Do All VA Disability Claims Require a C&P exam?
Published February 10, 2022
Veterans can make VA disability claims to obtain monetary compensation for service-connected disabilities. These claims are usually made directly to the VA by the affected veteran, sometimes with the assistance of a VSO.
You may wonder whether the claim process requires a C&P exam (Compensation & Pension Examination).
The article will walk you through the C&P exam process and what C&P exam paperwork to expect.
Do you need a C&P exam in order to make a VA Disability Claim?
No, you do not do a C&P exam in order to file your VA disability claim application. However, the VA may require you to submit to a C&P exam as part of the VA’s evaluating of your claim and reaching a decision.
A C&P exam is an optional step in the veteran’s disability claim process at the option of the VA. You should be submitting your medical records to the VA as part of your disability claim, but there may be information missing, or the VA may want to confirm certain aspects of your condition.
If the VA requests a C&P examination, you will receive a letter scheduling the exam either at a VA medical center or at a doctor’s office designated by the VA. It is complicated to reschedule and can be fatal to your disability claim if you skip the C&P exam, so make sure you attend as scheduled. If the VA (and thus the C&P examiner) don’t have all of your relevant medical records, be sure they do before the C&P exam so the examiner can be sufficiently prepared.
A C&P exam involves a (usually short) visit with a medical professional designated by the VA. The medical professional reviews your medical records relevant to your disability claim and then examines the veteran to verify and/or get additional information about the veteran’s physical or mental condition. Depending on the nature of the disability claim, you could schedule more than one C&P exam with different specialties.
After the C&P exam, the examiner will create a C&P exam report for the VA. This document will become part of the entire disability claims file and part of the decision-making process on your disability claim.
If you are not scheduled for a C&P examination, there’s no need to worry. Certain types of disability claims are presumptively service-connected upon diagnosis (for example, certain diseases and cancers are presumed to have been caused by Agent Orange exposure if you served during specific timeframes in certain combat areas). For some of these claims, your medical and service records alone may be all that is required to approve your claim.
Is it common for the VA to deny you a C&P?
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. Furthermore, the C&P examination, by itself, does not result in either granting or denial of the underlying disability claim. It is just one part of the claim investigation process by the VA.
The VA may deny you the opportunity to appear for an exam if there isn’t enough in your records to warrant an exam. For example, if there is nothing in your service treatment records (STRs) about an injury claimed, you may receive a denial.
What do I do once I get my C&P results?
You will not automatically receive the results of your C&P exam. The report generated by the C&P examiner after reviewing your medical records and examining you will be forwarded directly to the VA. You can, however, get a copy. Contact the VA at 1-800-827-1000 to request a copy.
Is it possible to appeal the results of a C&P exam?
Directly, no. Indirectly, yes.
The C&P exam report is often one of the final steps in preparing your disability claim file for a decision by the VA. The VA will issue a Notice of Decision letter that sets forth (1) whether it has decided that you have a service-connected disability; and, if so, (2) what your disability rating is. A disability rating is a numeric designation from 10-100% describing the severity of your disability. This rating factors into calculating the disability benefits you are entitled to receive.
You have one year from the date of the Notice of Decision to file an appeal. The option of a VA appeals claim should be considered if the VA issued a complete denial or if the rating seems to be too low. There are several grounds for appealing a decision, and the C&P examination report disclosing errors or omissions may be one of them.
It is at this appeal stage that lawyers often get involved. Lawyers experienced in VA disability claims can review your claim file and see if there are legal or factual errors they can correct on appeal, which may result in granting disability benefits and/or increasing the rating number.
Information on appealing the results of a disability claim
The results of an initial VA disability claim, as outlined in a Notice of Decision, can be appealed one year after issuance. Some frequent reasons for claim denial are fixable, such as medical records not including all necessary information. Sometimes simply obtaining a more detailed and thorough medical or psychological examination will provide the information required to support a claim. Occasionally, key information is already in the claims file but was overlooked by the C&P examiner or the claim decision-maker.
All this and more can be fixed and result in a modified and better outcome for your VA disability claim.
If you have received a Notice of Decision on your VA disability claim that you think is wrong, get in touch with Veterans Law Group for a free evaluation of your appeal options. We have helped thousands of veterans obtain excellent outcomes on their disability claims appeals.