Any veteran who has filed a claim with the Veterans Administration (VA) for pension or disability compensation may be asked to undergo a compensation and pension (C&P) exam as part of the claims process. This exam helps the VA determine if a disability is service-connected, and whether or not the condition has worsened over time and should receive an increased rating. The purpose of the exam is for the VA to provide a rating for a veteran’s disability. This rating is based on the severity of the disability, and impacts the amount of disability compensation that a veteran will receive.
What is a C&P exam?
A C&P exam is different from a typical healthcare appointment or medical exam with the VA, because an examiner does not prescribe any medication or recommend any medical treatment. The exam is meant to allow the examiner to review and ask questions about any medical records related to a VA disability claim, which can include DoD personnel records, or treatment records from health care providers.
The length of the exam depends on the amount of conditions that have been claimed, and whether or not the VA needs more information to make a decision about the claim. Visits can be less than an hour, while an evaluation for mental health may last anywhere from two to four hours.
Who needs the exam?
Anyone who has filed a claim with the VA for pension or compensation benefits may be asked to complete a C&P exam. However, not every veteran who files a claim with the VA will be required to have a C&P exam. If there is enough medical evidence in a veteran’s record to support their claim, an exam is not necessary. This evidence could include reports from doctors and hospitals, test results, or other medical documentation. When this information is incomplete or missing, a C&P exam may be requested in order to fill any gaps in information to help ensure there is sufficient evidence and the claim is processed as accurately as possible.
How is the exam scheduled?
A VA medical center is responsible for contacting a veteran in regards to scheduling their C&P exam. The VA may mail a letter with the appointment date and time, or call to determine a time that is most convenient for the veteran filing the claim. For this reason, it is important for anyone receiving care from a VA facility to ensure that their contact information is up to date, so that they can receive timely notification of their scheduled appointment.
If a C&P exam is scheduled in a location that is a significant distance from the veteran’s home, the veteran may request reimbursement for travel. Mileage is calculated from the veteran’s home to the exam facility, and veterans can submit their travel pay reimbursement requests to the beneficiary travel office.
What should a veteran expect from a C&P exam?
Every C&P exam is different, and this exam is only one part of the claim review process. While exams may vary in length, it is possible that the exam may be relatively short. Often, examiners may spend time either before or after the appointment reviewing medical records, so a shorter appointment time does not mean that the claim has not been thoroughly reviewed. During an exam, the examiner may:
- Ask the veteran questions about their health
- Observe the veteran’s behavior
- Review the veteran’s VA file
- Perform a limited physical exam
C&P exam tips
Prior to and the day of the C&P exam:
- Make sure contact information is updated with the VA: Veterans should ensure that their nearest VA regional office and VA medical center have their current contact information, including phone number, email, and address
- Call the VA to confirm the exam appointment: confirming the date, time, and location of the exam is important so that veterans have the correct information for their appointment and do not miss it or arrive at the wrong time or location
- Prior to the exam, submit all medical evidence for a claim either with the claim application, or to a VA regional office: examiners cannot submit any new information to be added to a claim file, so submitting all the necessary evidence ahead of time will help the VA process the claim more accurately
- Make sure to attend the exam appointment: missing the appointment may cause the VA to delay its decision on a claim, or to rate a claim based only on information that is available in a veteran’s file; this may result in a lower disability rating. If the exam must be rescheduled, this should be done as soon as possible
- Arrive early: if an individual arrives late to their appointment, the examiner may refuse to perform the exam
- Be honest when answering questions: do not downplay pain or symptoms, but do not exaggerate. The purpose of the exam is to gain accurate information on the disabilities that have been claimed in order to provide an accurate rating
- Multiple claim exams are required if more than one disability is being claimed: the VA may request additional claim exams if veterans submit claims for multiple disabilities. The VA tries to schedule multiple exams for the same day to reduce the amount of time veterans must spend traveling to and from appointments, but this is not always possible
After the exam
Once the C&P exam has been completed, the VA will review all evidence in the veteran’s file, assign them a disability rating, and send them a letter outlining the VA’s decision on their rating. The claims process usually takes between three and four months, but depends on the complexity of the claim, and whether or not a veteran has claimed multiple conditions.
It is possible for veterans to check the status of their disability claim online.
Heather Maxey works at a non-profit that addresses military ineligibility. She is an Army spouse, and met her husband while working as a Health Educator at Fort Bragg.
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