The VA Claim Exam, also known as a VA compensation and pension (C&P) exam, provides those retiring or separating from military service with the option of filing a VA claim for service-connected disabilities, medical issues, PTSD, injuries, and more.
Those who have filed an initial claim may be contacted by a VA representative as part of the VA claim exam process, which is used as a tool to help the VA make a final determination for each claim. The Department of Veterans Affairs official site reminds users that the VA claim exam is a “normal part” of the VA claims process.
Without the exam, a decision on a claim for compensation may rely only on what is mentioned in medical records (which don’t always tell the whole or most up-to-date story behind a condition or set of conditions). So, while this exam is voluntary, the outcome of your claim may depend greatly on your participating in the exam.
The VA Claim Exam: Some Basics
Your VA claim exam may be requested by the VA regardless of how you did your initial claim; in person, online using the eBenefits portal, or by other means. Make sure the Department of Veterans Affairs has your most up-to-date contact information (especially if you are relocating after retiring/separating) so that you don’t miss a request to complete the VA claim exam.
This may seem like a very obvious bit of advice, but not everyone out processes the military from a stateside location; many retire or separate at an overseas base, then travel back to the USA to resume civilian life. Mail has trouble keeping up with service members moving from an overseas APO/FPO military postal address back to the USA.
Some already have a home waiting for them when they return, other service members may not be sure where they need to put down roots; provide the VA with your most current information including a reliable stateside address where you will be informed of incoming mail from the Department of Veterans Affairs.
Why is this issue so important? The VA reminds claimants that once an appointment is set, missing it could force the VA to make your claim determination with only the information on file. The VA still contacts and schedules by physical mail depending on circumstances, anticipate this and assume you’ll be notified by mail.
Submit Your Claim Evidence And Medical Records Ahead Of Time
The VA warns that supporting evidence, medical records, and any other material that may reinforce your VA claim will not be accepted at the time of your VA claim exam appointment-you must submit all these items in advance of your appointment.
How Will My Claim Exam Be Scheduled?
A representative from the Department of Veterans Affairs or a VA partner will contact you either via e-mail or by physical mail.
You may simply be assigned an appointment time or date, or you could be offered multiple appointment times to choose from. Do not miss this claim exam, as rescheduling may not be possible. The VA will contact you as space becomes available to accommodate your appointment. If you must reschedule and don’t have a bona fide emergency, it’s best to do so no later than three days prior, for maximum options.
Will I Have To Participate In More Than One Claim Exam?
You may (or may not) be required to sit for a claim exam for each of the claims made. That means if you have separate medical issues, each one will require an evaluation unless the VA determines it’s not needed.
Is The VA Claim Exam A Full Medical Review Like A Checkup?
No. In fact, you may not have to do anything more than answer questions. The actual requirements of the exam will vary depending on the nature of your condition(s) and other factors. Don’t expect a full medical exam, but don’t be surprised if there are exam-type situations you will need to participate in.
The VA official site states that claim exams can last anywhere between 15 minutes and a full hour.
Will I Receive Any Treatment At Exam Time?
No. The VA claim exam process is meant to evaluate your condition, not provide treatment or therapy.
Can I Learn About The Status Of My Claim At Exam Time?
No, the VA claim exam administrators know nothing of the status of each claim, they are simply tasked with gathering the information. The decision-making process comes later after your exam day has come and gone.
Can I Bring A Chaperone To My Exam?
According to the VA official site, you may bring a chaperone with the understanding that the person accompanying you cannot participate in the exam process in any way. Service animals are also permitted.
Who Conducts The Claim Exam?
A representative of the VA or a VA partner (contractor) may administer your claim exam. A contractor may administer the exam instead of a VA employee, subject to the same privacy protection requirements as VA staff.
I Was Never Scheduled For A Claim Exam And My VA Claim Did Not Turn Out As Expected. Why?
The Department of Veterans Affairs does not schedule a claim exam in all cases. Some VA claims are reviewed and decided upon with sufficient evidence in medical and military records. According to the VA official site, the agency approves disability compensation in cases where the records show three basics:
- Current diagnosis of a disability,
- Record of an event that happened during military service that could have resulted in the disability,
- An opinion that the disability is related to military service, the “nexus opinion” according to the VA.
The VA official site says if the first two in that list are “clearly shown” in your claim, the VA claim exam process is expected to follow up. Service members who didn’t provide sufficient information on their application have, according to the VA, a higher risk of not being given a claim exam.
“If you did not submit enough information with your claim application to show that you have a current diagnosis of a disability ort hat an event occurred in military service that may have caused the disability, there is no need for VA to schedule a claim exam to get a nexus opinion to tie the two events together” according to VA.gov.
Can I Use The Assistance of A Veteran Service Organization (VSO) To Navigate This Process?
What Happens After My Claim Exam?
The results of your exam are compiled into an exam report, which is added to your electronic claim file. This is done after a review of your medical records, and the entire claim is then submitted to a VA claims processor.
How Long Will The Process Take To Get My Claim Approved?
Much depends on variables including the volume of cases being handled at any given time, the number of outstanding appointments still waiting to happen, staffing levels, and funding. There is, at the time of this writing, no guarantee or specified time frame for completion of your individual claim. You should discuss your claim with a VA representative to learn of current status, estimated completion time, etc.
Can I Appeal My Claim?
Yes. The VA has an online Claims Appeal Tool that allows veterans to appeal some or all of your decision. Plus, it provides a status of the appeal, how long each step takes and alerts on actions that are needed by you. You can also get help using the tool through a Veterans Service Organization officer (usually free), lawyer or a claims agent.
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