VA claims assistance - C&P exams (2024)

The Compensation and Pension exam (C&P exam):

When you file an original claim for disability compensation, claim for an increase in evaluation, or sumbit "new and relevant" evidence for a supplmental claim, andVA determines they need to evaluate your claimed disabilities, they may schedule you for what's called a Compensation and Pension exam (known sometimes as a "C&P exam) with one of theirphysicians or a contractor.

These exams are designed to obtain the needed information required to evaluate the disability in question correctly according to the 1945 Rating schedule by the RVSR(Rating Veteran Service Representative). These exams are not for medical treatment! These exams generally either take place at the local VAMC or out-patient Clinic nearest theveteran's residence, or through a contract company (VES-Veterans Evaluation Services, LHI, or QTC). When the VAMC or contractor contacts you to schedule any needed exams, ensure you move heaven and earth to attend thescheduled exam(s)! If at all possible do NOT try and re-schedule any exam(s). Many times the VAMC or contractor will say it isn't a problem and will tell you they willcall you back with another appointment date, but then turn around and notify VA's regional office who requested the exam that you were a "no-show"! Then VA makes a decision based on the evidence ofrecord without the exam, which in many cases results in a denial of benefits because you failed to report for that scheduled exam! If this does happen to you, you just can't call the VAMC orcontractor to re-schedule the exam. You'll have to file a supplemental claim -after VA denies the claim in a rating decision- and have VA re-adjudicate it on that basis (i.e. the willingness toattend the needed exam as the needed "new and relevant" evidence). They will, generally, re-adjudicate the claim on the basis of your willingness to attend their exam and re-authorize the exam withthe VAMC or contractor. Then the VAMC or contractor will again contact you to re-schedule the needed exam(s). To avoid this hassle and major headache, just attend the first scheduled exam.

When you go to these exams do not over exaggerate your condion! These examiners have been doing this for awhile now and can see right through it! Just ensureyou portray your disabilities accurately, and ensure the examiner is aware of all your current symptoms. Remember, VA evaluates, or assigns, the disability percentage based on yourcurrent symptoms. So it is essential that VA is aware of all of your current symptoms. If you have any private treatment records outside of VA, you can bring these with you to the exam.However, be aware that the examiner is not obligated to look at them. They are there to make their own objective, independent, findings. If you want VA to consider your private treatment records whenthey make their decision, then simply submit them to VA as evidence.

If you're undergoing a C&P exam for any orthopedic condition, then make sure that when the doctor has you do any range of motion of the joint in question, youstop that movement at the point any pain, weakness, and/or fatigue starts, not after you cannot move the joint anymore! VA evaluates most orthopedic disabilities basedon the objective limited range of motion of the joint at the point where pain, weakness, and/or fatigue starts (called the DeLuca criteria at VA) in degrees. You may be ableto flex and extend your knee all the way with pain, but that is not what VA needs to know; they need to know at what point in this movement any pain, weakness, and/or fatigue starts! Although theC&P examiners are suppose to be trained to know this and to know at what point to measure any limited range of motion, many still do not and simply take the measurements at the point where theveteran cannot move the joint anymore because of the pain, weakness, and/or fatigue. To ensure your range of motion is recorded accurately make sure you follow this, so the RVSR can make an accurateevaluation on your claimed disability.

VA claims assistance - C&P exams (2024)

FAQs

Is duty to assist error a good thing? ›

On one hand, a VA duty to assist error is bad. It means that the VA missed something, and now you have to do extra work and wait even longer to get your claim approved. On the other hand, it's a good thing because it means your VA claim still has life.

What not to say at the C&P exam? ›

What not to say at a C&P Exam? Under no circ*mstances should you lie or stretch the truth (also called malingering) when it comes to your VA disability claim. At your C&P exam, you should be appearing as you do on a normal day.

What is the success rate of the VA supplemental claims? ›

The VA does not publish success rates for Supplemental Claims, so the exact number is not known. However, in my experience, I'd estimate a 50% success rate if you submit new and relevant evidence not previously considered. That means one in two veterans will get a successful VA higher level review decision.

Why was my C&P exam so short? ›

It all depends on the conditions you've claimed and whether VA need more information to make a decision. For example, the required questions the doctor asks about a knee injury may take only a few minutes. But the questions for a more complex illness or injury could take much longer.

What triggers the VA duty to assist? ›

VA has a duty to assist a claimant who files a substantially complete application in obtaining evidence to substantiate his or her claim before making a decision on the claim.

What does it mean when the VA says a duty to assist error has been identified? ›

If the reviewer finds that we didn't help you get all the evidence you needed for your claim, this is called a “duty-to-assist error.” To fix this error, we'll close the review and open a new claim to gather the missing evidence. We'll also send you a letter to tell you the steps we'll take to fix the error.

How do I ace my C&P exam? ›

Here are some tips to help your appointment go smoothly and promote a more favorable outcome for your claim:
  1. Be prepared to answer. ...
  2. Prepare to be judged. ...
  3. Know the purpose of the exam. ...
  4. Stick to the facts. ...
  5. Be honest. ...
  6. Be punctual.

Is it okay to cry at the C&P exam? ›

Crying during a C&P (Compensation and Pension) exam is not only okay, but it can also be an important part of conveying the impact of your condition to the examiner.

What is a VA duty to assist C&P exam? ›

Duty to Assist: C&P Exams

VA will order an examination as part of its duty to assist if the record contains evidence of a disability (or symptoms of a disability), evidence of an in-service event, and some indication that the veteran's disability is associated with service.

How far back does the VA pay a supplemental claim? ›

We date back increases in the disability rating to the earliest date when you can show there was an increase in disability. This is only if we get the new claim request within one year from that date. Otherwise, the effective date is the date we get the claim.

What is considered new evidence for a VA supplemental claim? ›

What's “new and relevant” evidence? Here's what we mean by “new and relevant” evidence: New evidence is information we haven't considered before. Relevant evidence is information that proves or disproves something in your claim.

What is the most commonly awarded VA claim? ›

The Top Ten Most Commonly Approved VA Claims:
  • Tinnitus.
  • Hearing Loss.
  • Limitation of Flexion, Knee.
  • Post-Traumatic Stress Disorder (PTSD)
  • Lumbosacral or Cervical Strain (Back Pain)
  • Scars, General.
  • Paralysis of the Sciatic Nerve.
  • Limitation of Range of Motion of the Ankle.

How to tell if you had a good C&P exam? ›

You want to see if the examiner accurately reflected the severity of your condition overall, whether they were familiar with your medical history, if they took a look at X-rays and accurately described them in the examination report.

What should I say during C&P exam? ›

You should be honest at your C&P exam. Tell the medical professional specific details about your symptoms and how they affect your daily life. Tell them about anything you used to be able to do that you can't do anymore and why.

Can the VA give a rating without C&P exam? ›

C&P examinations are an optional part of the VA disability claims process, optional to the VA. C&P examinations are either scheduled or not, depending on the nature of the claim and the sufficiency of the documentation provided along with your claim application.

What does duty to assist mean? ›

What's “duty to assist”? This means that we're required to help you gather evidence to support your claim for VA benefits. We'll make a reasonable effort to help you get these types of evidence: VA medical records. Military service records.

Is it good when VA is correcting an error? ›

One status that may signify approval of an appeal is “We are correcting an error.” This is a good sign for a Veteran because it means that mistakes were made on the VA's part and not on the Veteran's part.

What do favorable findings mean in a VA claim? ›

For example, if a veteran is claiming service connection for post-traumatic stress disorder and VA recognizes their stressor, it should be noted as a favorable finding in the Rating Decision. Importantly, VA adjudicators are bound by favorable findings and can only rebut them with clear and unmistakable evidence.

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