Can I skip my VA C&P exam?
What happens if I miss the C&P exam without giving the VA prior notice?
Here’s the bottom line:
If you don’t go to your scheduled C and P exam, the VA Rater can deny your claim!
Where is the reference, Brian?
38 CFR 3.655 provides that when entitlement or continued entitlement to a VA benefit can’t be established or confirmed without a current C&P exam and the claimant fails to report without good cause, action will be taken as provided in 38 CFR 3.655 (b) and (c).
Can I Miss My VA C&P Exam?
No, you can’t; if you get scheduled for a VA C&P exam, you need to report.
Why?
Because if you don’t show up, the VA Rater can deny your claim.
It’s also important to tell your true story at your C&P exam and make sure your current disability is medically diagnosed, you have a “Nexus” for service-connection, and your current severity of symptoms get properly documented prior to a VA rating decision.
Here’s the important references in 38 CFR and in M21-1.
38 CFR § 3.655: Failure to Report for VA Examination (VA C&P Exam)
38 CFR § 3.655 contains important details of what happens if you fail to report to your scheduled VA C&P exam.
General:
When entitlement or continued entitlement to a benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination, or reexamination, action shall be taken in accordance with paragraph (b) or (c) of this section as appropriate.
Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, death of an immediate family member, etc.
For purposes of this section, the terms examination and reexamination include periods of hospital observation when required by VA.
Original Claim, Supplemental Claim, or Increase Claim:
When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record.
When the examination was scheduled in conjunction with any other original claim, a supplemental claim for a benefit which was previously disallowed, or a claim for increase, the claim shall be denied.
How Does the VA Define “Good Cause” for Missing a Scheduled VA C&P Exam?
“Good cause” means a reason that justifies failure to report for VA examination.
VA will generally accept any reason offered by the individual as good cause for failure to report for an exam.
Examples of good cause include, but are not limited to, illness or hospitalization of the claimant or death of an immediate family member.
Exception: Good cause is not established if the claimant
- Fails to provide any reason for failing to report
- Indicates failure to report was based on general concerns about being exposed to and/or contracting an illness while undergoing examination, or
- Indicates notice of the scheduled examination was not received.
References:
- Effect of non-cooperation on the duty to provide an examination or opinion, see M21-1, Part IV, Subpart i, 2.F.1.a
- Allegations of non-receipt of examination notice, see M21-1, Part IV, Subpart i, 2.F.1.e, and
- Cases where a claimant expresses a willingness to report for examination, see M21-1, Part IV, Subpart i, 2.F.1.f.
What If I Didn’t Get My C&P Exam Notice?
Well, that’s not a valid excuse.
A veteran’s allegation that notice of a scheduled C&P exam was not received is not considered good cause for failure to report.
An assertion that a notice was not received does not rebut the presumption of administrative regularity that VA discharged its duty to schedule an examination and notify the veteran of the scheduled examination.
A copy of an examination scheduling notice from the examining facility does not need to appear in the claims folder for the presumption of regularity to apply.
If evidence is available that rebuts the presumption of regularity, such as the failure of VA to timely update the claimant’s address or an assertion that the exam notice was received after the date of the examination, then that evidence must be considered.
References:
- Allegations of non-receipt of a scheduling notice, see Kyhn v. Shinseki, 24 Vet. App. 228 (2011)
- Effect of non-cooperation on the duty to provide an examination or opinion, see M21-1, Part IV, Subpart i, 2.F.1.a, and
- The definition of good cause, see M21-1, Part IV, Subpart i, 2.F.1.b.
VA Decision Table for Failure to Report to Your C&P Exam:
| IF the failure to report for your C&P exam is “without good cause” … | THEN take the VA Rater shall take the following action: |
| Original compensation claim, new claim (for a new benefit, or new disability) | Decide the claim based on the evidence of record. |
| Increased evaluation claim, supplemental claim for a previously denied benefit, or original claim for a benefit other than compensation | Deny the claim. |
| Examination ordered to assess continuing entitlement when there is a running award | Discontinue payment for the benefit, or reduce payment for the disability for which examination was scheduled to a minimum evaluation established under 38 CFR Part 4, or lower protected evaluation under 38 CFR 3.951(b). Notes: Discontinuance or reduction is only finalized after due process, as provided in M21-1, Part IV, Subpart ii, 2.B. Reduction or discontinuance will not be finalized when the claimant submits evidence during the proposed reduction period justifying continuation of the benefit or indicates a willingness to report for examination. |
About the Author
Brian Reese
Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).
Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start.
As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).
