Understanding C & P Exams

When you are ordered to attend a Compensation & Pension examination, YOU MUST ATTEND. 

Failure to show up is likely to terminate your application for benefits immediately or cause significant delay. I don's suggest rescheduling the exam, even if it isn't convenient for you! It doesn't matter if you don't understand why you are scheduled for a C & P exam. That isn't important. You must attend and you must understand how the process works.

The C & P exam is usually done by a health care professional who works for a company that is a contractor to the VHA. We call these people C& P Examiners.

Separating Fact From Fiction

The Do's & Don'ts of the C & P Exam

• NEVER try to fake any symptom. If you aren't prescribed a neck brace, don't wear one.
• Do not allow the examiner to cause you pain or discomfort during the exam by manipulating joints, etc.

• Don't ask The examiner for any insight about how your claim will be decided. 
• You may request that a family member or friend join you during the exam. 

The examiner may agree or refuse your request.

• DO NOT attempt to secretly record any part of the exam.
• DO make notes for yourself before you go. This is the only way you'll 

be sure to tell the examiner all the details you want to share.

• DO NOT over-exert yourself trying to please the examiner. This exam is 

about your worst symptoms, not the best.

• DO be courteous at all times.
• DO NOT complain to the examiner about all the

indignities you've suffered. Focus on the reason you're there.

• DO use your common sense. This exam probably won't make or break 

the decision about your claim but it can help.

 The C & P Examiner does not make the decision about your claim!

The Ratings Veterans Services Representative (RVSR) is a primary decision maker of the outcome of your claim for VA disability compensation benefits. Once the veteran has filed for the compensation benefit a folder or file is created and data (called evidence) is added to the file for consideration by the RVSR.

The condition you claimed will likely have some past evidence in the form of a Service Medical Record (SMR) or records of diagnosis and treatment from civilian providers. No matter the amount of evidence you have, it's likely that the Veterans Service Representative (VSR) or the RVSR will request that a VA contractor perform a C & P exam on you.

The C & P examiner will not treat you or order any medications. Lab work, x-rays and other such studies may be ordered by the C & P examiner. The depth of the examination is determined by order of the VSR or the RVSR and is included in the request for examination. When you have filed a claim or VA has decided to review the status of your condition, the VSR completes an order to have you attend a C & P exam. The order is very specific as to exactly what the VSR believes should be examined. If you have claimed a condition of your left leg, the C & P examiner will only address issues about your left leg.

The examiner has no authority to go beyond what is ordered by the VSR. Frequently the examiner will not have your medical records or any other history available. That is often the case when the VSR only wishes to determine the degree of function of a joint, as in a knee injury. In that instance, the examiner won't consider that the history or treatments over time is of any particular importance. She or he will only be looking for the physical effects that are observable and measurable at that moment. The knee may be flexed and rotated so that the examiner can record those motions for comparison to the norm. If there is scarring, crepitus (joint noise), swelling or redness, all of that will be noted in a report.

In other cases, the VSR or RVSR may request that the examiner give the medical record a very thorough review to determine whether or not a condition originated in the time of military service. A claimed back injury may have a reference of a similar injury in the SMR of 30 years prior to the date of the claim. The examiner will be asked for an opinion that will state that the condition of today is or is not likely to have resulted from the injury in the SMR or if it is a condition that is of different origin and likely happened long after the ETS.

This is sometimes referred to as a nexus letter and may connect the condition you allege today with an event that happened many years ago.