Common Errors in C&P Exams

Almost every veteran who applies for disability will be scheduled for a compensation and pension exam also known as VA claim exam. This medical exam will be done by a VA doctor or a doctor contracted by the VA. The VA uses the results of your C&P exam to establish if there is a service-connection for your disability and to determine how severe your disability is so they can set a rating, that is a percentage of benefits, for your impairment.

The C& P exam must meet several criteria established by the VA. The exam results must  be  based  upon  sufficient  facts  and  information  relevant  to  the  issue  before  the  examiner.  The exam must be  supported  by  sufficient  reasoning,  not  merely  a  list  of  data  and  conclusions. In cases where a vet’s symptoms could be due to a service-connected condition or to a non-service-connected condition, the examiner must submit an opinion as to whether or not it is possible to separate the effects of these conditions. You cannot be denied benefits just because there are no medical records from the time of an service injury or illness to back up your claim.

You should be provided a copy of the results of your C&P exam. If you are denied benefits because of an unfavorable C&P exam, you have the right to appeal.

As you might expect, errors can occur in administering a C&P exam which can result in a unjust denial of VA disability benefits. Let’s take a look at some of the more common types of errors which may be the basis for appealing a denial.

Sometimes the examiner will rely on speculation to support a denial. The VA says that medical opinion based on speculation—rather than supportable facts—is inadequate.

The examiner may misreport what you said to him or her during the exam, so be sure to carefully check the written report of your C&P exam. It also may be that you misunderstood what the examiner said or asked you about during the exam. This is can happen easily when the doctor is tossing around unfamiliar medical terms.

In some instances, we see outdated medical information used as the rationale for denying a VA disability claim. If the medical research the examiner references in the C&P report is more than five years old, you may have a legitimate reason for an appeal.

Perhaps the examiner was not qualified to evaluate your condition. Unfortunately it is not uncommon for C&P exams to be conducted by non-physicians like a nurse or a physician’s assistant.  Or maybe the specialty of the examining physician is in an area that is unrelated to your impairment. 

Finally an error we see from time to time is when the examiner in their report only references medical treatment records that make a case for denial, and ignores information that is favorable to a disability claim. For example, let’s say we have a vet with a service-connected knee injury and the examiner references one doctor visit where the vet said she was feeling fine, but never mentions the five other doctor visits where she said the pain was extreme even when just walking a few steps. In this case our vet has a good argument for reversing a denial.

When C&P exam errors occur it’s important to address them through a hearing or through buddy statements. If your buddy—that is a military co-worker, a friend or a family member--has witnessed your symptoms and can provide specific examples of how they affect your life, a buddy statement can be a useful tool.

If you believe that you are the victim of C&P exam errors, we can help. The attorneys at Cuddigan Law can help determine if you have grounds to request a new examination, and we don’t get paid unless we win your case. Contact us today for a free evaluation of your situation.

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