If you’ve filed a VA claim for musculoskeletal conditions, you will likely be scheduled for an in-person Compensation & Pension (C&P).
Understanding what to expect and how to prepare can significantly impact your ability to secure the VA rating and compensation you deserve, while also easing any anxiety about the exam.
During the exam, the examiner will assess your Range of Motion (ROM), evaluate pain levels, and document any functional limitations.
Pro Tip: VA ratings for musculoskeletal conditions range from 0% to 100%, depending on the specific condition and the frequency, severity, and duration of your symptoms. According to the VA’s painful motion principle, if you experience any pain during movement, the VA must award at least the minimum compensable rating of 10%. This ensures that even mild pain during motion is recognized and compensated.
Table of Contents
Summary of Key Points
- Filing a VA claim for musculoskeletal conditions will likely result in being scheduled for an in-person C&P exam. Proper preparation and understanding of what to expect can significantly influence your ability to secure the deserved VA rating and compensation while also easing anxiety about the exam.
- During the exam, the examiner will assess your Range of Motion (ROM), evaluate pain levels, and document any functional limitations. This thorough evaluation is crucial in determining the severity of your condition and its impact on your daily life.
- VA ratings for musculoskeletal conditions range from 0% to 100%, depending on the specific condition and the frequency, severity, and duration of symptoms. According to the VA’s painful motion principle, experiencing any pain during movement ensures at least the minimum compensable rating of 10%.
- Proper preparation involves gathering medical records, documenting symptoms, being ready to discuss your medical history and treatments, and clearly communicating pain levels and functional limitations. Wearing comfortable clothing and potentially bringing a support person can also be beneficial during the exam.
What to Expect at Your C&P Exam for Musculoskeletal Conditions
During your VA C&P exam for musculoskeletal conditions, the examiner will evaluate the functional capacity and limitation of Range of Motion (ROM).
Here’s what typically happens during the exam:
- Initial Interview: The examiner will begin with a detailed interview about your medical history, current symptoms, and how your condition affects your daily life.
- Physical Examination: The examiner will conduct a physical assessment, focusing on the affected joints or areas. They will measure the range of motion using a goniometer, which includes flexion, extension, rotation, and any other relevant movements.
- Pain Assessment: The examiner will note any pain during movement, particularly when the pain starts and how it impacts your motion. They will also observe for signs of pain, such as facial expressions or verbal indicators.
- Repetitive Use Testing: To assess the impact of repetitive motion, you may be asked to perform specific movements multiple times. This helps determine how repetitive use affects your range of motion and pain levels.
- Flare-Up Evaluation: If you experience flare-ups, the examiner will ask about their frequency, duration, and severity. They may also ask you to describe how flare-ups affect your range of motion and daily activities.
- Weight-Bearing and Non-Weight-Bearing Tests: The examiner may perform tests to compare your ROM in weight-bearing versus non-weight-bearing conditions.
- Comparison with Opposite Joint: If applicable, the examiner will measure the range of motion in the opposite, unaffected joint for comparison purposes.
How to Prepare for Your C&P Exam Involving Range of Motion
Proper preparation can help ensure your ROM C&P exam is thorough and accurate.
Here are some steps you can take to get ready:
- Gather Medical Records: Bring all relevant medical records, including previous VA and private treatment records, to provide a comprehensive history of your condition.
- Document Your Symptoms: Keep a detailed journal of your symptoms, including pain levels, frequency of flare-ups, and how your condition affects your daily life. This information will be valuable during your interview.
- Know Your Medical History: Be prepared to discuss your medical history, including when your symptoms started, how they have progressed, and any treatments you have received.
- List Medications: Make a list of all medications you are currently taking, including dosages and any side effects. This helps the examiner understand your treatment regimen.
- Be Honest About Pain: Clearly communicate your pain levels and how they impact your range of motion. If certain movements cause pain, make sure to mention it during the exam.
- Describe Flare-Ups: If you experience flare-ups, be ready to describe their frequency, duration, and how they limit your activities. Providing specific examples can help the examiner understand the severity of your condition.
- Wear Comfortable Clothing: Wear loose, comfortable clothing that allows easy access to the affected joints. This will make it easier for the examiner to perform the physical assessment.
- Bring a Support Person: If possible, bring a friend or family member to the exam. They can provide additional information and support if needed. This is optional and not required.
List of Questions You Might Get Asked at a C&P Exam for Musculoskeletal Conditions
Here’s a list of common questions that a veteran can expect during a VA C&P exam for musculoskeletal conditions, focusing on pain, limitation of Range of Motion (ROM), and functional loss:
- What is the history of your musculoskeletal condition?
- Describe the nature and severity of your pain.
- How often do you experience pain, and what activities or movements trigger it?
- Do you have flare-ups? If so, how frequently do they occur, and how long do they last?
- Describe any functional loss you experience due to your condition.
- How does your condition affect your daily activities and ability to work?
- Can you walk, sit, stand, or climb stairs without difficulty? If not, what limitations do you have?
- Do you use any assistive devices like a cane, crutches, or wheelchair?
- How does your condition affect your ability to perform tasks that require lifting, bending, or twisting?
- Have you noticed any swelling, redness, or warmth in the affected areas?
- Have you experienced any instability or episodes of your joints giving way?
- Describe any stiffness or decreased range of motion you have in the affected joints.
- How do you manage your pain, and what treatments have you tried?
- Do you experience muscle spasms, weakness, or fatigue in the affected areas?
- Have you had any surgeries or procedures for your condition, and what were the outcomes?
- On a scale from 0 to 10, how would you rate your pain?
- Do you have difficulty with repetitive motions, such as typing or using hand tools?
- Have you experienced any numbness or tingling in the affected areas?
- How do your symptoms change throughout the day? Are they worse in the morning or evening?
- Are you able to perform self-care activities like dressing, bathing, and grooming without assistance?
- Have you ever missed work or been unable to perform your job duties due to your condition?
- Do you have difficulty sleeping because of your pain or discomfort?
- Have you tried any physical therapy, and if so, was it helpful?
- Are you currently taking any medications for your condition? If so, do they provide relief?
- Have you had any imaging studies, such as X-rays or MRIs, to evaluate your condition?
- Do you experience any grinding, popping, or clicking sounds in your joints?
- How has your condition progressed over time? Is it getting better, worse, or staying the same?
- Have you experienced any side effects from treatments or medications?
Range of Motion VA C&P Exam Testing: Initial and Repetitive Use Requirements
- Initial ROM Assessment: A C&P examination for musculoskeletal conditions begins with an initial measurement of the joint’s ROM as measured by a goniometer. This baseline measurement is crucial for understanding the joint’s current function.
- Repetitive Use Testing: After the initial assessment, the C&P examiner must perform repetitive-use testing. This involves repeating the ROM test at least three times to observe any changes or additional limitations that occur with repeated motion. The examiner must report these post-test measurements. If repetitive-use testing cannot be performed, the examiner must provide a clear explanation.
Addressing Pain and Functional Loss
- Pain Assessment: It is mandatory to test pain in both active and passive motions, and during weight-bearing and non-weight-bearing states. This comprehensive pain assessment helps to paint a full picture of the joint’s functionality. If the veteran has any pain upon movement, the VA Rater is required to award the minimum compensable rating for that condition, which is usually 10%.
- Functional Loss: The examination must account for any additional functional loss due to pain, weakness, fatigability, or incoordination during flare-ups or with repeated use over time. If assessing this functional loss is not feasible, the examiner must explain why.
Ensuring C&P Examination Sufficiency
- Consistency in Findings: Examiners must avoid contradictory statements in their reports. For example, noting an “unaffected gait” while also stating the veteran “walks with a cane” is inconsistent and requires clarification. Similarly, if a joint surgery is mentioned, the associated scars must be addressed in the report.
- X-Ray and Diagnostic Requirements: For conditions like arthritis, a diagnosis must be confirmed with an X-ray. If arthritis is claimed but not diagnosed, the examination must include X-rays to ensure completeness.
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.
