How a C&P Exam Can Make or Break Your VA Disability Claim

When veterans file a VA disability claim, they’re often required to get a C&P exam. The Compensation and Pension exam is more than just a doctor’s visit. It’s one of the most important steps in the disability claims process.

Knowing what to expect and how the C&P exam can impact your claim can mean the difference between an accurate disability rating and a denial that drags on for months or years.

What Is a C&P Exam?

A Compensation and Pension (C&P) exam is a medical evaluation designed to help the VA determine how severe your disability is and/or whether it is caused or aggravated by military service. C&P exams are not intended for treatment, medical advice, or medication adjustments. The sole purpose of the C&P exam is to gather evidence for your VA disability claim.

The exam is conducted by either a VA clinician or a contracted provider. These providers use standardized examination templates, known as Disability Benefits Questionnaires (DBQs), to record findings. The examiner reviews your medical records, listens to your description of symptoms, and documents objective findings such as range of motion, test results, or mental health assessments.

In short, the C&P exam provides the VA with an expert medical opinion that directly impacts your disability rating. The better prepared you are to present accurate, detailed information, the more likely your record will reflect your true level of disability.

When Are C&P Exams Required?

C&P exams are not required for every veteran, but they’re common in most disability claims. The VA uses these exams to answer three key questions:

1. Do you have a current diagnosed condition?
2. Is that condition related to your military service?
3. How severe are your symptoms?

If the VA can’t answer these questions using existing medical records, they’ll schedule a C&P exam. Here are some examples of scenarios in which the VA may order an exam:

• Initial claims: When you first apply for service connection, the VA almost always orders an exam to confirm your diagnosis and connection to service.

• Increased rating claims: If you’re already service-connected but your condition has worsened, the VA may order another exam to reassess your current severity.

• Reexaminations: Sometimes, especially if your condition may improve over time (such as post-surgery recovery), the VA will schedule follow-up exams every few years.

• Secondary service connection claims: If you’re claiming a condition as secondary to an existing service-connected disability (for example, depression caused by chronic pain), a C&P exam helps establish that link.

The VA isn’t supposed to schedule an exam if there’s already enough solid medical evidence in your file (such as detailed private treatment records or recent specialist evaluations) to decide the claim. However, most of the time, they still want their own evaluation before making a decision.

Which Disability Claims Are C&P Exams Most Relevant To?

Technically, any disability claim can trigger a C&P exam. Some of the most common reasons for C&Ps include:

• Musculoskeletal Claims: Back, knee, shoulder, neck, and joint injuries often require precise range-of-motion measurements. The VA examiner uses a goniometer (a device that measures joint angles) and notes pain, weakness, or functional loss during movement. These details are essential because VA ratings for musculoskeletal conditions are largely based on range-of-motion limits.

• Mental Health Claims: For PTSD, depression, anxiety, military sexual trauma (MST), or other psychiatric conditions, the C&P exam carries enormous weight. The examiner evaluates your symptoms, functional impairment, and occupational impact, then assigns a WHODAS 2.0 score (World Health Organization Disability Assessment Schedule 2.0) or equivalent measure. These findings directly correlate to your disability rating percentage.

• Neurological and Sleep Disorders: Claims for migraines, traumatic brain injury (TBI), or sleep apnea often hinge on specialized C&P evaluations. These exams document symptom frequency, diagnostic test results, and functional effects, such as cognitive impairment or fatigue.

• Agent Orange and Toxic Exposure Claims: If you’re claiming a condition related to herbicide exposure, burn pits, or Gulf War illnesses, the C&P exam focuses on confirming diagnosis and identifying potential links to your service history and exposure type.

• Unclear or Complex Claims: When the evidence in your file is mixed or incomplete, the C&P exam can serve as a tiebreaker, helping the VA determine whether your condition meets the “at least as likely as not” threshold for service connection.

How to Schedule a C&P Exam

If the VA decides a C&P exam is needed, you don’t need to schedule it yourself. The VA or a contracted provider will contact you. You’ll typically receive a call, email, or letter with the exam date, time, and location.

That said, veterans do have a few responsibilities:

1. Confirm the appointment quickly. Missing or ignoring the contact attempts can delay your claim or even result in a denial due to “failure to report.”

2. Request rescheduling only if absolutely necessary. Life happens. If you’re sick or have a legitimate conflict, you can reschedule. But do it promptly and document the reason.

3. Prepare your materials. Bring your photo ID, relevant medical records (especially from private doctors), and a list of medications. Review your claim before the appointment to ensure you’re clear on what you have filed for.

If you haven’t heard anything within a few weeks of submitting your claim, you can track C&P exam requests and updates through your VA.gov account or by calling the VA hotline (1-800-827-1000).

What to Expect During Your C&P Exam

Specific C&P exam procedures vary widely depending on your claimed condition, but the structure is fairly consistent. Here’s what typically happens during a C&P exam.

1. Identity Verification and Review: The examiner will confirm who you are, explain the purpose of the exam, and review your claim details. They may have already read your file, or they might skim it during the appointment.

2.  History and Symptom Discussion: You’ll be asked to describe your symptoms, onset, and how they affect your daily life. This is not the time to “tough it out” or minimize pain. Be honest and specific.

For example, instead of saying, “My back hurts,” say, “I can’t stand for more than 10 minutes without pain shooting down my left leg.” Specific, functional descriptions are best. Be sure to keep your answers consistent with your written claim and medical records. Inconsistencies, even unintentional ones, can raise red flags for the reviewer.

3. Physical or Psychological Examination: Depending on your condition, the examiner may perform physical tests (range of motion, strength, reflexes) or ask detailed mental health questions. For psychiatric exams, expect questions about mood, memory, relationships, and work performance.

4. Diagnostic Tests (if applicable): Some exams include X-rays, pulmonary function tests, or sleep studies. The examiner may order these if needed.

5. Documentation and Closing: You won’t receive results during the C&P appointment. The examiner submits a report to the VA, which becomes part of your claim file. You can request a copy later through your VA.gov account or a Freedom of Information Act (FOIA) request.

C&P Exams Can Help or Harm Your VA Disability Claim

C&P exams can be a turning point in your case. The report carries significant weight because it comes from a VA-approved medical professional, often viewed as an objective evaluator. That influence can cut both ways.

Ways C&P Exams Can Help Your Claim

• Objective confirmation: They can validate your diagnosis and connect it to your service record, solidifying your claim.

• Updated documentation: For chronic or worsening conditions, an exam provides up-to-date evidence that supports an increased rating.

• Clarification of secondary conditions: Examiners can help identify how one condition may have caused or aggravated another, opening the door for additional service connections.

Ways C&P Exams Can Hurt Your Claim

• Inaccurate or incomplete exams: Some examiners rush through evaluations or miss key details. If the report downplays your symptoms, it can lead to a low rating or outright denial.

• Overreliance by the VA: Even if you have strong private medical evidence, the VA may lean heavily on a single C&P report that contradicts your file.

• Miscommunication or understatement: If you minimize your symptoms or fail to explain how they affect your daily life, the examiner may record “mild” impairment, reducing your rating.

If you believe your C&P exam was unfair or inaccurate, don’t panic. You can challenge it. Options for challenging a C&P exam report include:

• Submit a personal statement or “buddy letter” clarifying discrepancies.
• Get an independent medical opinion from a private provider.
• File an appeal disputing the exam and/or submit new supporting evidence

A skilled VA disability attorney can help evaluate your C&P report and identify weaknesses or errors in the VA’s reasoning.

While C&P exams are simply part of the process, how you approach them matters. Understanding their purpose, being familiar with your claim, and communicating clearly can significantly enhance your chances of receiving the rating you deserve.

For help reviewing your C&P exam results, gathering the right medical evidence, and presenting the strongest possible claim for benefits, contact an experienced VA disability lawyer with Gang & Associates. Call 888.878.9350 or Connect Online.