Today, Brian Reese, the VA Claims Insider, will explain everything veterans need to know about a C&P exam for PTSD increase.
It’s understandably scary and uncomfortable to get scheduled for any type of PTSD C&P exam.
However, understanding what to expect and how to prepare, along with some of the questions asked during a mental health C&P exam, can help educate and empower you to open up and share your uncomfortable truths on exam day.
You must be uncomfortably vulnerable and tell the examiner how you are on your very worst days (ensure you’re being honest and truthful).
Pro Tip: You do not need to prove that you have PTSD or that it’s service-connected during a PTSD increase exam. The focus is on whether your symptoms have worsened since your last exam and if you qualify for the higher rating criteria under the law.
Table of Contents
Summary of Key Points
- Understanding a PTSD Increase C&P Exam: The PTSD increase exam focuses on whether your symptoms have worsened since your last evaluation, rather than proving you have PTSD or that it’s service-connected.
- Preparation is Crucial: Knowing what to expect and how to prepare can help you communicate your symptoms effectively. Be ready to discuss changes in your condition, provide detailed examples, and be honest about your worst days.
- Review of Medical History: The examiner will review your medical records since your last PTSD exam, focusing on your PTSD diagnosis, treatments, and any previous evaluations. Be sure to review your medical records prior to exam day.
- Questions to Expect: You’ll be asked about your current PTSD symptoms, their frequency and severity, how they impact your daily life, and any history of treatment, including medications and therapy.
PTSD Review Exam for Increased VA Disability Compensation
Since you already have a PTSD rating and are seeking an increase, you’ll undergo a PTSD review exam.
This type of exam is for veterans who are already service-connected for PTSD and are looking to increase their rating or review their initial rating within the first 5 years.
This category includes both combat and non-combat-related PTSD that is already service-connected at 0% or higher.
The primary focus of a review exam for PTSD is to determine if your symptoms have worsened since your previous exam and last rating.
If your symptoms have worsened since your last evaluation, you may qualify for a higher VA rating for PTSD.
What to Expect During a VA C&P Exam for PTSD Increase
1. Review of Medical History
The examiner will review your medical records, focusing on your PTSD diagnosis, treatments, and any previous evaluations. Ensure all your records are comprehensive and up-to-date. Note: The examiner should only review your records since your last PTSD exam. You are already service connected for PTSD, so you don’t need to prove your diagnosis or nexus for service connection.
2. Discussion of Symptoms
You’ll be asked about your PTSD symptoms, including when they started, their frequency, and severity. Be prepared to discuss issues like flashbacks, nightmares, anxiety, depression, and avoidance behaviors. Detail any changes in symptoms since your last evaluation. Your PTSD increase claim will be approved or denied based on the severity of symptoms and if they’ve worsened since your last exam.
3. Impact on Daily Life
The examiner will inquire about how PTSD affects your daily activities, such as sleeping, concentrating, working, socializing, and your overall quality of life. Provide specific examples to illustrate how your PTSD interferes with your ability to function normally.
4. Mental Health Evaluation
Expect a mental health evaluation that includes questions about your military service, traumatic experiences, and the progression of your symptoms. The examiner may also assess your coping mechanisms and any treatments you’ve received.
5. Psychological Testing
You may undergo standardized psychological tests to objectively assess the severity of your PTSD symptoms. These tests help the examiner understand your condition in a structured way.
6. Completion of the Disability Benefits Questionnaire (DBQ)
The examiner will document their findings on the VA DBQ for PTSD Review. This form will be submitted to the VA rater, who will use it to decide your claim. The DBQ is critical as it largely determines your final VA rating for PTSD.
How to Prepare for Your VA PTSD Increase C&P Exam
1. Gather Records and Documents
Collect all relevant medical records, including diagnoses, treatment histories, therapy notes, and any correspondence related to your PTSD. Bring these documents to the exam.
2. Create a Symptom Diary
Keep a detailed log of your PTSD symptoms, noting their frequency, severity, and duration. Document any factors that exacerbate or alleviate your symptoms. This diary will help you articulate the impact of your PTSD during the exam.
3. List Functional Impacts
Make a list of specific ways your PTSD affects your ability to perform daily tasks and activities. Providing concrete examples of how PTSD negatively impacts your daily functioning will strengthen your case during the exam.
4. Review the DBQ for PTSD
Familiarize yourself with the PTSD Review. Be prepared to describe the onset and progression of your PTSD symptoms over time and discuss how PTSD impacts your work, life, and social functioning.
5. Prepare for Common Questions
Anticipate questions the examiner might ask, such as:
- List your current symptoms of PTSD and whether they’ve worsened since your last C&P exam for PTSD. If you think they’ve worsened, please explain how with examples.
- Do you still experience symptoms like flashbacks, nightmares, and anxiety? If yes, describe in detail.
- How does your PTSD negatively affect your work, life, and social functioning?
- Describe any history of treatment, including medications and therapy. Do any of these help relieve symptoms? If yes, explain how.
- Is there anything else you’d like to add about the severity of your PTSD?
6. Bring a Support Person
Consider bringing a trusted friend, family member, or advocate to the exam. They can provide additional insights into how PTSD affects you and offer emotional support. Their perspective can be valuable in illustrating the impact of your condition. Note: This is not required.
7. Be Honest and Detailed
When discussing your symptoms and their impact, be honest and detailed. Don’t downplay your experiences. Explain your worst days and how PTSD affects you at its most severe. This honesty is crucial for an accurate assessment of your condition.
VA Disability Ratings for PTSD
The VA rates PTSD from 0% to 100% based on how severe your symptoms are and how much they affect your occupational and social impairment.
0% Rating
Symptoms are present but do not interfere significantly with work or social life.
Occasional nightmares or mild anxiety but generally functioning normally.
10% Rating
Symptoms cause mild impairment in work or social life.
Occasional sleep disturbances, mild anxiety, or hypervigilance, but maintaining relationships and employment.
30% Rating
Symptoms cause occasional decreases in work efficiency and intermittent periods of inability to perform work tasks, though generally functioning satisfactorily.
Occasional panic attacks, chronic sleep impairment, or mild memory loss. May struggle with work-related stress or social interactions.
50% Rating
Symptoms cause reduced reliability and productivity in work and social situations.
Frequent panic attacks, mood swings, difficulty maintaining work performance or social relationships, and struggles with concentration.
70% Rating
Symptoms cause significant impairment in most areas such as work, school, family relations, judgment, thinking, or mood.
Near-continuous panic or depression, significant difficulty in social and work settings, neglect of personal hygiene, severe issues with anger management, and inability to maintain stable relationships.
100% Rating
Symptoms result in total occupational and social impairment.
Unable to work or maintain any social relationships, severe memory loss, hallucinations, dangerous behavior, disorientation, and inability to perform basic daily activities.
Conclusion & Wrap-Up
Navigating a C&P exam for a PTSD increase can be daunting, but being well-prepared and understanding what to expect can make a significant difference.
This exam is not about proving your PTSD diagnosis again but about showing whether your symptoms have worsened since your last evaluation.
By gathering your medical records, documenting the impact of your symptoms on daily life, and being honest about your experiences, you can present a strong case for a higher VA rating.
About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
