What to Expect at a Compensation & Pension Exam
The VA may send you to a Compensation & Pension Exam before deciding your disability compensation claim.
After you have applied for VA service-connected disability compensation, you will eventually receive a phone call or a letter from the VA asking you to come to a Compensation and Pension exam (C&P exam). If you have several disabilities, you may be asked to report for several C&P exams. This is a routine request.
What Happens at a Compensation and Pension Exam?
A Compensation and Pension (C&P) exam is a doctor’s appointment where your disabilities get evaluated. Usually this exam is conducted at a VA hospital or clinic. The doctor writes a report, which goes back to the VA Regional Office where you submitted your application for benefits.
When you go to your Compensation and Pension Exam, it will be different from a regular doctor’s visit because you won’t get prescribed any medicine or given any medical treatment.
If you have a mental health disability, the doctor will ask you questions and have you explain your symptoms. You might be asked to complete some psychological tests. Don’t be alarmed by this; testing is routine and it’s only one part of the exam.
If you have a physical disability, the doctor will examine you, ask you questions, and, if necessary, perform some medical tests.
Who Schedules the C&P Exam
The VA Medical Center is responsible for sending a C&P exam notice to you with the date and time of appointment. After you apply for benefits, make sure the VA Medical Center where you go for treatment has your current address and phone number. Otherwise, you may not get notice of your C&P exam, and if you don’t show up, you may not be able to get it rescheduled. Your benefits may get denied as a result, or, you may wait several months for another exam to get scheduled.
Even though the VA Regional Office has your current address, this won’t help. This is because it's the VA Medical Center that has to set up the appointment, and the medical centers do not have access to the records at the VA regional offices.
How to Answer Questions at the Exam
Don’t exaggerate your symptoms, but don’t diminish them either. When the doctor asks you questions, be truthful. Explain to the doctor exactly how your symptoms impact your life. This can be uncomfortable, since this will be your first visit with the doctor, but it is important to your claim that you be as open and honest as possible. Even if you feel frustrated by the questions or have a personal dislike of the doctor, be courteous.
Doctor's Review of Your Records
The VA is supposed to send a copy of your claims file to the doctor in advance of the exam. This is because for a C&P exam to be considered adequate, the doctor is required to review the documents in your claims file.
If You Have New Documents
If you have new documents that you haven’t sent them to the VA yet, or documents you have submitted in the prior month, be sure to bring copies for the doctor, because these won’t be in your claims folder yet. Also bring a copy of any document that is very important to your disability claim. But keep it simple; doctors don’t like to have to review too many pages of documents.
If you give the doctor any documents you haven’t sent to the VA Regional Office yet, make sure you have kept a copy. You have to submit these documents to the VA Regional Office yourself; the doctor won’t do it for you.
If the VA Didn't Send the Doctor Your Records
Usually the VA does send the claims file to the doctor in advance of the exam, but sometimes the agency neglects to. If the VA doctor hasn't received the records, he or she may not even be sure of the reason for your visit. If this happens, tell the doctor you’ve been treated at the VA, and the doctor should be able to pull up your records on the computer. However, the doctor won't have any access to private treatment records if you have seen doctor’s outside the VA. And the doctor won't see any statements about your disability that you have submitted to the VA Regional Office.
If you live far away from a VA Medical Center, the VA may send you to a private physician. In that case, if the VA doesn’t send over your records, the doctor will not be able to access your treatment information on the computer at all. The Compensation and Pension exam will then have to be rescheduled. This is because a C&P report is considered inadequate by the VA Regional Office unless the doctor has reviewed the claims file.
The Compensation and Pension Report
The doctor will write a report after the exam. This report will usually include information about your medical history and evaluate how severe you symptoms are. Often the report will include the doctor’s opinion about whether your medical conditions are related to your military service or not.
The doctor's report will get sent to the VA Regional Office that is processing your claim for benefits. It isn’t the doctor who will decide if your disability qualifies you for benefits, but the VA Regional Office. Likewise, the Regional Office make the decision about the disability rating you should get, not the doctor.
The C&P Report is a significant factor in the VA's decision about whether or not to grant you benefits, but the VA will also consider all the medical evidence in your record.