3 Signs Your VA C&P Exam Was Performed Properly
You may wonder, ‘How do I know if my Compensation & Pension (C&P) exam went well?’ after completing your disability Compensation and Pension (C&P) examination. The short answer is: it depends. However, a foolproof way you can tell if it was favorable is by reviewing a copy of your C&P exam results.
Ultimately, you may understand if you are going to receive a VA disability rating before receiving a decision. Again, you can get your information through your accredited representative.
How do I know if my Compensation and Pension exam went well?
Sometimes it’s more unnerving to leave a C&P exam not knowing whether or not the C & P exam went well or ‘favorably.’ The time between your C&P exam and the final determination can take months. If the exam did not go well, you’ve already lost considerable time in getting your VA disability claim(s) approved. It is brutal knowing you may have to continue the arduous process of more paperwork, additional trips to the VA medical center, and possibly other C&P exams. However, some insights can bring peace of mind while you wait for your final determination.
#1. The Compensation & Pension examiner had a positive attitude during your exam
This sign may not be as obvious depending on the physician’s natural bedside manner. Still, a positive attitude during the exam indicates that the results may favor you. Additionally, knowledge the examiner may have of your medical records is another key point.
Showing a genuine interest in your condition versus medical gaslighting paired with dismissive language could mean that your examiner could write a favorable nexus letter.
Did You Know?
The raters have the final decision, yes, but the C&P Exam is THE MOST IMPORTANT PART OF YOUR CLAIM!
We have found that VA claims that the C&P exam is almost always followed and trusted, particularly in new and increased ratings. Therefore, do not minimize your exam!
#2. The completeness and accuracy of the C&P exam
The duration and composition of your C&P exam depend on what information the VA needs to gather to determine your disability claim. However, it is all part of the claims process. Some C&P exams are short and consist of the examiner asking a few questions, while others may be more lengthy and thorough.
The examiner should review your medical records and your military service records during the exam process.
Did You Know?
Typically private medical opinions are weighted much lower at the beginning phases of the VA claims process. As a result, even information from the VA medical center may not find its way into your decision.
The reality is that the rater relies on the C&P examiner to review these records and opine appropriately. It is commonly why many veterans find themselves in the appeals process.
Mental Health VA Disability Claims
For mental health claims, the doctor might ask about your mental health condition and how they negatively impact your daily lifestyle concerning social, personal, and work settings. These C&P exams are usually more extensive because blood work and x-rays can not prove your health regarding depression, PTSD, or anxiety.
You will most likely have to answer questions about your daily life during the exams. Many veterans have a very difficult time providing some of this information. An important aspect of these exams is to ensure the examiner has specific examples from you and a possible family member (via a lay statement) on how your mental health symptoms negatively affect your life.
Internal Medicine VA Disability Claim
Internal medicine claims will likely require blood work, MRIs, X-rays, colonoscopies, and other tests to corroborate your VA disability claim. However, C&P exams may take less time to conduct and interpret results for these conditions.
Physical VA Disability Claims
Physical VA disability claims are similar to internal medicine claims in that they usually rely on specific tests and a physical exam, generally providing a stark indication of disability. However, it is essential to note that physicians must perform a physical assessment like testing for ‘range of motion in conjunction with tests like x-rays and MRIs for a more comprehensive Compensation and Pension exam.’
Acceptable Clinical Evidence (ACE) Reviews – C&P Completed without speaking with you.
Sometimes the physician may not need to make an in-person appointment with you based on the medical evidence you have already submitted with your claim (called an Acceptable Clinical Evidence (ACE) review). ACE reviews are pretty standard with Internal medicine VA claims.
However, the performance of ACE reviews for Physical or Mental Health claims is rare and is typically not allowed.
An ACE review could mean that your medical documentation or military records were sufficient for the physician to opine on the service connection. The examiner may or may not contact you via telephone for any follow-up questions.
#3. The Nexus is favorable and includes the words 'At least likely as not"
C&P exam report will often contain the examiner’s nexus letter. A nexus letter is a statement written by your physician conducting a C&P exam detailing their credentials, a review of your medical records, whether they believe the veteran’s condition is service-connected, and the rationale behind their decision.
Keywords they will include in your nexus letter to indicate service connection are “at least likely as not.” Therefore, if your exam report contains the words “at least likely as not,” you have a high chance of getting that VA disability claim approved, and you will receive the proper VA benefits.
What is a VA C&P Exam?
A VA C&P exam, or Veterans Affairs Compensation and Pension exam, is a medical examination where the assigned practitioner assesses the disability on your VA claim. Unlike a typical medical examination you would undergo with your primary care provider; the VA examiner will typically not diagnose or treat the disability of your VA claim. They will not typically diagnose or treat any other ailment during your appointment either.
If you already have an approved service-connected disability, the examiner will determine the severity of that disability. C&P exams may be at a VA clinic or with a VA contract examiner, depending on your location and the type of condition. For example, you may have multiple C&P examinations for various medical conditions on your VA claim— a psychiatrist would not be qualified to examine a musculoskeletal disorder.
Furthermore, not every VA claim will require a C&P exam, depending on how much medical evidence you submitted with the original claim. However, the C&P exam report is uploaded to your VA claims file and then used when determining a decision on your VA disability claim.
The examiner will provide a Disability Benefits Questionnaire (DBQ) as a deliverable of the exam. This DBQ will be completed and returned to the VA regional office. It will then be interpreted for service connection and rating purposes to assign the veteran’s disability compensation properly.
How much weight does a C&P Exam have?
Critical information may need to be included in your medical evidence file if the VA requires you to schedule an appointment for a C&P exam. Therefore, the C&P exam can be the determining factor that makes or breaks an initial VA disability claim.
The most common reasons that Veterans Affairs requests a C&P exam are:
To clarify, the physician conducting the C&P exam is not the person making the final decision on your VA disability claim. Instead, they offer their expertise based on the information you give them and what they observe during your visit.
Who Can Provide A C&P Examination?
The VA can perform the C&P examination, or they can contract a provider to do the examination. The providers that can perform the C&P are:
How Do I Obtain My C&P Exam results?
Unfortunately, Veterans Affairs does not give a copy of the C&P exam results unless the veteran specifically requests it.
It also depends if the VA did your C&P or if one of the VA C&P exam contractors did the exam.
Another thing to consider is that the C&P Exam results are only sometimes immediately completed. Meaning it could take months for the VA to finalize your case. And that is why paying close attention to the signs mentioned above of favorable results can help bring peace of mind during the waiting game.
Where do you get VES C&P Exam results?
Veterans Evaluation Services (VES) C&P exams are conducted by contracted physicians. Therefore, you may not be visiting a VA facility for this exam and instead will have an appointment with a provider or subcontractor trained in completing C&P exams. To obtain a copy of your VES C&P examination results, you have three options:
What should I do if I receive an unfavorable or inadequate C&P Exam (38 CFR 4.70)?
The VA physician will annotate on your C&P exam results that your condition is either:
- “At least likely as not” or,
- “Less likely than not” caused by your service in the military.
The latter indicates unfavorable findings regarding your claim but is not a complete and final decision. You may need to provide more evidence or get a second opinion.
If your results from your C&P exam come back unfavorable, you can submit a Supplemental Claim, Higher Level Review, or Board Review. The appropriate forms are typically included with your claims decision and can allow you to argue and list the decisions with which you disagree.
If you feel that the examiner wasn’t fully qualified to assess your condition, you can get a second opinion from a private doctor. This doctor should ideally be well-versed in the claim process and exceptional at writing a nexus letter.
A favorable C&P exam is integral to streamlining the VA disability claim process. Therefore, it is important to exercise all your resources to ensure you have provided as much information to substantiate your claim. However, an unfavorable C&P exam can mean you still have options to argue the C&P exam. Therefore, it is vital to become educated on the VA process and understand how to fight it.
Additional key takeaways for your C&P examination:
- It doesn’t matter if you have a LHI VA exam, VES C&P exam or QTC C&P exam; it all comes down to the individual examiner.
- Customer service for each of the contractors does matter. VES is very good about rescheduling bad examinations upon request and with justification of a bad C&P exam. LHI is not very good at rescheduling bad examination.
- Be TRUTHFUL! It is against the law to be fraudulent. If you aren’t going through a flare-up at the time of the exam, let the examiner know that you are not going through a flare-up. Try to describe what happens and what causes the flare-up. Frequency, duration and severity are the most important things to discuss at the C&P examination.
- Attend all examinations! If you do not attend, the VA can deny your claim.
- Ensure you understand the examiners qualifications. The VA is not perfect at finding nurse practitioners or doctors whom are qualified in a specific specialty.
- If you had a negative examination, CONTACT US IMMEDIATELY! We can tell you what to do in this case – No obligation.
Often, it can help to have an accredited representative proficient in VA claims terminology to assist you in the process. For example, suppose you’re feeling overwhelmed with the VA disability claims process and looking for a better way to strategize your VA disability claim. In that case, Blue Cord Patriots can help by offering a free strategy session. All of the Blue Cord Patriot’s team is prior service and understands the frustration of the VA disability claims process. Therefore, they develop the best strategy to win YOUR VA disability claims.
For additional tips & tricks, please read our article: 5 Ways to Identify a Bad C&P Examination.