If you are in the process of filing for disability benefits from The Department of Veterans Affairs (VA), you will most likely be asked to complete a Compensation and Pension (C&P) examination.
This exam is to determine if your disability is service connected, the level of your disability and if the condition should receive a rating increase or decrease.
While the thought of another doctor’s appointment may be daunting, it’s important to remember that the C&P exam is an important part of your disability claims process.
It also can be a time consuming and frustrating process at times. Fortunately, there’s some things you can do and be aware of to help ease the process.
What can I do to help make my C&P exam successful?
There are a variety of ways you can contribute to the success of your C&P exam. Here’s a list of a few simple rules you want to keep in mind:
Prepare for Your C&P exam ahead of time.
- Keep careful records of your condition.
- Know what you are being evaluated for.
- Have all the appropriate forms at hand.
Be upfront with your concerns and day-to-day issues.
- Be straightforward and honest with your answers to questions.
- Note if your conditions are interfering with your work or home life.
- If you are limited by pain, anxiety or other issues not accurately able to be measured at the appointment, be sure to let the examiner know.
Explain about “bad days” and how often they occur. For example:
- What does your disability prevent you from doing in your normal life?
- Does it prevent you from working? Interacting with friends and family?
- Does it impede basic activities?
Get a copy of the C&P results.
- The VA will be able to provide you a copy with this report.
- This report is helpful if you need to argue about a diagnosis later.
Bring someone close to you to the appointment.
- Someone close to you may be able to offer valuable insights.
- They also can offer another set of eyes about the appointment details.
Note: Sometimes the examiner may not allow a 3rd party to attend the exam, but they can still be helpful in noting things like how long the exam was or observing other circumstances surrounding the appointment.
For example, if you were kept waiting for an extended period of time.
Remember that you might have multiple visits.
If you file multiple claims, you might have multiple C&P exams. It is frustrating, but it occurs quite often.
Just remember, these exams should be used for your benefit and to help your claim. The more successful and smooth they can be, the better it is for your claims case.
You may have a chart review instead of a C&P exam.
Sometimes the VA won’t bring you in for an exam, but instead have an examiner do what is called a “chart review” for your exam.
It can often feel like they may be passing over your claim, but depending on the circumstances surrounding the claim, a chart review might be sufficient.
If you feel like the chart review is insufficient, you can always get a second opinion through an independent medical facility.
Other Frequently Asked Questions about C&P Exams
What is a C&P exam and why do I need one?
A C&P exam, as mentioned above, is a part of the claims-review process that allows the VA to determine:
- if the veteran’s disability is service-connected
- the level of the veteran’s disability, and
- if the condition should receive a rating increase or decrease.
The VA bases your rating on how severe your disability is–and your rating will affect how much disability compensation you receive.
Compensation may include things like monthly payments and enrollment in the VA healthcare program.
The length of time that a C&P exam lasts will vary greatly depending on what medical condition you have.
For example, a common evaluation for mental health conditions can often last between two and four hours.
During the examination, you will be asked questions, have your behavior observed, have a physical examination performed, or they may just review your file with you (a chart review).
How does my C&P exam get scheduled?
The VA or VA contract examiner will mail you a letter or call you with your appointment date and time.
If you are receiving treatment at a medical center, make sure the facility has all of your updated information (address, phone number, email, etc.)
The wrong information could potentially delay your appointment.
You can request the specific sex of your medical provider for gynecological, breast, ana/rectal and mental health examinations during the scheduling process.
Additionally, if the claim is related to a mental or physical health condition resulting from Military Sexual Trauma (MST), the law permits you to choose the sex of your examiner.
Prior to the exam, contact the VA or the VA contract examiner to confirm your exam date, time and location.
If you do not report for your exam, it could delay or hinder your claim.
What if the date and time don’t work for me? Can I reschedule?
If a life event prevents you from being able to attend your scheduled exam, immediately notify the VA at the number you are provided to try and reschedule.
Unless it’s an emergency, you should try to reschedule at least 48 hours before the appointment.
What can I expect during my C&P exam?
A C&P exam varies significantly from a typical medical exam, because the examiner will not be giving you any treatment or prescribing any medication.
They may ask you questions, observe you and/or perform a limited physical exam.
The purpose of the exam is to have your condition evaluated and review claim-related medical records and your claim file (C-File).
The C-File typically includes medical records, personnel records, treatment records from health care providers, and any other documents you may have submitted.
What happens after my claim exam?
The examiner will write up a report and then send it to the VA.
The VA will then review all of the evidence in your file, including the exam report, and then make a decision on your claim and send you a letter.
The processing time for your claim depends on how complex your claim is and how many conditions you’ve claimed.
Note: Your examiner who performs your exam is not a part of the decision-making process.
They will never know the outcome of your pending claim, so they will not be able to tell you the status of your claim.
To get a claim status update, contact the VA at 1-800-827-1000 to have a representative assist you.
How do I get a copy of my claim exam results?
You can request a copy of your claim exam results, but you cannot get them directly from the provider.
Instead, you will need to fill out a Freedom of Information Act or Privacy Act Request (VA Form 20-10206).
You can submit this form by mail or in person.
What information will the VA use to make a decision about my claim?
- Medical records you’ve submitted
- Exam report (C&P) from the provider
- Results of any medical tests the provider ordered
- Statements from you and others about your claim
- Your military and personnel records
What if I disagree with the results of my C&P exam or had a bad experience with the examiner?
If you had a bad experience with the provider at your claim exam, you can report your concerns to the VA right away.
You can report in any of these ways:
- Give feedback on the contractor’s customer satisfaction survey.
- Write a letter and submit it as part of your claim file.
- Call the contractor who scheduled your exam.
- Call the VA at 1-800-827-1000..
You can also request a second opinion from a non-VA medical provider to submit with your claim as additional evidence.
How long after a C&P exam should I expect my decision?
The current estimate by the VA for the number of days to complete disability-related claims is, as of September 2022, 106.4 days.
If you are interested in learning more about filing for disability benefits, check out our FREE ebook The Road to VA Compensation Benefits.
