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Compensation and Pension Examinations (C&Ps)

C&P exams are medical examinations that assist the VA primarily in determining two things:

  1. Assessing the severity of the Veteran's disability (primary purpose); and

  2. Assessing whether the Veteran's disability claim is Service-connected or not (secondary purpose).

C&P exams are conducted by trained medical professionals, be it at a VA facility or through a contractor such as Veterans Evaluation Services (VES), Optum Serve Health Solutions (OSHS) AKA Optum Health -formerly Logistics Health Incorporated (LHI)-, Loyal Source (LS), or Quality Timeliness Customer service (QTC).

IMPORTANT NOTE:

  • Make sure you keep your mailing address, email address, and phone number up-to-date with the VA. Failure to do so may result in you missing notice of an examination!

Preparing for a C&P exam

Here are a few important things to do before the day of the exam.

Personal safety

If your exam might bring forth some dark inner demons that might put you into a really bad place. Ensure that you have an established safe place/plan to head to after the exam. If that means having a friend or family member with you. Make sure they can be there. If that means going to an emergency room, try to ensure if you have pets at home that someone can take take care of them.

Plan ahead and leave early

Know the route and how long it might take to get to the examiner. Please do not be late as you do not want your examiner either rushing through your exam or refusing to see you! Also, remember to fill out any paperwork that may have been sent to you BEFORE the day of the exam.

Need help getting transportation to an exam?

If you do not have reliable or affordable transportation to an exam, there are several options to consider:

Know what your C&P exam is for

If you are claiming multiple disabilities be sure to know what your C&P exam is for; generally speaking:

  • Musculoskeletal issues will all be lumped into a single exam.

  • Specialist issues such as dental, mental health, TBI. vision, or hearing will have their own separate exams.

If you aren't sure what the exam will be for, call the exam provider and ask them!

Read the Disability Benefit Questionnaire (DBQ) that correspond to your claimed issue(s). Often times examiners will ask you questions right off the DBQ.

Click HERE to view the current DBQs.

Look at the rating schedule

To get a better understanding of how your condition is rated. It is important to look at the rating schedule.

Click HERE to view the rating schedule.

During the C&P Exam

  • Be HONEST. Do NOT lie to the examiners! Fraud is a serious crime! Seriously... do not be a clown. This is not the examiner's first rodeo. So do not try and be the circus! If you try and embellish or make a show out of things the examiner will know and they may write that you are a suspected malingerer which could result in your claims being denied!

  • During a Range of motion tests STOP when pain begins or worsens. If you are in chronic pain, stop when the pain increases.

  • If you are not having a flair up (bad day) during the exam, EXPLAIN to the examiner what your range of motion is during those days!

  • For Mental health claims: If today is not your worst day, explain to the examiner your worst mental health day within the past month. This way the examiner will understand that you do have downswings in your mental health and just how serious they are and how they affect you.

  • If the examiner fails to ask, tell them how your disability affects your social life, relationships, and work! Especially mention how flair ups affect you. The examiner needs to how how your condition effects you on its worst days, regardless of how good or bad a day you are having when you meet with them.

After the Exam

For the most part, after you have attended your exam your part in the Claims process is complete.

Unless you have additional evidence to submit with your claim, your job is done. All you need to do now is wait... which may take as little as a few weeks after the exam to a few months. So please try and find something healthy and productive to do while you wait rather than constantly hitting refresh.

We here at r/VeteransBenefits wish you the best and hope that you receive the highest level of compensation under the law that you are entitled to.

If the VA determines that your claims are not service-connected or if you disagree with the severity rating, you can Appeal the decision. Just be sure to do so within one year of the decision. Otherwise you will forfeit any accrued back pay!

Reexaminations

If a Veteran's disabilities are not determined to be static then the Veteran will receive regularly scheduled reexaminations (RFR) in the future.

Unlike the Veteran's first exam. Reexaminations are NOT concerned with service connection. Their purpose is to help determine the Veteran's current degree of disability. Usually the examiner will ask the Veteran what treatment(s) they have tried since their last exam as well their current symptoms.

Currently, the VA is making MOST conditions static out the gate. However, there are still some circumstances in which the Veteran may have a reexamination. Such as:

  • Active cancer; and

  • When mandated by the Rating schedule or other VA regulations.

Determining if your disabilities are static or not

In order to definitely tell which of your disabilities are static a Veteran needs to look at their Code Sheet. This can be done by requesting your c-file.

  • Click HERE to learn how to request your code sheet.

    • Alternatively, you may want to trying asking VERA or your VSO if they can tell you which conditions are static on your codesheet.

Frequently Asked Questions

  • It's possible to be scheduled for an exam as early as two weeks! However, in some cases a Veteran may not be scheduled till several months have passed. But within a month is fairly common.

  • Click HERE to learn what steps you can do to help get you another examination.

  • Not getting into the legalities of recording someone:

    The VA will NOT accept your recording. That said, the VA is VERY accepting to give you a new exam if you simply request a new one and state why.

  • Not necessarily. It comes down to the evidence you submitted. If your claim had sufficient evidence, be it in the form of extensive records or a completed Disability Benefit Questionnaire (DBQ), an exam may not have been needed.

  • Yes. However, an examiner may refuse your request. If allowed they should not participate in the exam (answering questions for you, etc.).

  • Nothing. C&P exams are provided at no cost to the Veteran.

  • Contact the contract company that did the exam (QTC, VES, etc). Sometimes they screw up the billing when it comes to the additional diagnostic tests. If the contract company gives you the run around then contact the VA's 1-800 number.

    • Contact the contractor you went to (QTC/VES/etc.) and tell them about the bill - they should sort the matter. If they fail to do so in a timely matter contact the VA.

  • If the exam was conducted at the VA:

    • A copy will be made available 30 days after the report has been finalized. The copy can be accessed on MyHealtheVet, under the blue button report generator.

    If the exam was conducted by a contractor:

    • Click HERE to learn how to request your C-file.

    SPECIAL NOTE:

  • Yes, however the examiner may refuse it.

    Whether the examiner accepts it or not the Veteran NEEDS to upload the evidence themselves to their own claim.

    • Yes* (if you are a Veteran). The VA or the third party examiner will mail you a check a few weeks after your exam.

    *UNLESS you are a Veteran who is in a foreign country.

    • No (If you are still active duty).

    • No. The VA will either fly a contractor to your country, or will contract a doctor in your country, or at the US Embassy to do the exam.

      • Do know the VA will NOT pay any travel related expenses you incur.

    • No... But it would be a really good idea to attend! Exams are ordered for a reason - Yes even if you supplied your own IMO and/or DBQ!

    • Failure to attend an exam that was ordered in relation to a Supplemental or increase claim may result in the claim being denied!

    • Failure to attend a reevaluation may result in the Veteran's rating being reduced or discontinued!

    • Call to reschedule as soon as possible!

    • Call to reschedule as soon as possible!

  • Exams may take as short as a few minutes to a few hours. Depending on how many claims you are being seen for as well as if the exam is for an initial claim or a reevaluation. Also, some examiners have the Veteran present for the entire process (filling in the required examination paperwork), while other examiners may examine the Veteran and then complete the paperwork after the Veteran has left.

  • VA language can be confusing. This doesn't mean that the exam is no longer needed- it means that the VA no longer is requesting an exam, because a third party contractor has accepted the assignment to provide an exam. The contractor should reach out to you shortly to schedule your exam.

  • An ACE exam (Acceptable Clinical Evidence exam) is a records review done by either the VA or a contracted examiner. The Veteran will not be physically present at the exam or present via telehealth.

    IMPORTANT NOTE:

    • The examiner MAY call you during the exam if they need a quick clarifying comment. So it would be a GOOD idea to answer all phone calls the day of an ACE exam!

    • If you have no further evidence to submit, yes.

    For more information click HERE.

  • Yes, upload a Personal statement.

  • Yes, upload a Personal statement.

References