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My Claim Was Denied, Now What?

Compensation & Pension Exam for Veterans With PTSD: What to Expect

A compensation and pension exam (“C&P Exam”) is a required step in the process of getting VA disability claims processed and approved.

The VA needs to verify your diagnosis (whether PTSD or something else), even if a VA physician provided your underlying diagnosis. Additional purposes are to evaluate two prongs of eligibility for benefits – whether the condition is service-related, and the severity of the condition.

What is a C&P Exam

A C&P Exam is a specially scheduled examination by a VA doctor or outside contractor (not your treating physician) for the purpose of evaluating your condition(s) for the purposes of a VA disability claim.

Upon filing a claim, appeal, or request for an increase, you will likely be scheduled for an examination by the VA. The VA or the outside contractor will notify you by mail or by telephone when and where your appointment will be.

Please note the VA is not required to schedule a C&P exam if there is no evidence of an in-service injury, even if you have a current diagnosis.

Once you are scheduled for a C&P exam, it is mandatory and failure to cooperate will result in denial of your disability claim. You can;  however, request a reschedule if you have a conflict.  Just be sure to tell them beforehand and not be a no-show.  C&P exams can be stressful; however, with a little preparation of what to expect and what information to bring, it can be a relatively painless process.

A C&P exam may also be required during an appeal process to provide further documentation or clarity of a diagnosis or the extent of disability. This allows the VA to not only confirm the existence of the declared disability but to obtain the necessary information regarding symptoms and severity to allow for an appropriate rating level to be assigned.

A disability rating is part of the formula for determining overall percentage and monthly benefit payments.

General Guidelines For Your C&P Exam

Contact your VSO or attorney representative to notify them of the scheduled exam when as soon as you receive notice. The VA does not notify your VSO or attorney of the scheduled exam.

It is absolutely necessary that you attend your scheduled C&P Exam. If you do not attend your C&P Exam, your claim will likely be denied. If you are unable to make the exam at the scheduled time, you MUST contact the VA and reschedule the examination.

The physician conducting your examination is not your treating physician. They will not be providing medical advice or discussing future medical treatment plans for your disability. The examiner is supposed to provide an opinion to the VA regarding the severity and history of your claimed disability.

Here are some additional guidelines to keep in mind:

If you have them available, you should bring the following documents along with you to your C&P Exam:

  • • A doctor’s letter that directly addresses the severity and/or origin of your disability
  • • Social Security Earning Statements, if your C&P is related to Individual unemployability

At the beginning of the appointment, ask the physician to specify which disabilities will be evaluated during the exam. You should only be discussing issues for which the exam was scheduled.

At the examination, the examiner will ask you specific questions related to your disability. You may need to provide additional information regarding your disability to indicate the severity of the condition. Give the examiner a clear picture of how your disabilities affect you on a daily basis. For example:

For a physical C&P: If the examiner asks if your broken foot hurts when you walk and the answer is yes, say yes. However, if your foot also hurts when you drive, stand too long, take your shoes on and off or do anything other activity, be sure to state that as well. You should be as specific and detailed as possible when describing your past and current pain.

For a mental health C&P: If you suffer from PTSD the severity of your symptoms may change from week to week or even daily. Even though you might be on your “good” day at the exam, you will want to make sure the examiner knows how you also are on your “worst” day. If your depression usually causes you to neglect basic hygiene practices such as brushing your teeth, but you chose to brush them the day of the exam, the examiner will not notice that your depression is affecting your hygiene.

In this case, it is up to you to tell the examiner that you typically neglect your basic hygiene needs even though you did brush your teeth the day of the exam.

  • •Be sincere in your responses. Accentuate but do not over-exaggerate your condition.
  • •If you do not recall specific information, do NOT guess. For example, if the doctor asks for a specific date of an injury and you don’t know, simply state that you are not sure or don’t remember. Only give specific information when you are absolutely sure of your response.
  • •You might want to write a summary of the examination immediately afterward. Make note of the topics discussed, the length of the exam, and anything that really stuck out in your mind. Send these notes to your VSO or attorney representative. Keep in mind that it may be some time before you attend a hearing if requested, in which your exam might be brought up. It may be difficult to remember details of the exam several months afterward and your summary can be very helpful.
  • •About two weeks after your exam, request a copy of the C&P exam report and send a copy to your VSO or attorney. This can be done at the Release of Information Office at your regular VA Medical Center.

Tips and Reminders for C&P Exams

When you are preparing for your C&P Exam remember that your task is, to be honest, and forthcoming with the examining doctor, and also as detailed as possible about your condition(s) and symptoms. As a soldier, you are trained to always show strength, to not admit weaknesses or insecurities. A C&P Exam is not the time to follow that training. It is the time to be real about everything that is going on.

This is especially true for PTSD. Many symptoms are things that others may not know about – anxiety, nightmares, the need to self-medicate with alcohol or drugs. Disclose them. It is part of the evaluation process.

This should go without saying, however, that you should not study illnesses or symptoms and try to report those in order to increase your chances of getting a significant disability rating. Some of the testing done during a C&P is specifically designed to detect deception so that’s not a route you want to take.

You may want to jot down some notes before your appointment. Sometimes the stress of any doctor’s appointment can make you forget things.

You may also request to have your spouse or another support person with you as a witness and for moral support. There is a dual purpose to having another person present. They may have been witness to behaviors and symptoms that you as the veteran aren’t aware of. Furthermore, the mere nature of PTSD or some other mental health issue is an impaired ability to convey or recall information.

A C&P exam may seem like a daunting hurdle to getting VA disability benefits, but is just an opportunity for documentation of necessary elements of your claim. Collect your files, your notes, and bring along a support person as a witness, and get it done.

If you need to initiate a new disability claim, contact a VSO in your area to help you prepare it, keeping in mind that the VA will almost always request a C&P Exam be performed. If your claim is denied, or you feel you were underrated, please contact Veterans Law Group.




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