Why Did I Get a 2nd C&P Exam for PTSD?

In my experience helping over 25,000 veterans since 2016, a 2nd C&P exam for PTSD is generally positive and can lead to a more favorable VA claim decision or avoid a VA claim denial.

Why do I say this?

Because a second C&P exam is usually ordered for one of four reasons, all of which are designed to help you:

• #1. You had a bad first C&P exam and the VA Rater has pre-emptively requested a second opinion from a new C&P examiner.

• #2. You had a bad first C&P exam, and you called 1-800-827-1000 to request a new C&P exam. Pro Tip: You can request a new C&P exam if you think you got a bad first exam!

• #3. The VA Rater identified a “Duty to Assist” error. For example, maybe the first C&P examiner failed to address the proper medical etiology for direct service connection, secondary service connection, or service connection by aggravation. A second VA exam can help correct this mistake.

• #4. The first C&P exam was not accurate or complete. Sometimes the C&P examiner fails to conduct an adequate examination for rating purposes. In that case, a second C&P exam to correct the errors is especially important.

Summary of Main Points

• Positive Impact of Second C&P Exam for PTSD: In my experience helping over 25,000 veterans since 2016, a second C&P exam for PTSD generally leads to a more favorable VA claim decision or helps avoid a VA claim denial.

• Common Reasons for a Second VA Exam: A second C&P exam is usually ordered for one of four reasons: (#1) an unfavorable first exam leading to a preemptive second opinion, (#2) a veteran’s request for a new exam, (#3) a “Duty to Assist” error needing correction, or (#4) an incomplete or inaccurate first exam.

• Importance of Accurate Assessment: A second C&P exam ensures a thorough evaluation, corrects any errors from the first exam, and provides the VA Rater with all necessary information for a fair and accurate VA rating decision.

• Nuanced Nature of PTSD Claims: PTSD claims require detailed documentation of symptoms, their impact on daily life, and adherence to DSM-V standards. A second exam can address any inadequacies in the initial assessment, such as improper documentation of PTSD stressor events or incorrect medical opinions for service connection.

The Truth About a 2nd C&P Exam for PTSD

First things first: A second C&P exam is not a bad thing; in fact, it can be a positive sign for your claim.

PTSD claims are incredibly nuanced, and the examiner is required to confirm a diagnosis that conforms to DSM-V standards, give their medical opinion for service connection, and document the severity of your PTSD symptoms as well as “how” those symptoms relate to your level of occupation and social impairment.

Sometimes the first C&P examiner fails to conduct an adequate exam for rating purposes, so a second C&P exam gets ordered to correct the errors from the first exam.

For example, let’s say the first C&P examiner didn’t give a correct medical opinion for service connection—in this instance, a new C&P exam is necessary so the VA Rater has all the information he/she needs to make a rating decision.

Another example is a C&P exam where the examiner didn’t properly address your PTSD stressor event, which is critical to determining your eligibility for a VA rating for PTSD.

A second exam would require the examiner to properly document whether the PTSD stressor event is valid and severe enough to lead to the development of PTSD.

4 Common Reasons for a Second C&P Exam

Here’s a list of the most common reasons why the VA ordered a 2nd VA C&P exam:

• #1. Preemptive Second Medical Opinion: If your first C&P exam was unfavorable, the VA Rater might request a second opinion from a new C&P examiner to ensure a fair evaluation.

• #2. Veteran’s Request: If you believe your first C&P exam was inadequate, you can call 1-800-827-1000 to request a new exam for a more accurate assessment.

• #3. Duty to Assist Error: The VA Rater may identify a “Duty to Assist” error, such as the initial examiner failing to address the correct medical etiology for direct service connection, secondary service connection, or service connection by aggravation. A second exam can rectify this oversight.

• #4. Inaccurate or Incomplete First Exam: If the first C&P exam was not thorough or accurate, a second exam is crucial to correct any errors and ensure a comprehensive evaluation for rating purposes.

How to Prepare for Your Second C&P Exam

Preparing for your VA C&P exam for PTSD is essential to effectively communicate the severity of your symptoms and their impact on your daily life.

Here’s some tips to ensure you’re ready to go on exam day:

1. Gather Records and Documents

Collect all relevant medical records, including diagnoses, treatment history, therapy notes, and any correspondence related to your PTSD. These documents provide crucial evidence to support your claim. Review them thoroughly and bring hard copies to the exam for reference.

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, such as triggers or coping mechanisms. This diary will help you articulate the impact of your PTSD on your daily life during the exam.

3. List Functional Impacts

Make a list of specific ways your PTSD affects your ability to perform daily tasks and activities. This may include difficulties with concentration, sleep disturbances, or challenges in social or work environments. Providing concrete examples of how PTSD negatively impacts your daily functioning will strengthen your case during the exam.

4. Review the DBQ for PTSD

Review the PTSD Disability Benefits Questionnaire (DBQ). Be prepared to describe the onset and progression of your PTSD symptoms, as well as any treatments you have pursued and their effectiveness. Additionally, be ready to discuss how PTSD impacts your work, life, and social functioning.

5. Prepare for Common Questions

Anticipate the mental health C&P exam questions you might get ask based on the DBQ, such as:

• Descriptions of traumatic events that led to your PTSD
• How you experience symptoms like flashbacks, nightmares, and anxiety
• How PTSD negatively affects your relationships, work, and social life
• Any history of treatment, including medications and therapy

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. Describe how you are on your very worst days. Don’t downplay your experiences. Explain how your PTSD affects you when it’s most severe. This honesty is crucial for an accurate assessment of your condition.

About the Author

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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.