The VA Veterans’ disability claim process can be daunting because it’s unfamiliar, and the stakes are high. You may have heard that the process will require a C&P exam (formally a Compensation & Pension Examination) and wonder what the C&P exam process looks like and how to get this scheduled and completed.
This article will simplify all of that for you.
Before getting into the details, let’s recap what a C&P exam is, what C&P exam paperwork you should expect, and why it is so important.
A C&P exam is an optional step in the VA Veterans’ disability claim process, part of the claims file research that the VA sometimes, but not always, requests.
It is required, however, for the veteran to attend if the VA decides to schedule one. 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, more than one C&P exam could be scheduled with medical professionals with different specialties. After the C&P exam, a report will be written and submitted to the VA to be considered along with the rest of its contents to decide whether the veteran has a service-connected disability and, if so, how significant it is.
It is crucial to attend a C&P exam if scheduled. Failure to do could result in an outright denial of your disability claim. Sometimes it is possible to convince the VA to reschedule, but there are no guarantees.
There is no need to book a C&P exam. The VA will schedule one for you if they think they need one as part of your disability claim process. C&P exams are scheduled either at a VA medical facility or with a medical professional contracted with the VA.
Carefully review the C&P exam paperwork when you receive it to make sure you understand where you are supposed to report and when. If there is some problem with the date and time scheduled for your C&P exam, be proactive and contact the C&P examiner’s office to modify your appointment and don’t just miss it. There should be a contact number on the letter you receive.
As noted above, a veteran does not book a C&P exam. Instead, a veteran who has filed for VA disability benefits needs to track the process and all communications from the VA and wait to see if the VA requests a C&P exam to be performed. Then it’s simply a matter of following the instructions, showing up on time (early is better) for your appointment, and being prepared to answer questions about your physical or mental health at the C&P exam scheduled for you.
Technically, you cannot directly appeal the results of a C&P exam.
However, mistakes can be made during a C&P exam that negatively affects the resulting decision on your VA disability claim, and some things can be done about that.
First of all, if you have any concerns at all about what happened during the C&P exam, if you think the C&P examiner didn’t ask the right questions, didn’t seem to have reviewed your medical records in advance, wouldn’t let you talk, or veered off in a different direction than the disability you have actually claimed, document that.
If you think you had a bad C&P Exam, you should immediately write out a statement identifying your concerns on a 4138 VA form and submit it to the VA to become a part of your disability claim file. The VA may, after seeing that, schedule you for a new exam. Even if they don’t, it can help form the basis for an appeal of an eventual adverse decision.
A report is written by your C&P examiner and is then submitted to the VA and included in your disability claim file. You cannot “appeal” that report directly. Upon reviewing the C&P exam report and all other information in your claims file, a decision will be made, and a Notice of Decision letter will be sent out. That Notice of Decision will outline whether the VA agrees that you have a service-connected disability and, if they do, what the disability is and how severe it is.
The severity is rated on a percentage basis (10% – 100% in increments of 10), which is your Disability Rating. Your Disability Rating determines the extent of benefits to which you will be entitled.
This Notice of Decision can be appealed if you believe mistakes were made either on the determination of the existence of a covered disability or the rating number. You have one year from the date of the Notice of Decision to file such an appeal, an appeal which may challenge the accuracy or findings of the C&P examination.
At this appeals stage, lawyers can be involved in your case, helping you to evaluate whether an appeal would be appropriate and representing you in that process.
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If you disagree with the Notice of Decision you have received on your VA disability claim, contact us for a free evaluation of whether we can help you with an appeal.