What happens at a Compensation and Pension (C&P) Exam?
A Compensation and Pension (C&P) exam is a doctor’s appointment where your disabilities get evaluated. This examination is ordered when you have applied for VA service-connected disability compensation or when you are filing a claim for an increase rating to your existing service-connected condition. If you have more than one condition for which you seek compensation, you may be asked to attend several C&P exams.
The VA Medical Center is responsible for scheduling C&P examinations. As such, you have to make sure the VA Medical Center where you go for treatment has your current address and telephone number. This is the facility that will mail you a notice with the address, date and time of your scheduled C&P exam. Typically, the examination is conducted at the VA clinic or hospital closest to you. The VA also contracts outside providers to perform these examinations outside a VA facility. The C&P examinations are not scheduled with your treating physicians. They are similar to an independent medical evaluation and you will not get prescribed any medication or given any type of medical treatment.
Before going to your examination, think about the conditions for which you are going to be examined and try to document on a piece of paper all of your activities that are impacted by your condition. Be yourself, dress as you normally would. During your examination, be truthful with your symptoms and give examples of any limitations that the symptoms cause. Know that you are seeing this physician for the first time, and some of the issues you may have to discuss are uncomfortable, but it is important to your claim that you disclose all of the symptoms and limitations to the best of your knowledge.
Be thoughtful to your responses to the questions posed. For example, if the doctor asks you, “How are you today?” Your automatic response is probably, “I am fine, how are you?” This is not a social occasion and you are not there to get to know the doctor. After the initial salutations, keep in mind that whatever you say that day may be permanently written in your medical file and submitted as evidence in support of your claim.
If you have a physical disability, the doctor is required to examine you and perform range of motion testing, strength testing and reflex testing, among other, as appropriate. The examination may cause physical discomfort or pain, but remember that the doctor is trained to determine when and where your limitations lie and you should not feel pressured to bend or flex any further than your pain and symptoms allow. Make sure you explain why you have reached your limit and where the pain is located.
If you have a mental health disability, focus on your condition and how it affects your daily activity, as well as those around you. If it involves a specific experience or event in the service, it may be difficult to discuss it. However, the outcome of your claim is at stake and this is your opportunity to document your experience, symptoms and residuals from the event in service. The doctor may also administer a written test to evaluate any neuropsychological deficit. These tests are crucial to brain injury examinations (TBI), Post Traumatic Stress Disorder (PTSD) or any other type of cognitive impairment.
Cognitive impairment is when a person has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life. Cognitive impairment ranges from mild to severe. With mild impairment, people may begin to notice changes in cognitive functions, but still be able to do their everyday activities. Severe levels of impairment can lead to losing the ability to understand the meaning or importance of something and the ability to talk or write, resulting in the inability to live independently.
The VA is supposed to send a copy of your VA Claims file (C file) to the doctor in advance of the exam. If the doctor has not reviewed or does not have the C file, that C&P examination is considered inadequate. If this is the case, a negative C&P report that does not comply with this regulation can be discarded as evidence.
After your appointment, the doctor will type a report that should include information about your medical history, examination findings, and severity of your symptoms. The doctor should render an informed opinion on the condition he was asked to examine. He/she should also provide a rationale to support his/her conclusion. The doctor does not make the decision about your claimed disability. His/her report will be sent to the VA Regional Office where you submitted your application for benefits. The Regional Office will make the decision about your disability, its rating, and effective date, not the doctor.
C&P examinations are important to your claim. If you do not show up, you may not be able to get it rescheduled or it may take several months before it is rescheduled. You need to have a valid reason for not attending the scheduled appointment. Failure to attend a C&P examination without good cause puts your claim at risk for denial.