH. C&P examiners are generally well educated physicians, nurses and psychologists who will most likely see right through any exaggerations of symptoms that are reported. If the examiner believes you are over endorsing your symptoms, he or she will put that in the report and the claim will most likely be denied. Conversely, if you do not tell the examiner about your symptoms or do not reveal complete symptoms and severity of your condition during the evaluation, the compensation you may be awarded will be minimal and you must appeal or reapply to get a proper evaluation.
- KEEP IT SIMPLE. The examiner is not the benefits department, he or she is not there to hear complaints about the length of claims for benefits. The examiner has no ability to change the past or the benefits system. Although the examiner may evaluate the severity of your condition or the possible link to service, he or she has not written the laws and regulations and is simply providing a service to veterans. Be courteous and kind and thank the examiner for his/her time and assistance.
- TAKE RELEVANT EVIDENCE. If you have private medical records or any additional evidence that the VA may not have available, take that with you to the exam. If you have kept a journal or would like to make a statement, you should take that to the exam. This evidence must be pertinent to the condition. If you arrive for an examination on your shoulder and take evidence or a statement about the severity of your knee, the examiner will be less likely to review any evidence you bring. Again, do not engage the examiner in a discussion specific to your claim for benefits, but only to the severity of your disability or evidence that links your condition to an event or injury in service.
- POST EXAMINATION. Have a discussion with your representative. Once the examination is over, let your attorney or representative know how it went. First impressions, the length of the exam and your overall perception of how it went are important facts.
After the exam, the report will be forwarded to the VA Regional Office. The adjudicator will either order additional evidence or make a decision based on the findings of the exam. This decision most likely will arrive two to four months post examination, although it may take even longer for a final adjudication.
GETTING A COPY. These examinations are placed into your claims file and may be available through your ebenefits. However, if you want a complete copy of your file, to include any and all examinations, you can complete VA Form 3288, and submit it to the Records Management Center in St. Louis.
There are many reasons why you may be denied benefits or why a minimal evaluation may be awarded. The compensation and pension examination is one of the spokes in the wheel of the machine that is the Veterans Benefits Administration. This exam is not the final say and the decision that is rendered is not completely contingent on the findings in these exams.