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Compensation and Pension Examinations

Compensation and Pension examinations, also known as “C&P exams,” are frequently used by the VA when deciding veterans’ disability claims. Specifically, the VA uses C&P exams as part of its duty to assist in order to diagnose conditions, rate disabilities, and to determine service connection issues. Because C&P examinations are so common, it is important that veterans understand what to expect when attending a C&P exam and that veterans are as prepared as possible prior to attending the exams.

The first thing that is important to understand is that the C&P examiner is not the judge of your case. The examiner writes a report that is forwarded to the VA Regional Office and there an adjudicator reviews it and makes the decision. Please see our prior post on this issue.

When the VA schedules a C&P examination, the veteran will receive written notice of the date, time, and location of the exam. Unfortunately, it is not always clear what type of examination the veteran will undergo, especially if there are multiple claims pending at the same time.  Failure to attend a C&P examination will like result in the denial of the claim. If the veteran does not receive notice of a C&P exam for some reason and discovers this after the fact, he/she should request that the VA reschedule the exam, and give a good faith reason in writing why the exam was missed (i.e. change of address, no transportation, in the hospital, etc.). 

It is always a good idea for the veteran to take a witness to the examination.  A few examples of great witnesses are spouses, adult children, or close friends.  A witness is important because it is very easy for veterans to forget important details about the exam, let alone deal with the normal stress that veterans experience when being evaluated by the VA’s C&P examiners. If possible, the veteran should take the witness into the examination room with them; however, this request is frequently denied by the VA.  If the request to take a witness into the examination is denied, it is important that the veteran maintain composure, and proceed with the exam.  Failure to cooperate with a C&P examination can result in denial of the claim. At the very least, the veteran should ask for the examiner’s business card, so that the veteran can ensure that the person doing the examination was actually the one who wrote the final report.

It is important to know that C&P examiners are literally examining thousands of veterans per year, and most of the examiners simply do not have the patience, time, or resources to try to decipher how a veteran really feels or to dig deep to figure out what the veterans symptoms really are.  As such, it is important that veterans be as honest and forthright with the C&P examiner as time allows.

It is always a good idea for the veteran to take a written list of symptoms, including embarrassing symptoms, to help refresh his/her memory during the exam.  What veterans sometimes feel are inconsequential details could very well be the key to success in the claim.  Additionally, if one of the veteran’s treating medical providers has provided a favorable opinion in the matter, it does not hurt for the veteran to give the favorable opinion to the C&P examiner for consideration.

Recently, the VA has really begun to heavily advocate the use of Disability Benefits Questionnaires (DBQs) by the C&P examiners. The VA has said that the DBQs were created to help streamline the VA claims process, and to help complete the record if they determine that the record as a whole is incomplete or insufficient to decide a claim. According to the VA, there are more than 70 DBQs, covering the overwhelming majority of conditions for which a veteran can receive disability compensation.  Here is a helpful link to a page on the VA’s website which gives more information about the DBQ process: http://benefits.va.gov/TRANSFORMATION/disabilityexams/index.asp.  In addition to C&P examiners, DBQs can also be completed by treating medical providers and independent medical examiners.

After a C&P examination, it is important that the veteran and witnesses write down their thoughts about the examination as soon as possible. Issues to consider in this regard include: whether the exam was thorough, whether the veteran was able to express all of his/her thoughts about the disabilities being evaluated, whether the examiner seemed to be listening and writing down the veteran’s responses, whether the examiner expressed a negative opinion to the veteran about the strength of his/her claim, etc. 

The more specific the veteran and the witnesses are regarding any deficiencies with the C&P exams, the better chances of getting the VA to correct the problem. Depending on the situation, the veteran or his representative may choose to send in a response to the VA challenging the C&P results. The written response may request several things, for example, that the VA order a new C&P examination with a different C&P examiner and/or that the VA order the C&P examiner to clarify his/her opinion.

The bottom line is that C&P exams are not always bad for veterans.  In fact, if favorable, these exams can be very helpful. However, being an informed participant and adequately preparing for the examination is crucial.

For Questions About Your Disability Claim... Contact Us

by Attorney Leslie Gaines
June 26, 2012

What is Gulf War Syndrome? Do I Have It? Can I Be Compensated for It?

After the 1991 Gulf War, veterans began reporting a wide range of unexplained symptoms and were often told that it was “all in your head.”  People started referring to this phenomenon as “Gulf War Syndrome.”  It has since come to light that these veterans were not imagining or inventing their symptoms but suffer from very real illnesses without fully defined causes or effects.  Once the studies were done, and these illnesses were recognized as being related to service in the Gulf, VA began to compensate veterans for these disabilities.   Just because you were once turned down by VA for benefits because your symptoms were thought to be psychological rather than physical does not mean that you are not, now, entitled to those benefits.

VA does not really use the term “Gulf War Syndrome” anymore because the word “syndrome” indicates a disease which has a defined set of symptoms.  The Gulf War veterans, however, suffer from widely varying symptoms, all of which do not necessarily occur in every veteran.  These symptoms include fatigue, rashes or other skin problems, headaches, joint and muscle pain, respiratory problems, sleep disturbances, gastrointestinal problems, heart problems, abnormal weight loss, neurological problems, neuropsychological problems, and menstrual disorders.  VA refers to these symptoms as “undiagnosed illnesses” or “medically unexplained chronic multi-symptom illnesses.”  As of yet, there is no definitive answer as to the cause of these illnesses though exposure to toxins or chemical weapons is thought to be a possibility.

Who is entitled to these benefits?  Veterans who served in the Southwest Asia theater of military operations (Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations) during the Persian Gulf War and developed medically unexplained signs and symptoms such as those listed above are entitled to compensation.  If a veteran develops these medically unexplained symptoms or develops a chronic, multi-symptom illness, he is entitled to a presumption that such illness is related to service.

At one time, veterans struggled to have these illnesses compensated due to regulations which specified that only undiagnosed illnesses would qualify for the presumption of service connection.  Doctors, however, are trained to provide a diagnosis for a patient’s symptoms and would assign a diagnosis to the veteran’s symptoms of fatigue, pain, or gastrointestinal problems. Once a diagnosis, such as Chronic Fatigue Syndrome, Fibromyalgia or Irritable Bowel Syndrome, had been assigned to the veteran’s symptoms, VA no longer considered the illness to be “undiagnosed.”  Many veterans were, then, denied benefits.   VA later recognized this error and amended the regulation to included chronic, multi-symptom illnesses as well as undiagnosed illnesses.  If you were denied service connected compensation for Fibromyalgia, Chronic Fatigue Syndrome or another illness which includes the symptoms identified as “Gulf War Syndrome,” be aware that these disabilities are now recognized by VA as related to service in the Gulf.  You are entitled to this compensation.

For Questions About Your Disability Claim... Contact Us

by Attorney Shannon Brewer
June 26, 2012

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