Does the VA provide C&P exams for every case?

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Unfortunately not and in many cases constitutes error.

This discouraging fact may potentially frustrate anyone navigating the VA claims process for the first time. Disappointingly, the VA frequently refuses to provide this fundamental medical assessment defying numerous obligating authorities. VA’s failure to provide exams is troubling because exams are critical in establishing the required “nexus” between your service and current disability. Although exams also serve other purposes to include providing a diagnosis and the disability’s severity level, you may read more about exams in this prior post.

For decades, veterans were at the VA’s relentless mercy to receive an exam. Despite the passage of the Veterans Claims Assistance Act on November 9, 2000, the controversy regarding when an exam was justified continued until June 5, 2006 when the US Court of Appeals for Veterans Claims decided the landmark case McLendon v. Nicholson. The Court, through this case, effectively lowered the threshold necessary to obligate the VA to provide an exam.

The McLendon case established three requirements to receive an exam, (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with service. In other words, a current diagnosis is no longer required rather only evidence of persistent symptoms and an in service event that feasibly could be responsible. In 2010, the VA also lowered the requirements to receive an exam regarding psychological disabilities by issuing internal guidance known as Training Letter 10-05. This directive authorizes an exam when evidence corroborates service in a hostile area and the veteran provides a statement.

However, despite an administrative directive, Federal law and even precedence established by a governing Court the VA continues to deny veterans exams, which constitutes a majority of errors identified during judicial review. This may not pose undue hardship for veterans with private insurance because the VA accepts exam reports, or Disability Benefits Questionnaires, for many conditions directly from private physicians. Conversely, this places significant financial burden on veterans seeking benefits they desperately need and deserve who rely solely on the VA for their healthcare.

In the event you receive notice that an exam was scheduled, be sure to read our post on how to prepare and what to expect at the exam. Additionally, do not be surprised if your VA examiner is not even a certified doctor as many examiners are only physician assistants. As frustrating as that sounds, this could actually be to your benefit because an Independent Medical Opinion or IMO easily counters the inferior medical opinion. If denied an exam and thus benefits, do not accept this at face value – rather seek legal advice from an experienced attorney immediately.

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