What kinds of test should I expect during my VA C&P exam, and what happens after?

A Compensation and Pension Exam—often referred to as a C&P exam—is a doctor evaluation used by the United States Doctor Holding a Clipboard in an Exam RoomDepartment of Veterans Affairs (VA) when determining approval or denial of a veteran’s disability claim. A C&P exam is used by the VA to rate disabilities, diagnose conditions, and determine if you have a service-connected disability.

After you’ve applied for disability and the VA is working to process your claim, it’s almost guaranteed that you’ll receive a call or letter asking you to report for a C&P exam. Usually this exam will take place at a VA hospital or clinic, and if you have more than one disability, you may have to report for additional exams.When you get the letter schdueling the exam call the number on the appointment letter and find out what kind of exam you are going to have. It is important to look at the Disability Benefit Questionnaire (DBQ) form ahead of time to know what to expect.

What Happens During a C&P Exam?

A C&P exam is really nothing more than a doctor appointment; however, you don’t receive medication or treatment. Instead, the doctor will focus on your physical or psychological condition and evaluate your situation in the following ways:

A Psychological Condition

If you are suffering from a psychological condition or disorder that creates stress and negatively impacts multiple areas of your life, the doctor will ask you questions and give you an opportunity to describe the symptoms you’ve experienced and how the stress has affected you. The doctor may also ask you to complete some standard psychological tests—for example, a memory test to see how many words you can remember a few minutes after you read them from a list. This part of the exam is minor and routine. 

A Physical Condition

If you are suffering from a physical illness, injury, or condition, the doctor will examine you to evaluate your situation. He may ask you questions, order lab work, and conduct medical tests standard for your condition.

It’s important to note that when the doctors asks “How are you?” most people are programmed to answer “Fine” or “Okay.” The C&P exam is not the time to respond this way—because honestly, if you were doing fine, you wouldn’t be seeking disability compensation. If you want the doctor to accurately assess your illness, injury, or situation, you need to be honest and give detailed information about why you’re not okay. If your doctor writes in his report that you claimed you were doing pretty well, your claim will likely be denied.  

For most any VA disability claim, a C&P exam is required, and it’s important to know what happens at the appointment. But it’s also important to know what happens after your exam and how it affects your claim.

What Happens After a C&P Exam?

After you’ve had your C&P exam, the doctor will prepare a report that may include information on your medical history, your current symptoms, and the severity of your symptoms, along with a professional opinion about whether your disability is service related.

Once the doctor finishes the report, he sends it to the VA Regional Office where your claim will be processed. It’s important to remember that it’s the Ratings Veterans Services Representative (RVSR) at the VA Regional Office that makes the determination about your eligibility for disability benefits—not the doctor. And while the C&P exam is a key piece of data in the decision making process, the RVSR bases the decision on all evidence submitted for a claim.

C&P Results

Your C&P exam will typically result in one of two outcomes: Favorable or Unfavorable. Here is a brief overview of both result types:

Favorable

  • The doctor wrote a nexus letter, giving his medical opinion about why he believes your condition is service related.
  • The doctor reviewed all of your medical records and stated this in his exam report.
  • The doctor was skilled, experienced, and well qualified.
  • The exam was performed accurately; all questions were answered completely; all necessary testing was performed and completed; and the exam report was marked “Veteran friendly.”

Unfavorable

If your C&P exam result was unfavorable, it may mean that one or more of the Favorable points was missing from the doctor’s report, and you may want to do the following:

  • Get expert medical help. If you want to refute the report, have an independent medical examination (IME) or get an independent medical opinion (IMO). An IMO  may or may not require your physical presence; rather, the doctor forms his opinion after reviewing all of your records.
  • Get legal representation. Get help from an accredited VA attorney. Because the VA can be difficult to navigate, having a skilled attorney to guide you through the process can be very beneficial. 
  • Don’t wait. If you delay refuting an unfavorable C&P exam and wait until after your claim has been denied, you may add 4 – 5 years to your claim.

At Cuddigan Law, we understand how critical it is for veterans to get disability benefits. That’s why we provide free information to help veterans with their claims. Download our free book, The Essential Guide to VA Disability Claims, or call us today at 402-933-5405 to ask us a question about your disability case.

 

Sean D. Cuddigan
SSA and VA Disability Attorney in Omaha, Nebraska