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October 14, 2024

How Much Weight Does a C&P Exam Have for VA Disability Claims?

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The results of your Compensation and Pension (C&P) exam hold a ton of weight before the VA and can literally make or break your disability claim.

It’s not an exaggeration to say that your C&P exam is the #1 most critical part of the claims process!

Why?

In our experience helping over 25,000 disabled veterans secure the VA disability benefits they’ve earned, we’ve seen firsthand that VA claims adjudicators place significant weight on the results of your C&P exam, including the details of the condition-specific Disability Benefits Questionnaire (DBQ), the medical opinion for service-connection, and the C&P examiner’s notes, findings, and conclusions.

Understanding how much weight the C&P exam carries can be the difference between getting your claim approved or denied—or even receiving the appropriate rating percentage for your service-connected conditions.

3-Minute Video Explainer: How Important Are the Results of Your C&P Exam?

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How Much Weight Does a C&P Exam Have for VA Claims? Veterans: FIND OUT NOW! The C&P exam is the most important day in the VA claims process. The results can make or break your claim. #vaclaims #vadisability #vabenefits #vadisabilitybenefits #vaclaimssupport #vaclaimhelp #vacandpexam #vaclaimdenied #veterans #disabledveteran #vaclaimsinsider

♬ original sound – VA Claims Insider

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Summary of Key Points

  • C&P Exam’s Critical Role: The results of your C&P exam can significantly impact your VA disability claim, often being the most important factor in determining whether your claim is approved, denied, or appropriately rated. VA adjudicators heavily rely on the C&P exam, including the DBQ, medical opinion, and examiner’s notes.
  • Purpose of the C&P Exam: The C&P exam serves to confirm your diagnosis, establish a service connection (nexus), verify the severity of your symptoms, and assess how your condition affects your work, life, and social functioning. These are crucial elements for your disability rating.
  • Common Issues with C&P Exams: Veterans often face problems during C&P exams, such as unqualified examiners, rushed evaluations, bias, dismissal of private medical evidence, or inaccurate assessments. These issues can lead to incorrect ratings or claim denials. The good news is you can challenge the results of your C&P exam and even request a new exam.
  • C&P Exam Education is Mission Critical: Education is super important to a successful C&P exam. Veterans should focus on describing their worst days, explaining the impact on their daily life, and ensuring their condition is properly documented in medical records. If a bad exam occurs, options include requesting a new C&P exam, filing a formal complaint, writing an online review, and/or submitting additional medical evidence to challenge the results.

What is the Purpose of a C&P Exam?

A C&P exam is a routine medical examination ordered by the VA to evaluate the severity of your service-connected conditions and to determine whether there is enough medical evidence to approve your claim.

The exam is conducted by either a VA examiner or a contracted private healthcare provider (most likely), and the results of the exam are sent back to the VA claims adjudicators for review.

The primary goals of a C&P exam are to:

  • #1. Determine if you have the condition and if it’s diagnosed in a medical record.
  • #2. Determine whether there is a “nexus” (link or connection) between your condition and your military service or another service-connected disability for secondary service connection.
  • #3. Verify the severity of your symptoms in terms of frequency, severity, and duration.
  • #4. Assess how your condition negatively impacts your work, life, and social functioning to include functional impairment or loss.

How Much Weight Does a C&P Exam Have?

Short answer: a lot!

The C&P exam results are the VA’s most significant source of medical evidence when adjudicating your claim.

Here’s why:

  • Direct Medical Evidence: The C&P exam provides a current snapshot in time of your medical condition, and the VA will use it to verify the severity of your symptoms. If your medical records are outdated or don’t include comprehensive details, the C&P exam often becomes the go-to source for decision-making.
  • Impact on Disability Ratings: The C&P exam directly influences the rating percentage you receive for your service-connected condition. For example, the examiner will document your limitations, pain levels, and how your condition impacts your daily life and work. This information is critical in determining whether you get a 10%, 50%, or even a 100% rating. Remember, the more severe your symptoms, the higher the VA rating you’ll receive.
  • Nexus for Service-Connection: If you’re filing a new VA disability claim, the C&P examiner will give their medical opinion about whether your condition is “at least as likely as not” related to your military service. This “nexus” is crucial for service-connection. Without it, your claim will likely be denied. If you filed a secondary claim, the C&P examiner will give their medical opinion for secondary service connection. A medical opinion is not needed for presumptive service connection.
  • Tends to Weigh Heavier Than Private Medical Evidence: In many cases, the VA gives more weight to the results of a VA-conducted or contracted C&P exam than to private medical opinions. This doesn’t mean private evidence is irrelevant, but it underscores the importance of a thorough and accurate C&P exam.

What Happens During a VA C&P Exam?

During your C&P exam, the examiner will review your medical records, ask questions about your condition, and sometimes perform a physical examination.

They will also complete the condition-specific Disability Benefits Questionnaire (DBQ), which is a standardized form used to evaluate the specific details of your medical condition.

The DBQ contains sections for symptoms, diagnostic tests, and impact on your ability to work, which helps the VA understand how your condition fits into the VA Schedule for Rating Disabilities (VASRD).

Here’s what you can expect:

  • Questions about your condition: The examiner will ask you about your symptoms, including when they began, how often they occur, how severe they are, and how they negatively impact your day-to-day activities.
  • Physical examination: Depending on your condition, the examiner may conduct a physical examination to assess your range of motion, strength, or other relevant factors.
  • Review of medical records: The examiner may review any available medical records to understand your medical history and service-related events.

Pro Tip: Be honest and thorough when describing your symptoms. Don’t downplay or exaggerate them—accuracy is key. Be sure to tell the C&P examiner how you are on your worst days. It helps to have specific examples of “how” your condition negatively affects your work, life, and social functioning.

Warning Signs of a Bad C&P Exam: Did the C&P Examiner Get It Wrong?

A bad C&P exam can result in a lower disability rating or even a denied claim.

Unfortunately, many veterans walk out of their C&P exam feeling like the examiner didn’t fully understand their condition or listen to their concerns.

Here are some common problems veterans face at their C&P exams and reasons to object to the exam results:

#1. Unqualified C&P Examiners

Some C&P examiners lack the expertise to assess certain conditions properly. Complex issues like PTSD, traumatic brain injuries (TBI), or chronic pain often require specialists. When examiners are not trained in the specific area, it leads to incomplete or inaccurate evaluations.

Example: An examiner with limited or no mental health training may underestimate the severity of a veteran’s PTSD, leading to a lower disability rating.

#2. Rushed C&P Exams

Many veterans report that their C&P exams felt rushed, with the examiner failing to ask detailed questions or perform necessary assessments. A rushed exam can result in missed symptoms and incomplete reports.

Example: If an examiner skips a thorough evaluation of a veteran’s back injury and doesn’t check the range of motion with a goniometer, it can lead to an inaccurate lower disability rating.

#3. Bias or Dismissiveness Toward You or Your Condition

Some C&P examiners may bring biases into the exam or dismiss the severity of “invisible” conditions like chronic pain or mental health issues. This bias can result in the veteran’s symptoms being minimized.

Example: A veteran’s chronic pain might be downplayed because the examiner, after hearing similar stories before, assumes the condition isn’t serious.

#4. Dismissal of Private Medical Evidence

Some examiners may ignore or devalue private medical evidence from independent doctors, especially if the doctor was paid for their evaluation. This bias can negatively impact the claim, even though VA guidelines require all competent evidence to be considered equally.

Example: A veteran submits a private medical report for Major Depressive Disorder, but the C&P examiner dismisses it because the evaluation was done by a paid independent examiner. This is wrong and shouldn’t ever happen! There’s no prohibition against paid medical evidence for a VA claim. In fact, the C&P examiner is getting paid to conduct their exam.

#5. Pencil-Whipped C&P Exams

A “pencil-whipped” exam occurs when an examiner fills out the Disability Benefits Questionnaire (DBQ) without conducting a proper evaluation, essentially rubber-stamping conclusions.

Example: An examiner might mark “normal range of motion” for a veteran with severe back pain without performing any physical tests.

#6. Inaccurate Assessment of Symptoms Severity

Some conditions, like migraines or mental health disorders, fluctuate in severity. If the examiner evaluates the veteran on a “good day” and doesn’t consider how severe the symptoms are typically, it can result in an inaccurate rating.

Example: A veteran with severe migraines might be assessed on a day when their symptoms are mild, leading to a lower disability rating.

#7. Negative Medical Opinions Lacking Evidence

Sometimes, an examiner’s negative medical opinion—that a condition is “less likely than not” related to service—isn’t backed by evidence. This can lead to a denial of service connection even when there is a clear link.

Example: A veteran’s PTSD is linked to a service-related stressor, but the examiner doesn’t connect the condition properly, leading to a claim denial.

#8. Mere Speculation Instead of a Quality Medical Opinion

When an examiner says they can’t provide an opinion without “resorting to speculation,” it can delay or even derail the claim. This can happen if they feel there isn’t enough evidence, but it’s frustrating for veterans seeking a fair evaluation.

Example: An examiner might refuse to give an opinion on whether a veteran’s knee pain is linked to a service injury, forcing the veteran to provide more evidence or attend another exam.

What Can You Do If You Had a Bad C&P Exam?

If you feel that your C&P exam was unfair or inaccurate, you have multiple options.

Here’s some action steps to take right away:

  • Call the VA Hotline ASAP: Contact the VA at 1-800-827-1000 and explain the problems you encountered during your C&P exam. Ask the representative to make a note in your records and request a new exam. This is a crucial first step, as the VA needs to be aware of the issue as soon as possible. You should try to do this as soon as possible!
  • Write and Upload a Detailed Memorandum for Record (MFR): Just like we wrote in the military, document the details of your bad C&P exam in a Memorandum for Record (MFR). Stick to the facts and pertinent details only. Include information such as who conducted the exam, what went wrong, and why you believe the exam was incomplete or inaccurate. Upload this document to your VA.gov account for the disability claim and condition in question to ensure it becomes part of your claim file.
  • Consider Filing a Formal Complaint: If you believe the examiner was biased or unprofessional, consider filing a formal complaint with the VA or even your state’s House and Senate representatives. This can help hold the examiner accountable and may result in more oversight into future exams.
  • Write an Online Review of the C&P Examiner: If you got a bad C&P examiner, consider writing an online Google, Yelp, or other platform review of the provider to warn other veterans. I think this is one of the most powerful things we can do as veterans to stop bad C&P examiners.

How to Prepare to Crush Your C&P Exam: Education is Key!

To maximize your chances of a successful VA disability claim, education is key.

Here are some VA C&P exam tips and strategies:

Tip #1: Read Through Your Military, VA, and Private Medical Records

Familiarize yourself with your entire medical history, including military, VA, and private records. Knowing these details will help you accurately discuss your conditions during the exam and ensure that no important information is overlooked.

Tip #2: Review CFR, Title 38, Part 4, “Schedule for Rating Disabilities”

Understanding the VA’s Schedule for Rating Disabilities (VASRD) helps you know how your conditions are rated. This knowledge can guide you in discussing your symptoms and limitations in a way that aligns with the VA’s criteria for different disability percentages.

Tip #3: Do Not Describe Your Best Day

During your exam, focus on describing your worst days rather than your best. This ensures that the examiner gets a realistic understanding of how your disabilities affect your daily life. Stick to the facts of what a normal day is like for you.

Tip #4: Be “Uncomfortably Vulnerable”

Be honest and open about your symptoms, even if it’s difficult. This level of vulnerability is necessary for the examiner to fully understand the extent of your disabilities.

Tip #5: Explain How Your Disabilities Are Limiting Your Work, Life, and Social Functioning

Clearly articulate how your disabilities impact your ability to work, engage in social activities, and perform daily tasks. This helps the examiner grasp the full extent of your limitations. Remember, your final VA rating will depend on the severity of your symptoms in terms of frequency (how often), severity (how bad), and duration (how long).

Tip #6: Know Your True Story Completely, Plus Any In-Service Incidents or Stressor Events

Be prepared to discuss any incidents during your service that contributed to your current disabilities. Understanding and conveying your full story is crucial for establishing a service connection.

Tip #7: Give the C&P Examiner a Detailed Picture of Your Life Before, During, and After Service

Paint a comprehensive picture of how your life has changed due to your service-related disabilities. This context helps the examiner understand the impact of your conditions over time.

Tip #8: The C&P Examiner is NOT Your Friend; Your Exam Starts in the Parking Lot

Remember that the examiner’s role is to evaluate, not to advocate for you. You aren’t friends and neither of you are there for small talk. Maintain a professional attitude throughout the exam and be prepared from the moment you arrive. Your C&P exam starts before you pull into the parking lot!

Tip #9: Bring Hard-Copy Documents With You to the C&P Exam

Having physical copies of your medical records, notes, and any other relevant documents can help you reference important details during the exam and ensure nothing is missed.

Tip #10: After Your Exam, Ask Your Accredited VSO to Download Your C&P Exam Results from VBMS

Once your exam is complete, work with your VSO to obtain a copy of your C&P exam results from the Veteran Benefits Management System (VBMS). Reviewing these results can give you insight into how your claim may be rated.

How to Get Copies of Your C&P Exam Results  

The results of your VA C&P exam play a massively important role in determining the outcome of your VA claim.

After completing the exam, it’s critical that you obtain a copy of the C&P examiner’s report.

The examiner’s DBQ report and notices contains the medical examiner’s findings and conclusions, which heavily influence the VA rater’s decision on your claim.

Reviewing your C&P exam results allows you to catch any potential inaccuracies or omissions in how your condition was described.

If the report doesn’t accurately reflect your situation, you can gather additional medical evidence or request a new exam to ensure your claim is fairly considered.

You have two primary options to get copies of your C&P exam results:

  • Option #1: The fastest way to get your C&P exam results is to have your accredited VSO download copies of the final exam report from the Veteran Benefits Management System (VBMS). This is a system that only accredited representatives have access to. Also note that not all accredited representatives can access VBMS. Ask your VSO and don’t take no for an answer!
  • Option #2: The alternate method to get your C&P exam results is by filing a FOIA request for a copy of your VA C File. Note that this option can take 12-24 weeks or more. The good news is you’ll get all your records, literally every document for every claim you’ve ever filed, including your VA Rating Code Sheet.

Conclusion & Wrap-Up

The C&P exam is often the single most critical factor in your VA disability claim.

Its outcome can make or break your case, which is why it’s essential to approach it fully prepared and informed.

Here’s the bottom line: VA claims adjudicators (VSRs and RVSRs) place tremendous weight on your C&P exam results, so it’s crucial that your condition is thoroughly documented and accurately represented.

The good news?

If your C&P exam didn’t go as expected, you have multiple avenues to challenge the results and fight for the rating and benefits you deserve.

You’re not alone in this journey—there are always options to push back and ensure you get the compensation you’ve earned!

About the Author

Brian Reese
Brian Reese

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.

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