Compensation and Pension (C&P) exams can often be the source of a lot of anxiety and frustration amongst veterans, whether it is from the examination or examiner, the preparation for the exam, or the results thereafter.
But how much weight does a C&P exam actually have on your VA disability claim?
What is a Compensation and Pension (C&P) Exam?
A Compensation and Pension (C&P) examination, is a medical exam of the state of a veteran’s disabling condition(s), performed by a VA healthcare provider, or a VA contracted provider.
The VA utilizes these exams to gather evidence on the claimants condition before issuing a decision for their claim and assigning a rating, if applicable.
Most commonly, C&P exams are used to determine two things:
- If there is a service connection
- The severity of the disability itself
C&P exams are required to:
- Analyze any discrepancies about a diagnosis
- Verify service-connection and establish a link (nexus) to the condition and service
- Supply any necessary information
During the C&P exam, the examiner will ask questions about a veteran’s day-to-day life, how well they function in various scenarios given your disability.
They also may have a veteran to fill out what is known as a Disability Benefits Questionnaire (DBQ), which is tailored to a specific condition.
The C&P will be added to the claims file post the examination, with any findings, test results and any information deemed necessary by the examiner.
How much weight does a C&P exam actually have?
C&P examiners do not make the final decision regarding whether or not a claim is granted. They are a very important part of the process, and the data that they collect is utilized in the process of making that decision.
After the C&P, the examiner will create a report of the exam. In this report, they are able to support a veteran with their opinion and descriptions of their condition and symptoms.
They can be a useful tool to help further emphasize that a disability does impact their life the way the claim describes it does.
However, they can also disagree with the opinions of the veteran. In this case, the results can be a pretty devastating blow to a claims process, and likely result with a denial of benefits.
“As least likely as not.”
That being said, the way the C&P examiner presents the report is incredibly important. They must state that a veteran’s condition is at least as likely as not caused by their service. This means that there is at least a 50 percent chance the disability is in-service related.
The team at Hill & Ponton may be able to assist you with a denial of benefits. Click the button below to get more information.
What is the role of the C&P examiner?
As previously stated, the examiner for your C&P is integral to the outcome of a claim, and is either a VA physician or one contracted by them.
They are trained to examine the disability of the veteran at the exam, which is the reason you may be seen multiple times for multiple conditions.
Before the examination, they should familiarize themselves with your case and claim, by closely looking at your medical and service records (C-File).
Sometimes, veterans may find they run into issues with the examiner, for many reasons. Some examples of mistakes examiners might make include:
- Don’t know what they are doing (not trained to handle the disability)
- Has a personal agenda against the military or veterans
- Didn’t perform the appropriate exam
- Took too little time with the veteran and the exam
- Made a mistake with completing all the information or assisting with DBQ
- Didn’t understand the importance of the C&P
How to approach a negative examination?
Since the C&P exam is so critical to your claim, it’s important to understand the steps to take if you feel it went badly.
First and foremost, request a copy of the report right away.
You can do this through your Regional Office by submitting a request letter. There may be a chance that the report is misrepresenting the details of your ailment as you presented it to the examiner at your C&P.
The additional actions you should also take, include:
Get a second opinion from a private doctor.
One of the biggest reasons claims are denied is due to lack of medical evidence or no clear nexus. There is absolutely nothing stopping you from requesting a second opinion.
A medical opinion from a private doctor can be used to dispute the report made by the C&P examiner. You are allowed to obtain additional medical opinions.
Therefore, this can be HUGE in helping the success of your claim!
Submit a Notice of Disagreement.
If your C&P exam is unfavorable, then you’ll also want to submit a statement about why you disagree with the results of the C&P examination.
If you get rejected by the VA, the Notice of Disagreement (NOD) is your opportunity to explain why you disagree with the decision.
This form is included with your claim. There are spaces for every medical condition on your claim, so you can state every one you disagree with.
You also can disagree with the decisions about service connection, evaluation of your disability, and the effective date itself. There is a place for you to write a long-hand description of your opinions.
Request an examiner’s credentials.
Another final option you can utilize, is to request the examiners credentials. The reason this may be important is if you think they aren’t qualified to have an objective opinion about your condition.
If you challenge the examiner, you will be required to explain why.
Remember, an unfavorable C&P may not be a big deal.
Hopefully, you understand a little more about the weight of a C&P exam, and the important steps you need to take to ensure success.
While a C&P exam is certainly important in the claims process, remember its purpose is ultimately to get you a favorable disability rating.
Have Questions About Appealing Your Claim or Understanding How the Claims Process Works?
The attorneys at Hill & Ponton are here to support you with appealing a claim to get disability benefits.
If you do get denied, you can always file again if you have the necessary medical documents and nexus that support your claims. Don’t lose hope–especially when it comes to fighting for the benefits you deserve!
If you are intending to appeal a denied claim, you can contact us for an evaluation and we can help you with this process.
However, if you are considering filing an initial claim, or even if you are interested in learning about the appeals process, we offer a free ebook to get you started on the right foot!
The Road to VA Compensation Benefits will help break down the claims process from start to finish. Click the link below to learn more.
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